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移植前后的复杂细菌性感染。

Complex bacterial infections pre- and posttransplant.

机构信息

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.

出版信息

Semin Respir Crit Care Med. 2010 Apr;31(2):234-42. doi: 10.1055/s-0030-1249119. Epub 2010 Mar 30.

Abstract

Infections complications following lung transplantation are associated with significant morbidity and mortality. Management of infections is most challenging in patients with cystic fibrosis (CF), but all lung transplant recipients are at heightened risk for opportunistic infections. Particularly in CF, pretransplant infections with PSEUDOMONAS AERUGINOSA, other highly resistant bacteria (e.g., STENOTROPHOMONAS, BURKHOLDERIA), and mycobacteria play a major role in recipient selection and post-lung transplant outcomes. Understanding the clinical impact and management strategies for each of these different pathogens is critical to maximizing the benefit of lung transplantation. In the review, we discuss each of these infections both as pretransplant risk factors as well as posttransplant pathogens and the individual issues that arise with each infection.

摘要

肺移植后的感染并发症与较高的发病率和死亡率相关。在囊性纤维化(CF)患者中,感染的管理极具挑战性,但所有肺移植受者都面临机会性感染的高风险。特别是在 CF 中,移植前感染铜绿假单胞菌、其他高度耐药菌(如嗜麦芽窄食单胞菌、伯克霍尔德菌)和分枝杆菌,对受者选择和肺移植后结局有重要影响。了解这些不同病原体的临床影响和管理策略对于最大限度地提高肺移植的获益至关重要。在这篇综述中,我们讨论了这些感染作为移植前危险因素以及移植后病原体的情况,以及每种感染所带来的具体问题。

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