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实体器官移植受者鲍曼不动杆菌感染的临床特征

Clinical Characteristics of Acinetobacter baumannii Infection in Solid-Organ Transplant Recipients.

作者信息

Serifoglu Irem, Er Dedekarginoglu Balam, Savas Bozbas Serife, Akcay Sule, Haberal Mehmet

机构信息

Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

Exp Clin Transplant. 2018 Mar;16 Suppl 1(Suppl 1):171-175. doi: 10.6002/ect.TOND-TDTD2017.P51.

Abstract

OBJECTIVES

Acinetobacter baumannii, depending on the immune status of the host, may result in one of the most serious hospital infections. Infections involving A. baumannii infection have been recently rising. However, little is known about the clinical features of A. baumannii infection in solid-organ transplant recipients. We aimed to share our clinical experiences with A. baumannii infection in our transplant recipients.

MATERIALS AND METHODS

Between 2011 and 2017, 41 solid-organ transplant patients developed A. baumannii infection at Baskent University Hospital. Medical records were reviewed, and patient demographics, microbiology results, and overall outcome data were noted.

RESULTS

Of 41 solid-organ transplant patients with A. baumannii infection, 29 were male and 12 were female patients with mean age of 47.15 ± 13.24 years. Our infection rate with A. baumannii infection was 6.1%. The most common sites of infection were deep tracheal aspirate (48.8%)and bloodstream (36.6%). Onset of infection 1 year posttransplant was identified in 58.5% of recipients. Risk factors included presence of invasive procedures (56.1%) and administration of high-dose corticosteroids for rejection 1 year before infection (68.3%). Thirty-day mortality rate was 41.5% (17/41 patients) and was not associated with the infection site, microbiological cure, clinical cure, and drug resistance in our study group.

CONCLUSIONS

Acinetobacter baumannii is an important cause of hospital-acquired infection and mortality worldwide. A major problem with A. baumannii infection is delayed initiation of appropriate antibiotic treatment and the rising numbers of extensively drug-resistant organisms. Predicting the potential risk factors, especially in the already at-risk solid-organ transplant population, has an important role in patient outcomes.

摘要

目的

鲍曼不动杆菌根据宿主的免疫状态,可能导致最严重的医院感染之一。涉及鲍曼不动杆菌感染的病例近来不断增加。然而,关于实体器官移植受者鲍曼不动杆菌感染的临床特征,人们了解甚少。我们旨在分享我们在移植受者中治疗鲍曼不动杆菌感染的临床经验。

材料与方法

2011年至2017年期间,41例实体器官移植患者在巴斯肯特大学医院发生鲍曼不动杆菌感染。回顾病历,并记录患者人口统计学资料、微生物学结果及总体结局数据。

结果

41例发生鲍曼不动杆菌感染的实体器官移植患者中,男性29例,女性12例,平均年龄47.15±13.24岁。我们的鲍曼不动杆菌感染率为6.1%。最常见的感染部位是深部气管吸出物(48.8%)和血流(36.6%)。58.5%的受者在移植后1年出现感染。危险因素包括有创操作(56.1%)以及在感染前1年因排斥反应使用大剂量皮质类固醇(68.3%)。30天死亡率为41.5%(17/41例患者),在我们的研究组中,其与感染部位、微生物学治愈、临床治愈及耐药性无关。

结论

鲍曼不动杆菌是全球医院获得性感染和死亡的重要原因。鲍曼不动杆菌感染的一个主要问题是适当抗生素治疗的启动延迟以及广泛耐药菌数量的增加。预测潜在危险因素,尤其是在本就处于高危状态的实体器官移植人群中,对患者结局具有重要作用。

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