非结核菌在患有囊性纤维化或晚期肺部疾病的患者中的作用
Shirin Barcikowski1, Ribal Bou Mjahed2, Oriol Manuel2
1Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
概括
在囊性纤维化 (CF) 患者中,非结核菌 (NTM) 感染与更低的移植前死亡风险,但更高的移植后死亡率有关. NTM感染不是肺移植的绝对禁忌,需要对患者进行仔细评估.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 移植医学 移植医学
背景情况:
- 接受CFTR调节器的囊性纤维化 (CF) 患者仍然面临晚期肺部疾病.
- 非结核菌 (NTM) 是CF中具有挑战性的病原体,对疾病进展和移植结果产生不确定的影响.
研究的目的:
- 调查NTM感染对CF患者疾病进展和肺移植结果的影响.
- 为了比较接受肺移植的NTM阳性和NTM阴性CF患者之间的结果.
主要方法:
- 对1998-2020年间在苏黎世和洛桑大学医院接受治疗的CF患者的回顾性分析.
- 移植前后结果的比较,包括死亡,肺移植,生存和慢性肺异位移植功能障碍 (CLAD),在NTM阳性和NTM阴性队列之间.
主要成果:
- 在20.7%的CF患者中发现了NTM阳性,其中Mycobacterium abscessus complex (MABSC) 是最常见的.
- 阳性NTM患者在移植前死亡或移植的风险较低 (21.4%与46.5%相比).
- 移植后的死亡率在NTM阳性患者中较高 (27.3%对13.0%),但CLAD发病率没有显著差异.
结论:
- 在CF患者中,NTM感染与移植前死亡风险降低,但移植后死亡率增加有关.
- 似乎NTM感染并不是肺移植的绝对禁忌.
- 对于NTM阳性CF患者来说,仔细的个人评估至关重要,因为移植后可能出现严重并发症.
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