儿童肺移植受者的真菌感染：定植和侵袭性疾病。
Fungal infections in pediatric lung transplant recipients: colonization and invasive disease.
机构信息
Department of Pediatrics, Children's Hospital, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
出版信息
J Heart Lung Transplant. 2009 Nov;28(11):1226-30. doi: 10.1016/j.healun.2009.06.006. Epub 2009 Sep 26.
BACKGROUND
The purpose of this study was to evaluate the epidemiology and investigate the impact of colonization and pulmonary fungal infections (PFIs).
METHODS
In this investigation we performed a retrospective analysis of 55 pediatric lung transplant recipients from 2002 to 2007 at a single institution. Associations between risk factors and time to post-transplant colonization, PFI, and other outcomes were assessed using Cox proportional hazard models.
RESULTS
Although 29 patients had positive pre-transplant colonization, 33 (60%) were colonized post-transplant and 20% (11 subjects) developed proven or probable PFI. In a multivariate model, post-transplant fungal colonization was associated with older age (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.1 to 7.6), cytomegalovirus (CMV) prophylaxis (HR 5.6, 95% CI 1.3 to 24.6) and respiratory viral infection prior to fungal colonization (HR 2.9, 95% CI 1.0 to 8.3).
CONCLUSION
Neither fungal colonization nor PFI was associated with the development of chronic allograft rejection or death.
背景
本研究旨在评估流行病学并调查定植和肺部真菌感染 (PFIs) 的影响。
方法
在这项调查中，我们对 2002 年至 2007 年在一家机构接受肺移植的 55 名儿科患者进行了回顾性分析。使用 Cox 比例风险模型评估了风险因素与移植后定植、PFI 及其他结果之间的关联。
结果
尽管 29 例患者在移植前定植阳性，但 33 例（60%）在移植后定植，20%（11 例）发生了确诊或可能的 PFI。在多变量模型中，移植后真菌定植与年龄较大（风险比 [HR] 2.9，95%置信区间 [CI] 1.1 至 7.6）、巨细胞病毒 (CMV) 预防（HR 5.6，95% CI 1.3 至 24.6）和真菌定植前呼吸道病毒感染（HR 2.9，95% CI 1.0 至 8.3）相关。
结论
真菌定植和 PFI 均与慢性移植物排斥反应或死亡的发展无关。
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