在当前的时代,肝移植接受者的侵入性阿斯伯吉洛症
Muneyoshi Kimura1, Matteo Rinaldi2, Sagar Kothari1
1Transplant Infectious Diseases, Ajmera Transplant Program, University Health Network, Toronto, Ontario, Canada.
概括
侵入性阿斯伯吉洛症 (IA) 是肝移植接受者 (LiTRs) 的严重风险,死亡率高. 识别抗生素使用和肺炎等危险因素可以指导有针对性的预防和治疗策略.
科学领域:
- 医学 医学 医学 医学 医学
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 侵入性阿斯伯吉洛症 (IA) 对肝移植接受者 (LiTRs) 构成一种罕见但重大威胁.
- 与IA相关的高死亡率强调需要更好地了解风险因素.
研究的目的:
- 确定LiTRs中IA发生的独立风险因素.
- 确定与LiTRs早期IA和12周全因死亡率相关的因素.
- 探索在LiTRs中针对IA死亡率的保护因素.
主要方法:
- 一个多中心的1:2病例对照研究,将62个具有IA的LiTR与124个没有侵入性真菌感染的匹配对照进行比较.
- 使用多变量物流和Cox比例危险回归分析来确定风险和保护因素.
主要成果:
- 系统性抗生素使用和肺炎史是IA的独立风险因素.
- 重复手术,全身抗生素使用和缺乏抗菌预防是早期IA的危险因素.
- 阿斯伯吉勒菌殖民,ICU住院,传播IA和透析增加了死亡风险,而塔克罗利莫斯接收是保护性的.
结论:
- 在LiTRs中IA的死亡率仍然很高,强调需要改进管理策略.
- 鉴定的风险和保护因素可以为LiTRs中IA的向预防和治疗方法提供信息.
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