Kovats Z, Sütto Z, Muraközy G, Bohacs A, Czebe K, Lang G, Renyi-Vamos F, Klepetko W, Müller V
Department of Pulmonology, Semmelweis University, Budapest, Hungary.
Transplant Proc. 2011 May;43(4):1290-1. doi: 10.1016/j.transproceed.2011.03.075.
After lung transplantation, a high level of immunosuppression is needed to prevent rejection. This demand renders recipients more sensitive to infections. As pulmonary infections are a major clinical problem during the first postoperative year after lung transplantation, preventive treatment and regular surveillance examinations are needed for immediate, adequate therapy. We describe the airway pathogens registered during the first posttransplantation year among our 12 lung transplant recipients since December 2008. Samples were obtained for microbiologic analysis from the upper and lower respiratory tracts and from serum as part of routine care. During the first year after transplantation the most frequent pathogens were fungi (Candida albicans 82%; Aspergillus 50%), Pneumocystis (8%), gram-negative bacteria (Pseudomonas spp 60%; Klebsiella 25%, Acinetobacter 17%; Escherichia Coli 17%; and Enterococcus faecalis 25%), and Staphylococcus aureus (50%, including methicillin-resistant strains 25%). This pathogen spectrum in the first postoperative year after lung transplantation was similar to other centers. Colonization with Pseudomonas or fungi presented early and was prevalent among our patients.
肺移植后，需要高水平的免疫抑制来预防排斥反应。这种需求使受者对感染更加敏感。由于肺部感染是肺移植术后第一年的主要临床问题，因此需要进行预防性治疗和定期监测检查，以便立即进行充分治疗。我们描述了自2008年12月以来我们12例肺移植受者在移植后第一年记录的气道病原体。作为常规护理的一部分，从上下呼吸道和血清中获取样本进行微生物分析。移植后的第一年，最常见的病原体是真菌（白色念珠菌82%；曲霉菌50%）、肺孢子菌（8%）、革兰氏阴性菌（铜绿假单胞菌60%；克雷伯菌25%，不动杆菌17%；大肠杆菌17%；粪肠球菌25%）和金黄色葡萄球菌（50%，包括耐甲氧西林菌株25%）。肺移植术后第一年的这种病原体谱与其他中心相似。铜绿假单胞菌或真菌的定植出现较早，在我们的患者中很普遍。
