超越第一年:移植后晚期机会性感染的流行病学和管理
V Esnault1, L Hoisnard2,3,4, B Peiffer5
1Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d'Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France.
概括
移植 (KT) 后的晚期机会性感染 (OI) 是常见的,主要是病毒性感染,如疹. 虽然这些感染不会增加死亡率,但预防策略可以帮助预防它们.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 移植后的晚期机会性感染 (OI) 尚未得到充分研究,缺乏有针对性的预防措施.
- 了解晚期OI的流行病学和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 描述KT后一年以上发生的晚期OI的流行病学,风险因素和影响.
- 将晚期OI与早期OI和没有OI的KT接受者进行比较.
主要方法:
- 在10年内对1066名KT接受者的回顾性单心队列研究.
- 纳入标准:需要治疗的临床症状性OI (不包括BK病毒病).
- 控制组:早期的OI (在KT后1年内) 和KT接受者没有OI和1年后的功能性全移植.
主要成果:
- 19.4%的接受者经历了第一次OI发作,其中120人是晚期OI (64.9%) 和65人是早期OI (35.1%).
- 晚期OI主要是病毒性 (69.2%),主要是疹 (43.4%),与早期OI相比,有更多的肺囊和更少的侵入性阿斯伯吉洛症.
- 晚期OI患者在KT时更年轻 (54.0 ± 13.3年 vs 60.2 ± 14.3年);患者和异种移植的生存率在各组之间相似.
结论:
- 晚期OI,主要是病毒性,在KT后的第一年后经常发生,但与增加的死亡率或移植损失无关.
- 移植时的年龄较小是晚期OI的风险因素.
- 实施预防策略可能有助于预防移植患者晚期机会性感染.
相关概念视频
01:29Pulmonary Tuberculosis I
242
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
242
01:28Pulmonary Tuberculosis V
179
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
179
01:30Pneumonia I: Introduction
236
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
236
01:30Pneumonia V: Nursing management and Prevention
2.0K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.0K
01:24Tissue Transplantation
366
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
366
01:28Pneumonia IV: Management
324
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
324