预防性抗生素策略用于保存液中的グラム阳性细菌:一个单中心的经验
Jianming Li1, Jianyi Li2, Jun Li1
1Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Frontiers in medicine
|September 26, 2025
概括
脏保存液 (PF) 中的高毒性グラム阳性细菌增加了移植后的感染风险. 预防性抗生素治疗显著减少了高风险接受者的可能的捐赠源感染 (P-DDIs).
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 传染性疾病 传染性疾病
背景情况:
- 脏保存液 (PF) 中的阳性细菌构成移植后感染的风险.
- 在PF中,高毒性病原体如Enterococcus faecium,Enterococcus faecalis和Staphylococcus aureus在PF中定义了移植接受者的高风险组.
研究的目的:
- 为了分层与PF中阳性细菌相关的风险.
- 研究抗生素耐药性模式及其对移植后早期感染的影响.
- 评估预防性抗葛阳性抗生素 (P-antiGP) 治疗的有效性.
主要方法:
- 从144名脏捐赠者和218名接受者 (2015年4月 - 2020年10月) 的临床数据的回顾性分析.
- 接收者的分类为高风险 (PF中存在高毒性グラム阳性细菌) 和低风险组.
- 在PF中分析感染事件,可能的供体衍生的感染 (P-DDI) 和多药耐药生物体 (MDROs/XDROs).
主要成果:
- 高风险组的感染事件发生率明显高 (42.6%与26.2%相比).
- 在高风险组中观察到,早期移植后感染增加的趋势 (调整后OR=1.855).
- 仅在高风险组中发现P-DDI,在广泛耐药 (XDR) 病例中更高的发病率 (11.1%对2.1%).
- 预防性抗葛阳性抗生素 (P-antiGP) 治疗显著降低了P-DDI (4.3%与23.8%相比).
结论:
- 在PF中存在的Enterococcus faecium,Enterococcus faecalis和Staphylococcus aureus代表了移植接受者的高风险.
- 在PF病原体中存在高患病率的抗生素耐药性,包括MDROs和XDROs.
- 在高风险的移植接受者中,P-antiGP疗法有效降低P-DDI.
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