Ban Hideki, Miura Kenichiro, Ishizuka Kiyonobu, Kaneko Naoto, Taniguchi Yohei, Nagasawa Takeshi, Shirai Yoko, Yabuuchi Tomoo, Takagi Yoko, Goto Aeko, Hattori Motoshi
Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
Department of The Center Inspection Department Microorganism Laboratory, Tokyo Women's Medical University, Tokyo, Japan.
Transpl Infect Dis. 2019 Apr;21(2):e13040. doi: 10.1111/tid.13040. Epub 2019 Jan 4.
There are few reports of patients with Campylobacter enteritis after renal transplantation, and only a few case reports of bacteremia have been published. Although antibiotic therapy for 3-5 days has been recommended for immunocompromised patients, the optimal treatment for Campylobacter enteritis after renal transplantation has not been established. This study aimed to clarify the clinical characteristics and treatment outcomes of Campylobacter enteritis after pediatric renal transplantation.
This retrospective study included patients who underwent pediatric renal transplantation and were found to have Campylobacter species in stool cultures between January 2014 and May 2017.
This study included eight patients who underwent pediatric renal transplantation. The median age at the time of renal transplantation was 14 years, and the median period between transplantation and disease occurrence was 4.6 years. Clinical symptoms were abdominal pain for eight patients, diarrhea for eight patients, fever for seven patients, vomiting for three patients, and headache for three patients. Campylobacter jejuni was isolated from the stool cultures of all patients. The median administration period of antibiotics as initial therapy was 7 days (range, 4-11 days). However, clinical relapse was observed in four patients after completing antibiotic therapy. Patients who experienced clinical relapse required a second course of antibiotic therapy for a median duration of 7 days (range, 5-10 days).
Patients with Campylobacter enteritis after pediatric renal transplantation are at high risk for clinical relapse and may require a longer duration of antibiotic therapy than that generally described.
肾移植后空肠弯曲菌肠炎患者的报道较少,仅有少数关于菌血症的病例报告发表。尽管推荐对免疫功能低下的患者进行3 - 5天的抗生素治疗,但肾移植后空肠弯曲菌肠炎的最佳治疗方案尚未确立。本研究旨在阐明小儿肾移植后空肠弯曲菌肠炎的临床特征和治疗结果。
这项回顾性研究纳入了2014年1月至2017年5月期间接受小儿肾移植且粪便培养发现有空肠弯曲菌属的患者。
本研究纳入了8例接受小儿肾移植的患者。肾移植时的中位年龄为14岁,移植与发病之间的中位时间为4.6年。临床症状包括8例腹痛、8例腹泻、7例发热、3例呕吐和3例头痛。所有患者的粪便培养均分离出空肠弯曲菌。初始治疗抗生素的中位使用时间为7天(范围4 - 11天)。然而,4例患者在完成抗生素治疗后出现临床复发。经历临床复发的患者需要第二个疗程的抗生素治疗,中位持续时间为7天(范围5 - 10天)。
小儿肾移植后空肠弯曲菌肠炎患者临床复发风险高,可能需要比一般描述更长时间的抗生素治疗。