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肺移植后的真菌感染

Fungal infections after lung transplantation.

作者信息

Solé Amparo, Salavert Miguel

机构信息

Pulmonary Transplant Unit, Hospital Universitario La Fe, 46009 Valencia, Spain.

出版信息

Transplant Rev (Orlando). 2008 Apr;22(2):89-104. doi: 10.1016/j.trre.2007.12.007.

Abstract

Lung transplantation (LT) is now considered to be the standard therapeutic intervention in some patients with end-stage pulmonary disease. Infectious complications after LT are relatively common due to the aggressive immunosuppression used in these receptors and local host factors derived from this type of transplant. The incidence of fungal infections after LT ranges up to 30%. However, the incidence of invasive mycoses has declined over the past decade. These mycoses are associated with high overall mortality rates despite increase of the antifungal armamentarium in the last years. Candida and Aspergillus spp produce most of these infections, but unusual moulds such as Scedosporium spp are increasingly recognized as opportunistic pathogens in LT. This review highlights the changing spectrum of invasive fungal infections, risk factors, antifungal prophylaxis, diagnosis, and treatment after LT.

摘要

肺移植(LT)目前被认为是一些终末期肺病患者的标准治疗干预措施。由于这些受者使用了积极的免疫抑制以及这种类型移植所产生的局部宿主因素,LT后的感染并发症相对常见。LT后真菌感染的发生率高达30%。然而,在过去十年中,侵袭性真菌病的发生率有所下降。尽管近年来抗真菌药物有所增加,但这些真菌病仍与较高的总体死亡率相关。念珠菌和曲霉菌属导致了这些感染中的大多数,但诸如赛多孢菌属等不常见霉菌在LT中越来越被认为是机会性病原体。本综述重点介绍了LT后侵袭性真菌感染的变化谱、危险因素、抗真菌预防、诊断和治疗。

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