从受感染的骨移植中传播的mycobacterium结核病来源:阳性感染的案例研究和我们的方法
Thomas Herb1, Jeffrey Jentzen, Carl Schmidt
1From the Department of Pathology, University of Michigan, Ann Arbor, MI.
The American journal of forensic medicine and pathology
|February 18, 2025
概括
在2023年美国爆发的疫情中,死尸骨移植的菌结核菌 (Mtb) 感染导致死亡. 这一案例突显了免疫受损患者传播的Mtb感染,强调了受污染的骨移植的风险.
科学领域:
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
- 公共卫生 公共卫生
背景情况:
- 来自尸体骨移植的阳性感染带来了重大风险,美国有两次结核菌 (Mtb) 爆发导致死亡.
- 免疫功能低下的个体,特别是有过器官移植史的人,非常容易受到这种感染的严重后果.
研究的目的:
- 报告2023年爆发的尸体骨移植接收者传播的Mycobacterium结核病 (Mtb) 感染病例.
- 为了调查与特定的尸体骨移植相关的Mtb感染的来源和传播.
- 将这次Mtb疫情与其他阳性感染疫情进行比较,并讨论管理策略.
主要方法:
- 一个57岁的免疫功能受损的女性患者的病例报告,她接受了尸体骨移植.
- 临床表现分析包括淋巴腺病变和手术部位.
- 微生物学工作与积极的Mtb培养物,尸检和受影响器官的组织学检查.
- 对骨移植来源的调查和在其他接受者中识别类似感染.
主要成果:
- 患者患有传播的Mtb感染,由尸检结果证实,包括肝脏和肺部颗粒瘤与酸性快速生物体.
- 脏脏被归因于Candida物种,表明了多微生物感染.
- 进一步的调查显示,同一骨移植来源的其他接受者身上也有类似的Mtb感染,证实了疫情的起源.
结论:
- 尸体骨头移植可以传播Mycobacterium结核病 (Mtb),导致严重的传播感染和死亡,特别是在免疫受损的宿主中.
- 这一案例强调了严格的查和灭菌协议对allograft材料的必要性.
- 有效的管理策略对于应对源自受污染的生物材料的有毒感染爆发至关重要.
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