Monitoring and control of infection in patients after renal transplantation.

ABSTRACT

Infection is a leading cause of death of renal transplantation and how to control it is still an urgent problem to be solved. Bacteria culture, computerized modified McGuckin's monitoring methods, OKT monoclonal antibody technique and radioimmunoassay (RIA) were used on studying the cause, monitoring and prevention of the infection. Results showed that 22 out of 24 cases (91.7%) were colonized by Gram-negative bacilli in pharynx and groin region. Of them, 15 were infected with the same bacteria in wound, urine, blood and lung. Six out of 7 cases with serious infection were colonized by Gram-negative bacilli on the surface of the whole body. The computerized modified McGuckin's method predicted and analyzed the infection outbreak much more fast and accurate, with a rate of over 80%. Helper/suppressor lymphocyte ratio of 1.08 was taken as a threshold value for the diagnosis of infection. The results suggested that the change of skin flora is closely related with the infection. Monitoring the alteration of skin flora is an effective method for the prevention and control of severe infection. The pharynx and groin regions of the patients are stable reservoirs of Gram-negative bacilli which may cause infection easily. Computerized quantitative analysis may increase the efficiency and accuracy of infection surveillance. In order to preserve the immune system as much as possible and prevent rejection of transplant graft, proper use of immunosuppressive drugs and regulation of the immune system of the patients are the key for preventing infection.