在阿尔伯塔省,来自无家可归的捐赠者的固体器官移植接受者的捐赠者衍生的巴顿氏菌病
Dima Kabbani1, Efrat Orenbuch-Harroch1, Carl Boodman2
1Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
概括
巴托内拉昆塔纳感染可以通过从血清阳性捐赠者的器官移植传播,接受者的攻击率为12.5%. 这凸显了死去的捐赠者的意外感染风险,特别是那些没有住所的人.
科学领域:
- 传染性疾病 传染性疾病
- 移植手术 移植手术
- 公共卫生 公共卫生
背景情况:
- 巴托内拉昆塔纳感染是固体器官移植 (SOT) 传染病的不常见原因.
- 不住的已故捐赠者 (UDDs) 可能携带通过标准查无法立即识别的感染.
- 了解传播动态对于预防移植后感染至关重要.
研究的目的:
- 调查SOT接受者中巴托内拉昆塔纳感染的集群,与血清阳性已故捐赠者相关联.
- 为了确定从阳性UDDs移植后巴托内拉昆塔纳感染的攻击率.
- 在受影响的SOT接受者中描述临床表现和诊断结果.
主要方法:
- 在阿尔伯塔省 (2022-2023) 的UDD接收器官的SOT接收者的回顾性研究.
- 在UDDs和接受者中进行巴托内拉IgG的血清学测试 (间接免疫光检测);标位≥1:64被认为是阳性.
- 对受影响的接受者进行临床数据审查和巴托内拉PCR测试.
主要成果:
- 在32个UDD中,有11个检测结果为巴顿氏菌 (B. quintana和/或B. henselae) 呈阳性.
- 六名SOT接收者在接受来自血清阳性捐赠者的器官后发生了巴托内拉昆塔纳感染.
- 阳性捐赠者的临床疾病发作率为12.5% (4/32),皮肤结和细菌性血管病变是常见的表现.
结论:
- 来自巴托内拉病毒阳性UDD的固体器官移植可以导致巴托内拉昆塔纳病毒的显著传播.
- 临床医生必须考虑来自供体的感染,特别是从有毒物质使用史的UDD.
- 加强警和潜在的捐赠者查巴顿氏菌可能是有必要的,以减轻移植相关的感染.
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