肾移植术后感染性心内膜炎
Infective endocarditis after renal transplantation.
作者信息
Moshkani Farahani Maryam, Rostami Zohreh, Einollahi Behzad, Khosravi Arezoo, Nemati Eghlim, Lessan Pezeshki Mahboob, Pourfarziani Vahid, Joneidi Nematollah, Hosseini Mohammad Javad, Ghorbani Gholam Ali
机构信息
Cardiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
出版信息
Nephrourol Mon. 2014 Jan 13;6(1):e12326. doi: 10.5812/numonthly.12326. eCollection 2014 Jan.
BACKGROUND
Infective endocarditis (IE) is a serious complication in immunosuppressive patients that has adverse effects.
OBJECTIVES
The aim of this study was to define the characteristics, outcomes, and correlating factors of mortality in renal transplant recipients.
PATIENTS AND METHODS
Infective endocarditis was diagnosed in 22 patients from three renal transplant centers in Iran between 2000 and 2010. Modified Duke criteria were applied to confirm the diagnosis.
RESULTS
Twenty-two renal transplant patients with IE were evaluated. Blood culture results were positive in 81%. Enteroccous and group D non-enterococcal were the causative microorganisms in 31% and 25% of patients, respectively. In-hospital and 12-month mortality was 41% and the mortality rate was higher in older patients in comparison to younger patients. Overall, the rates of one-year disease-free patient and graft survival were 49% and 88%, respectively.
CONCLUSIONS
Despite the availability of different and potent antibiotics, the mortality caused by IE remains considerably high. These patients are significantly prone to endovascular infections that affect the mortality and survival.
背景
感染性心内膜炎（IE）是免疫抑制患者的一种严重并发症，具有不良影响。
目的
本研究旨在明确肾移植受者感染性心内膜炎的特征、结局及死亡相关因素。
患者与方法
2000年至2010年间，伊朗三个肾移植中心的22例患者被诊断为感染性心内膜炎。采用改良的杜克标准确诊。
结果
对22例肾移植合并感染性心内膜炎的患者进行了评估。血培养结果阳性率为81%。肠球菌和D组非肠球菌分别是31%和25%患者的致病微生物。住院死亡率和12个月死亡率为41%，老年患者的死亡率高于年轻患者。总体而言，一年无病生存率和移植肾生存率分别为49%和88%。
结论
尽管有多种强效抗生素，但感染性心内膜炎导致的死亡率仍然相当高。这些患者极易发生血管内感染，影响死亡率和生存率。
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