肝移植中的万科米辛耐药性肠球菌的殖民:风险因素和生存影响
Nathalia Neves Nunes1,2, Lohayne Alves Ferreira1, Fernanda Spadão3
1Department of Infectious Diseases, Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil.
概括
在肝移植受体中,抗万科素的肠球菌 (VRE) 定居并没有显著影响180天的存活率. 在肝移植之前和之后确定了VRE殖民的危险因素,但生存结果没有受到影响.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 移植手术 移植手术
背景情况:
- 抗胺素的肠球菌 (VRE) 是多药耐药的微生物 (MDRO) 经常在肝移植 (LT) 接受者中发现.
- VRE殖民可能与LT患者的较差结果有关.
研究的目的:
- 确定肝移植受体中VRE殖民化的风险因素.
- 确定VRE殖民对移植后生存的影响.
主要方法:
- 成年LT接受者的回顾性队列研究 (2010-2022年).
- 对于VRE殖民风险的多变量后勤回归.
- 180天生存分析的多变量考克斯回归.
主要成果:
- 在LT之前的9.8%,在LT后的14.5%发生了VRE殖民;6.4%的人患有VRE感染.
- 在LT前的VRE殖民预测因素包括SBP预防,急性至慢性肝衰竭,HBV感染,ASA得分,住院和MELD得分.
- 后LT VRE殖民预测因素包括前LT住院,MELD得分,耐卡巴胺的格拉姆阴性殖民,手术内出血和再移植.
- 180天死亡率为VRE殖民的33.6%,VRE感染的50.6%,而非殖民患者的17.8%;在调整后,这种差异在统计学上没有显著意义.
结论:
- 在肝移植接受者中,VRE殖民或感染并没有显著影响生存率.
- 在这个人群中确定了VRE殖民化的风险因素.
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