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肺移植患者的抗生素预防:单中心队列研究

Renato Pascale^1,2, Beatrice Tazza², Armando Amicucci¹

¹Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Transplant international : official journal of the European Society for Organ Transplantation

|September 2, 2024

概括

肺移植接受者 (LuTRs) 的外科手术期间抗生素预防 (PAP) 策略在预防早期手术后感染 (EPOI) 之间没有显著差异. 在这项20年后期研究中,PAP持续时间也没有影响EPOI率.

科学领域:

医学研究医学研究
传染病传染病传染病传染病
移植手术移植手术移植手术

背景情况:

术后抗生素预防 (PAP) 实践在肺移植中心之间有很大差异.
优化PAP对于预防肺移植接受者 (LuTRs) 早期术后感染 (EPOI) 至关重要.

研究的目的:

追溯分析20年来 (2002-2023) 在单一中心对PAP的方法.
评估PAP疗法 (组合与单一疗法) 和持续时间对LuTRs中的EPOI的影响.

主要方法:

对111名接受肺移植的LuTR进行了回顾性分析.
暴露变量包括PAP类型 (单剂与组合) 和持续时间.
主要终点:在移植后30天内诊断出细菌感染.

主要成果:

在74.8%的患者中使用PAP组合,piperacillin/tazobactam是最常见的药物.
早期手术后感染 (EPOI) 在27%的LuTR患者中发生.
多变量分析显示,组合PAP与单剂PAP在预防EPOI方面没有显著的优势 (OR:1.57,p=0.448).
PAP持续时间≤6天没有显著影响EPOI发展 (OR:2.165,p=0.240).

结论:

目前的外科手术期间的抗生素预防策略,包括组合疗法,在预防肺移植接受者的早期术后感染方面没有明显的优势.
可能需要进一步的研究来为这种脆弱的患者群体建立最佳的PAP协议.

关键词:

抗生素预防抗生素预防细菌感染细菌感染捐赠者衍生感染供体衍生感染异形性肺纤维化症肺部移植是一项肺移植.

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