关键词: 肾移植受者, 感染, 病原体, 危险因素, 预后

Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the epidemiology and risk factors of infections in kidney transplant recipients.
Ｍｅｔｈｏｄｏｌｏｇｙ：The patients with infection after renal transplantation were enrolled in the intensive care unit (ICU) from January 2013 to July 2019.Clinical data such as time between infection and transplantation,infection site,pathogen,use of immunosuppressive agents and prognosis were retrospectively analyzed to explore  characteristics of infection and  risk factors affecting prognosis in renal transplant recipients.
Ｒｅｓｕｌｔｓ：A total of 209 patients were enrolled.72 patients (344%) were infected in the first year after kidney transplantation and 98 patients (469%) over 5 years.The most common site of infection was pulmonary infection in 165(789%),followed by bloodstream infection in 19(91%).The main pathogens were P. jirovecii in 54(258%),Klebsiella pneumoniae in 13(62%),Escherichia coli in 9(43%),Pseudomonas aeruginosa in 7 (33%),Aspergillus in 6 (29%) and Cytomegalovirus in 5 (24%). There were 101 cases of severe infection (483%) and 108 cases of nonsevere infection (517%).After treatment,177(847%) patients improved,32(153%) patients  died,12 of them with P. jirovecii infection,and 11 with bacterial infection. Hypoalbuminemia,CD4+T cell count ≤100/ul and hypotension were independent risk factors for death in renal transplant recipients after severe infection.
Ｃｏｎｃｌｕｓｉｏｎ：Infection was most common within one year after kidney transplantation,and pulmonary infection was the main site of infection. P. jirovecii was the main pathogen among known pathogens,and patients with multiple infections had a higher risk of death.The overall net state of immunosuppression,increased opportunistic infection and worse nutritional status were main factors affecting the prognosis of infected renal transplantation patients.

Key words: renal transplant recipients, infection, pathogen, risk factors, prognosis