Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Transplantation. 2012 Jan 15;93(1):69-72. doi: 10.1097/TP.0b013e31823aa528.
Clinical and epidemiological data of pandemic influenza A H1N1 infection in solid-organ transplant recipients have been described, but scarce data compare these outcomes with nonimmunocompromised patients.
We retrospectively reviewed and compared the clinical presentation, morbidity, and mortality of all kidney transplant (KT) and nonimmunocompromised (non-KT) patients admitted for at least 12 hr with a diagnosis of pandemic influenza A H1N1 infection in a single hospital complex during the 2009 pandemic.
There were 22 patients in the KT group (29.3%) and 53 in the non-KT group (70.7%). The prevalence of diabetes was higher in KT group (27.3% vs. 5.7%) while chronic pulmonary disease was more frequent in non-KT group (34% vs. 9.1%). Clinical and radiological presentations and duration of disease were similar between the two groups. The incidence of acute renal failure was higher among KT patients (40.9% vs. 17%). No differences in the rate of intensive care unit admission (22.7% vs. 22.6%) or hospital mortality (9.1% vs. 7.5%) were observed. For the overall population, poor outcome, defined as intensive care unit admission or death, was associated with in-hospital acquisition (relative risk [RR]=42.6 [95% confidence interval {95% CI } 2.2-831.9], P=0.003), symptom onset more than 48 hr (RR=12.17 [95% CI 1.3-117.2], P=0.007), and acute renal failure (RR=11.8 [95% CI 2.9-48.8], P<0.001). Among KT recipients, in-hospital acquisition was the only covariate associate with poor outcome (RR=30.0 [95% CI 2.1-421.1], P=0.004).
No significant differences in morbidity and mortality were observed comparing KT and non-KT patients infected with pandemic H1N1 influenza A virus.
已描述了大流行性甲型 H1N1 流感感染在实体器官移植受者中的临床和流行病学数据，但很少有数据将这些结果与非免疫功能低下患者进行比较。
我们回顾性地比较和比较了在 2009 年大流行期间，在一个单一医院中至少住院 12 小时并诊断为大流行性甲型 H1N1 流感感染的所有肾移植（KT）和非免疫功能低下（非-KT）患者的临床表现、发病率和死亡率。
在 KT 组中有 22 例（29.3％）和 53 例非-KT 组（70.7％）。在 KT 组中，糖尿病的患病率较高（27.3％对 5.7％），而慢性肺部疾病在非-KT 组中更为常见（34％对 9.1％）。两组之间的临床和影像学表现以及疾病持续时间相似。急性肾衰竭的发生率在 KT 患者中较高（40.9％对 17％）。入住重症监护病房的比率（22.7％对 22.6％）或医院死亡率（9.1％对 7.5％）无差异。对于整个人群，定义为入住重症监护病房或死亡的不良预后与院内获得性感染有关（相对风险[RR]为 42.6 [95％置信区间{95％CI}为 2.2-831.9]，P=0.003），症状发作超过 48 小时（RR=12.17 [95％CI 1.3-117.2]，P=0.007）和急性肾衰竭（RR=11.8 [95％CI 2.9-48.8]，P<0.001）。在 KT 受者中，院内获得性感染是唯一与不良预后相关的混杂因素（RR=30.0 [95％CI 2.1-421.1]，P=0.004）。
在感染大流行性甲型 H1N1 流感病毒的 KT 和非-KT 患者中，发病率和死亡率无显着差异。
