供体呼吸系统的多药耐药细菌和肺移植结果
Rayid Abdulqawi1, Rana Ahmed Saleh2, Reem Mahmoud Alameer3
1Lung Health Centre Department, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia.
The Journal of infection
|January 18, 2024
概括
呼吸道培养中的多耐药 (MDR) 细菌在肺移植捐赠者中很常见. 虽然MDR Klebsiella pneumoniae通常是安全的,但需要谨慎使用,因为它可能会影响移植结果.
科学领域:
- 移植免疫学 移植免疫学
- 传染病 传染病 传染病
- 微生物学 微生物学
背景情况:
- 肺移植捐赠者必须进行呼吸道培养查.
- 关于多耐药 (MDR) 细菌对肺移植结果的影响的数据有限.
- 解决这个问题可以帮助扩大捐赠者池.
研究的目的:
- 为了确定呼吸道MDR细菌在肺部捐赠者的流行率.
- 调查捐助者MDR细菌与肺移植后结果之间的关联.
主要方法:
- 对成年肺移植接受者的回顾性观察性研究.
- 从2015年1月到2022年5月收集的数据.
- 评估的供体支气管支气管支气管洗和支气管擦拭物培养.
主要成果:
- 37%的捐赠者 (67/181) 有呼吸道MDR细菌,最常见的是MDR Acinetobacter baumannii.
- 捐赠者MDR细菌与异体移植存活率或慢性肺异体移植功能障碍 (CLAD) 没有显著联系.
- MDR Klebsiella肺炎与90天死亡率和CLAD风险的增加有关.
结论:
- 与MDR细菌结合的肺异位移植可能在适当预防的情况下是安全的.
- 建议对MDR Klebsiella pneumoniae进行谨慎治疗,因为死亡率增加和CLAD风险增加.
- 需要进一步的研究来优化捐赠者选择和管理策略.
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