肺移植患者中的mycobacterium复杂感染:加拿大的多中心回顾性队列研究
Roni Bitterman1, Hafid Soualhine2,3, Pierre-Marie Akochy4
1Division of Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.
概括
在肺移植接受者中,mycobacterium疹感染并不常见. 移植前对M. abscessus的根除至关重要,因为它的缺失会增加移植后的疾病和死亡率,尽管整体存活率相似.
科学领域:
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
- 肺部医学 肺部医学
背景情况:
- 菌根杆菌综合体对肺移植接受者 (LTR) 构成重大威胁,往往导致危及生命的情况.
- 的存在经常被认为是肺移植 (LT) 的禁忌.
研究的目的:
- 调查加拿大的肺移植接受者中Mycobacterium疹感染的发生率和结果.
- 确定移植前M. abscessus殖民或感染对移植后结果的影响.
主要方法:
- 在加拿大4个LT中心进行了一项多中心回顾性队列研究.
- 包括在2006年至2016年间移植的LTR,在移植前或移植后为M. abscessus阳性呼吸道样本.
- 肺部疾病是根据美国胸腔协会的标准定义的,随访时间至少为5年.
主要成果:
- 在LT后的M.病发病率为1.1/1000移植年,殖民率为0.5/1000移植年.
- 在15名患有移植前M.的患者中,53%患有移植后感染.
- 移植前的根除与移植后的疾病显著降低 (0%vs85.7%,p=0.001).
- 移植前M.的和没有M.的LTR之间,整体存活率是可比的 (p=0.37).
- 然而,移植前感染的患者中死亡率较高,这些患者没有达到根除 (57.1%) 或发生移植后疾病 (66.7%).
结论:
- 菌根杆菌是肺移植接受者感染的不常见原因.
- 虽然整体存活率与移植前M.的LTRs相似,但移植前的根除是至关重要的.
- 不能在移植前根除M. abscessus与移植后疾病和死亡率的增加有关.
相关概念视频
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