Simkins J, Muggia V
Division of Infectious Diseases, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10467, USA.
Transpl Infect Dis. 2012 Jun;14(3):292-5. doi: 10.1111/j.1399-3062.2011.00674.x. Epub 2011 Sep 26.
Most cases of donor-derived infection due to Pseudomonas aeruginosa reported in the literature are associated with vascular dehiscence, all of which resulted either in death or graft failure requiring graft removal. We report the successful treatment of donor-derived infection due to multidrug-resistant P. aeruginosa in a 64-year-old male who presented with bacteremia and peritransplant renal fluid collection after undergoing deceased-donor renal transplantation. As a result of the report of positive donor cultures by the host Organ Procurement Organization, the infection was promptly identified by blood cultures drawn before appearance of symptoms. Surveillance blood cultures in recipients are not usually recommended. However, they should be done if donor cultures turn positive. Therefore, it is crucial to perform cultures in donors and to closely follow them up for early identification and prompt treatment of donor-transmitted infections due to organisms like P. aeruginosa that can be graft and/or life threatening.
文献中报道的大多数由铜绿假单胞菌引起的供体源性感染病例都与血管裂开有关,所有这些病例要么导致死亡,要么导致移植物功能衰竭而需要移除移植物。我们报告了一例64岁男性患者,在接受脑死亡供体肾移植后出现菌血症和移植肾周积液,成功治疗了由多重耐药铜绿假单胞菌引起的供体源性感染。由于供体器官获取组织报告供体培养结果呈阳性,在症状出现前采集的血培养及时发现了感染。通常不建议对受者进行监测血培养。然而,如果供体培养结果呈阳性,则应进行监测血培养。因此,对供体进行培养并密切随访,以便早期识别和及时治疗由铜绿假单胞菌等可危及移植物和/或生命的病原体引起的供体传播感染至关重要。