器官移植接受者的抗菌耐药性
Maddalena Giannella1, Matteo Rinaldi1, Pierluigi Viale1
1Infectious Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 11, Bologna 40137, Italy.
Infectious disease clinics of North America
|May 27, 2023
概括
多药耐药生物 (MDROs) 对实体器官移植 (SOT) 接受者构成重大威胁,影响了移植和患者的结果. 管理策略,包括预防和新的非抗生素方法,对于这个脆弱的人群至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 移植医学 移植医学
- 微生物学 微生物学
背景情况:
- 固体器官移植 (SOT) 接受者对感染非常敏感.
- 细菌多耐药生物体 (MDROs) 在SOT种群中代表着日益增长的临床挑战.
- 关键的MDRO包括MRSA,VRE,ESBL产生的肠杆菌,CRE,MDR P. aeruginosa,以及CR A. baumannii.
研究的目的:
- 总结MDROs在SOT接受者的负担,包括患病率,发病率和风险因素.
- 审查MDROs对不同SOT类型的移植和患者结局的影响.
- 探索MDROs在捐赠源感染中的作用,并讨论管理策略.
主要方法:
- 综合文献审查和数据综合.
- 在SOT.中分析与MDROs相关的流行,发病率,风险因素和结果.
- 审查来自供体的感染和当前/新兴的管理策略.
主要成果:
- MDROs显著增加SOT接受者的发病率和死亡率.
- 具体的MDRO有不同的影响,取决于SOT的类型.
- 源于捐赠者的感染是MDROs的关键传播途径.
结论:
- 有效预防和治疗MDRO对于改善SOT结果至关重要.
- 目前的管理涉及抗生素策略,但仍然存在挑战.
- 基于非抗生素的策略为SOT的MDRO控制提供了有希望的未来方向.
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