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目的:评价直肠拭子培养主动筛查耐碳青霉烯肠杆菌定植对成人肝移植的意义。方法:本研究选取了天津市第一中心医院器官移植中心2017年9月至2018年3月完成肝移植术的172例成人受者，在术后立即留取直肠拭子。统计随访术后90 d内发生耐碳青霉烯肠杆菌(CRE)感染或死亡事件。采用Logistic回归分析直肠拭子阳性、CRE感染的危险因素以及拭子阳性与不良事件之间的关系。结果:172例受者通过直肠拭子培养的主动筛查显示15.7%出现CRE定植，出现定植的受者中CRE感染发生率为18.5%。多因素分析显示头孢菌素的使用及血液净化治疗是出现CRE定植的独立危险因素。通过Logistics回归分析发现，定植受者的CRE感染风险(OR 4.12，95% CI 1.15～14.70；n P＝0.029)明显增加。而CRE感染则是术后90 d内死亡的独立危险因素(HR 15.17，95% CI 3.45～66.71；n P<0.001)。n 结论:对肝移植受者进行CRE筛查具有重要意义，可以识别发生CRE感染的高危受者。“,”Objective:To explore the role of active surveillance culture for carbapenem resistant Enterobacteriaceae(CRE)colonization in adult transplant recipients.Methods:This prospective cohort study involved 172 adult liver transplant recipients from September 2017 to March 2018. Surveillance culture for CRE was collected immediately after transplantation by rectal swab. During a follow-up period of 90 days, the postoperative incidence of CRE infection or death was recorded.Results:Rectal CRE colonization was positive in 15.7% of them and 18.5% of whom developed subsequent CRE infection. Cephalosporin usage and hemopurification were independent risk factors for CRE colonization by multivariate analysis. By Logistic regression analysis, CRE colonization increased the risk of CRE infection(OR 4.12, 95%CI 1.15~14.70; n P=0.029)among recipients. And CRE infection was an independent risk factor for 90-day mortality of post-transplant recipients(HR 15.17, 95%CI 3.453~66.71; n P<0.001).n Conclusions:Surveillance culture for CRE colonization plays an important role in identifying high-risk patients of CRE infection in liver transplant recipients.