固体器官移植后的第一年内细菌病:流行病学更新
Dionysios Neofytos1, Susanne Stampf2, Linard D Hoessly2
1Transplant Infectious Diseases Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
Open forum infectious diseases
|June 16, 2023
概括
几乎十分之一的实体器官移植受体 (SOTr) 在第一年内患有细菌病,自2014年以来,这一比例一直在下降. 科特里莫克萨预防与较低的细菌病发病率有关,指导量身定制的预防策略.
科学领域:
- 移植 传染病 移植 传染病
- 细菌病流行病学学
- 固体器官移植 实体器官移植
背景情况:
- 关于细菌病流行病学和固体器官移植接受者 (SOTr) 的结果的当代数据有限.
- 了解细菌血症对于改善移植后护理和患者存活率至关重要.
研究的目的:
- 描述移植后第一年SOTr中细菌病的流行病学.
- 确定SOTr中细菌病的危险因素和保护因素.
- 分析不同固体器官移植 (SOT) 类型的细菌病的趋势和变化.
主要方法:
- 使用瑞士移植队列研究注册表 (2008-2019) 进行的回顾性嵌套多中心队列研究.
- 分析了4383个SOTr,确定了415名患者和557例细菌病例.
- 统计分析以确定发病率,风险因素和保护因素.
主要成果:
- 总体而言,一年内细菌病发病率为9.5%,SOT类型各有差异 (例如,心脏12.8%,脏8.3%).
- 随着时间的推移,发病率下降了 (HR 0.66),其中最常见的病原体是グラム阴性细菌.
- 风险因素包括年龄,糖尿病,移植后并发症和排斥;科特里莫克萨预防有保护作用.
结论:
- 大约10%的SOTr在第一年内发展为细菌病,与30天死亡率低相关.
- 自2014年以来,细菌病率有所下降,并且科特里莫克萨预防显示有保护作用.
- 在SOT类型中细菌病发率,时间和病原体的变化需要量身定制的预防和临床策略.
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