在移植受体中进行非典型肺炎测试
Fionna Feller1,2, Paul Trubin3, Maricar Malinis3
1Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
概括
对移植受体进行的非典型肺炎测试显示,阳性率非常低. 有针对性的诊断策略可以提高产量,并降低免疫功能受损患者的成本.
科学领域:
- 传染性疾病 传染性疾病
- 移植医学 移植医学 移植医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 在免疫功能低下的患者中,非典型肺炎的诊断具有挑战性.
- 移植受体中非典型肺炎的发病率和诊断收益率尚不清楚.
- 这项研究调查了固体器官,造血干细胞移植 (HSCT) 和CAR T细胞接受者的非典型肺炎.
研究的目的:
- 评估移植受体中非典型肺炎的测试阳性率.
- 在这个人群中评估特定的非典型病原体 (Legionella,Mycoplasma,Chlamydia,Bordetella) 的发生率.
- 分析非典型肺炎诊断测试的成本效益.
主要方法:
- 耶鲁纽黑文卫生系统的回顾性队列研究 (2016年1月 - 2022年8月).
- 包括成年人进行固体器官移植,HSCT或CAR T细胞疗法,接受了非典型肺炎病原体检测.
- 在临床上判断了积极的结果;进行了成本分析.
主要成果:
- 在481名移植接受者身上进行了1021项测试,阳性率为0.7%, (7项阳性测试).
- 在裁决后,确定了三例已被证明的军团菌病例和一个可能的Mycoplasma感染.
- 传染病病例发生在移植后1年内,增强免疫抑制和淋巴缺血.
结论:
- 移植受体中非典型肺炎检测的阳性率非常低.
- 测试的算法方法,考虑到临床因素,可以提高诊断产量.
- 针对性测试策略可以在这个患者群体中节省大量的成本.
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