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控制耐药性铜绿假单胞菌感染的重要性:一例囊性纤维化患者肺移植的经验

Importance of controlling drug-resistant Pseudomonas aeruginosa infection: experience from lung transplantation in a cystic fibrosis case.

作者信息

Yamamoto Yoshihiro, Izumikawa Koichi, Hara Atsuko, Fujita Hanako, Amenomori Misato, Sakamoto Noriho, Seki Masafumi, Kakeya Hiroshi, Yanagihara Katsunori, Takasaki Kenji, Miyazaki Takuro, Tsuchiya Tomoshi, Yamasaki Naoya, Tagawa Tsutomu, Nagayasu Takeshi, Kohno Shigeru

机构信息

Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki.

出版信息

Intern Med. 2010;49(21):2353-8. doi: 10.2169/internalmedicine.49.3932. Epub 2010 Nov 1.

Abstract

Cystic fibrosis (CF) is rare in Japan. We encountered a CF case with drug-resistant Pseudomonas aeruginosa infection and successfully performed lung transplant from living related donors. A combination of beta-lactams and aminoglycosides for drug-resistant P. aeruginosa infection was administered before lung transplantation. Intravenous colistin was also used immediately before and after transplant surgery. Gram staining of respiratory specimens was performed every day after surgery and it was useful in monitoring infection status. Strict monitoring of infections by the Gram staining and culture of respiratory specimens is considered to be effective in preventing lower respiratory infection in lung transplantation.

摘要

囊性纤维化(CF)在日本较为罕见。我们遇到了一例患有耐多药铜绿假单胞菌感染的CF病例,并成功实施了亲属活体供肺移植手术。在肺移植前,使用了β-内酰胺类药物和氨基糖苷类药物联合治疗耐多药铜绿假单胞菌感染。移植手术前后还立即使用了静脉注射多黏菌素。术后每天对呼吸道标本进行革兰氏染色,这有助于监测感染状况。通过对呼吸道标本进行革兰氏染色和培养来严格监测感染,被认为对预防肺移植术后下呼吸道感染有效。

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