移植患者感染性腹
Yassin Loucif1, Collin Mackenzie2, Olga Tselikmann1
1Nephrology, Universitätsklinikum Düsseldorf, Düsseldorf, DEU.
Cureus
|May 15, 2025
概括
接受脏移植的人经常患有传染性腹,其中Clostridioides difficile和cytomegalovirus很常见. 免疫抑制增加了易感性,突出了针对性诊断和预防策略的需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 传染性腹是由于免疫抑制疗法导致的移植接受者的常见并发症.
- 它通过使机会性病原体和药物效应,增加了对移植功能和患者存活的风险.
研究的目的:
- 描述德国移植患者感染性腹的病原体谱.
- 识别相关的风险因素,了解区域模式和临床影响.
主要方法:
- 一项回顾性队列研究分析了604名患者 (436名移植接受者) 在2019-2023年期间因感染性腹住院治疗.
- 非移植患者作为对照组.
- 病原体鉴定主要集中在便样本上,收集了移植状态,免疫抑制和复发率的数据.
主要成果:
- 接受脏移植的人中最常见的病原体是Clostridioides difficile (26.3%),细胞巨型病毒 (CMV,12.3%),肠病原体大肠杆菌 (EPEC,8.6%) 和诺病毒 (4.8%).
- 免疫抑制显著增加了感染易感性;CMV相关的腹仅发生在移植接受者中.
- 观察到CMV和Clostridioides difficile的复发率较高,CMV感染在移植后大约13个月出现.
结论:
- 机会性病原体,如Clostridioides difficile和CMV在移植接受者中占主导地位,由免疫抑制驱动.
- 改进的诊断,早期的病原体查和有针对性的预防 (例如,CMV预防,卫生协议) 是至关重要的.
- 密切监测病毒载量和改善临床管理对于这个脆弱人群是必要的.
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