Cincinnati Children's Hospital Medical Center.
Curr Opin Gastroenterol. 2014 Jan;30(1):40-6. doi: 10.1097/MOG.0000000000000016.
Recipients of both solid organ transplant and hematopoietic stem cell transplantation are at increased risk for infectious morbidity and mortality after transplantation due to on-going immunosuppression. Gastrointestinal infections have been increasingly reported in these populations.
Increased reports of gastrointestinal infections including bacterial infection with Clostridium difficile, viral infection with norovirus and parasitic pathogens like cryptosporidium are emerging. Risk factors identified have focused on type of transplant, transplant immunosuppression regimens and exposures. Although many events are self-limiting, significant morbidity and rare mortality are reported.
Improved diagnostic techniques have increased the reporting of several gastrointestinal infections after transplantation, affording improved understanding of the epidemiology of these diseases. Armed with this emerging data, prevention, recognition of infection and treatment strategies can be more thoroughly assessed in these at-risk populations.
由于持续的免疫抑制,实体器官移植和造血干细胞移植受者在移植后发生感染性发病率和死亡率的风险增加。这些人群的胃肠道感染越来越多。
越来越多的报道称,这些人群中出现了胃肠道感染,包括艰难梭菌的细菌性感染、诺如病毒的病毒性感染和隐孢子虫等寄生虫病原体感染。已确定的危险因素集中在移植类型、移植免疫抑制方案和暴露情况上。虽然许多事件是自限性的,但仍有报道称存在严重的发病率和罕见的死亡率。
改进的诊断技术增加了移植后几种胃肠道感染的报告,使人们对这些疾病的流行病学有了更好的了解。有了这些新出现的数据,可以更全面地评估这些高危人群的预防、感染识别和治疗策略。