Panackal Anil A, Dahlman Andrea, Keil Katharina T, Peterson Carol L, Mascola Laurene, Mirza Sara, Phelan Maureen, Lasker Brent A, Brandt Mary E, Carpenter Joseph, Bell Michael, Warnock David W, Hajjeh Rana A, Morgan Juliette
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
Transplantation. 2003 Apr 15;75(7):1050-3. doi: 10.1097/01.TP.0000055983.69730.ED.
Invasive aspergillosis (IA) is rare among renal transplant recipients (RTRs). We investigated a cluster of IA among RTRs at a California hospital from January to February 2001, when construction was ongoing. We conducted a cohort study among RTRs who were hospitalized between January 1 and February 5, 2001, to determine risk factors for IA. IA was defined using established guidelines. Four IA cases occurred among 40 RTRs hospitalized during the study period. Factors associated with an increased risk of IA included prolonged hemodialysis, lengthy corticosteroid treatment posttransplant, and use of sirolimus alone or with mycophenolate (P<0.05). After the study period, three additional RTRs developed IA; two Aspergillus isolates recovered from these patients had indistinguishable profiles by DNA fingerprinting, suggesting common-source exposure. This study suggests that immunosuppressed RTRs can be at an increased risk for IA. Measures to prevent IA in these patients should be taken during hospital construction.
侵袭性曲霉病（IA）在肾移植受者（RTR）中较为罕见。我们调查了2001年1月至2月加利福尼亚一家医院正在进行建设期间RTR中的IA聚集情况。我们对2001年1月1日至2月5日住院的RTR进行了一项队列研究，以确定IA的危险因素。IA根据既定指南进行定义。在研究期间住院的40名RTR中有4例发生IA。与IA风险增加相关的因素包括长期血液透析、移植后长期使用皮质类固醇治疗以及单独使用西罗莫司或与霉酚酸酯联合使用（P<0.05）。研究期过后，又有3名RTR发生IA；从这些患者中分离出的两种曲霉菌株通过DNA指纹图谱显示特征无法区分，提示存在共同来源暴露。本研究表明，免疫抑制的RTR发生IA的风险可能增加。在医院建设期间应采取措施预防这些患者发生IA。
