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肠移植后手术部位感染:风险因素和结果
Mayyadah H Alabdely1, Jessica Lum1, Blanca E Gonzalez2
1Department of Infectious Disease, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
概括
手术部位感染 (SSIs) 在肠道移植后很常见,通常是由多药耐药生物体引起的. 这些感染显著增加了死亡或全移植失败的风险,特别是在移植后的第一年.
科学领域:
- 移植手术 移植手术
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 感染对肠道移植接受者构成重大威胁.
- 手术部位感染 (SSIs) 是这种患者群体中常见但不太了解的并发症.
研究的目的:
- 研究肠道移植受体中SSI的发病率,风险因素和结果.
- 定义SSI在这个脆弱人群中的流行病学和影响.
主要方法:
- 一项追溯的队列研究,对152名从2008年到2022年接受肠子移植的接受者进行了追溯研究.
- 使用CDC/NHSN标准对移植后30天内SSI进行分析.
- 多变量考克斯回归以确定风险因素和SSI与死亡率或全移植失败的关联.
主要成果:
- 超过三分之一 (36.2%) 的接受者发展了30天的SSI,主要是器官/空间感染 (90.9%).
- 常见的病原体包括Enterococcus faecium和Candida物种;多种耐药生物普遍存在 (68.6%).
- 包括肝脏在内的移植,高并发症指数和胃肠道泄漏是SSI的危险因素. SSI与死亡或异位移植失败的风险增加有关 (HR 1.71),特别是在第一年 (HR 3.30).
结论:
- 肠道感染是肠道移植中常见的严重并发症,通常涉及多药耐药生物.
- 肝肠和多体移植的接受者面临的风险最高.
- SSI与长期结果不佳有关,强调需要风险缓解策略.
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