固体器官和血液细胞移植接受者的胚芽球菌病相关的结果
Vaisak O Nair1, Bradley Johnson2, Paschalis Vergidis1
1Department of Medicine, Section of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
概括
固体器官移植 (SOT) 和血液细胞移植 (HCT) 接受者的胚芽球菌菌感染很少见,但与高死亡率有关. 尿抗原测试是敏感的,早期治疗对于更好的结果至关重要.
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
- 菌类学 菌类学是指菌类学.
背景情况:
- 在美国扩大胚芽球菌的流行病学.
- 需要评估移植受体中的胚芽球菌病发病率和结果.
- 专注于固体器官移植 (SOT) 和造血细胞移植 (HCT) 种群.
研究的目的:
- 评估SOT和HCT接受者中的芽细胞菌的发病率.
- 评估与这些患者的骨髓菌根症相关的临床结果,包括死亡率.
- 分析移植受体中的胚芽球菌病的诊断和管理策略.
主要方法:
- 在第三级护理医疗中心进行的回顾性案例系列.
- 在2005年1月1日至2023年9月30日期间包括成年SOT和HCT接受者.
- 将病例定义为培养证明的芽细胞菌;对诊断,管理和结果进行描述性统计分析.
主要成果:
- 胚芽细胞菌的累积发病率为0.11%,移植后感染的中位时间为743天.
- 尿抗原检测显示出高灵敏度 (100%);42%的病例具有超治疗性免疫抑制.
- 高1年死亡率 (26.3%) 尽管适当的治疗包括脂肪体安福特 B和醇治疗.
结论:
- 在SOT和HCT接受者中,虽然很少见,但胚芽球菌病与移植后的不良结果有关.
- 尿抗原检测有助于及时诊断和治疗.
- 终身二次抑制可以防止复发;需要进一步研究风险因素和预防.
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