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肠道和多脏器移植受者中的真菌感染

Fungal infections in intestinal and multivisceral transplant recipients.

作者信息

Florescu Diana F, Sandkovsky Uriel

机构信息

aTransplant Infectious Diseases Program, Division of Infectious Diseases bTransplant Surgery Division, University of Nebraska Medical Center, Omaha, Nebraska, USA.

出版信息

Curr Opin Organ Transplant. 2015 Jun;20(3):295-302. doi: 10.1097/MOT.0000000000000188.

Abstract

PURPOSE OF REVIEW

Patients who undergo intestinal and multivisceral transplantation are at increased risk for infectious complications. Fungal infections are major causes of morbidity and mortality in these patients. The current review highlights key diagnostic and management issues in this population.

RECENT FINDINGS

Invasive infections caused by Candida spp. remain the most common invasive fungal infections in intestinal and multivisceral transplant recipients. Aspergillus is an emerging pathogen but data are limited to case reports or case series. Other fungi including the mucorales, Cryptococcus and endemic mycoses are emerging pathogens but data regarding incidence and timing of disease in intestinal and multivisceral transplant recipients are lacking.

SUMMARY

Invasive candidiasis is the most common fungal infection in patients with intestinal and multivisceral transplants. Experience for diagnosis and management comes from case series and single centers. Diagnosis and management of infections caused by other pathogens such as Aspergillus, Cryptococcus, Mucor, and endemic mycoses is usually extrapolated from other solid organ transplant recipients.

摘要

综述目的

接受肠道和多脏器移植的患者发生感染并发症的风险增加。真菌感染是这些患者发病和死亡的主要原因。本综述重点介绍了该人群关键的诊断和管理问题。

最新发现

念珠菌属引起的侵袭性感染仍然是肠道和多脏器移植受者中最常见的侵袭性真菌感染。曲霉是一种新兴病原体,但数据仅限于病例报告或病例系列。其他真菌,包括毛霉目、隐球菌和地方性真菌病是新兴病原体,但缺乏关于肠道和多脏器移植受者疾病发病率和发病时间的数据。

总结

侵袭性念珠菌病是肠道和多脏器移植患者中最常见的真菌感染。诊断和管理经验来自病例系列和单一中心。由曲霉、隐球菌、毛霉和地方性真菌病等其他病原体引起的感染的诊断和管理通常是从其他实体器官移植受者推断而来的。

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