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肝移植患者血流感染的临床结果:一个十年的单中心回顾性分析,来自土耳其
Selda Aydin1, Meyha Sahin1, Bahadir Ceylan1
1Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Istanbul Medipol University, Istanbul 34080, Turkey.
Antibiotics (Basel, Switzerland)
|January 28, 2026
概括
血流感染 (BSI) 是肝移植后的一个主要并发症. 高的皮特细菌血症评分和耐卡巴胺肠道细菌 (CRE) 感染显著预测这些患者的死亡率.
科学领域:
- 移植医学 移植医学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 感染,特别是血液感染 (BSI),是肝移植后的关键并发症,对发病率和死亡率有重大影响.
- 鉴定肝移植接受者患有BSI的死亡率相关的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 在10年的时间里,确定肝移植接受者在患有血流感染后的死亡率的独立预测因子.
主要方法:
- 在2014年4月至2024年12月期间,对467名成年肝移植接受者的回顾性研究.
- 分析了136名患者的210例血流感染病例,重点关注病原体识别和临床结果.
- 多变量分析以确定与死亡率相关的因素,包括皮特细菌血症评分和特定耐药病原体.
主要成果:
- 血流感染发生在29.1%的患者中,大多数 (61.2%) 在移植后三个月内发生.
- 观察到抗菌素耐药性的高率,ESBL产生的肠杆菌 (72.6%) 和CRE (30.1%) 是普遍存在的.
- 总体死亡率为14.28%;高皮特细菌病评分 (HR 1.502) 和CRE感染 (HR 3.644) 是死亡率的独立预测因素.
结论:
- 血流感染构成了肝移植后的重大威胁,其特点是抗菌素耐药性的高率.
- 皮特细菌病评分作为死亡率的强有力的预测指标,使早期风险分层成为可能.
- 根据皮特细菌病评分和病原体耐药性概况,有针对性的管理策略对于改善肝移植接受者患有BSI的存活率至关重要.
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