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肺移植中赛多孢菌属和多育镰刀菌的研究现状:欧洲临床微生物与感染性疾病学会真菌感染研究组、免疫功能低下宿主感染研究组及欧洲医学真菌联合会的一项国际实践调查结果

Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology.

作者信息

Rammaert Blandine, Puyade Mathieu, Cornely Oliver A, Seidel Danila, Grossi Paolo, Husain Shahid, Picard Clément, Lass-Flörl Cornelia, Manuel Oriol, Le Pavec Jérôme, Lortholary Olivier

机构信息

Faculté de médecine et pharmacie, Univ Poitiers, Poitiers, France.

Service de maladies infectieuses et tropicales, CHU Poitiers, Poitiers, France.

出版信息

Transpl Infect Dis. 2019 Oct;21(5):e13141. doi: 10.1111/tid.13141. Epub 2019 Jul 22.

Abstract

BACKGROUND

Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung transplant recipients.

METHODS

We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a large number of lung transplant centers through an international practice survey from October 2016 to March 2017.

RESULTS

A total of 51 respondents from 45 lung transplant centers (17 countries, 4 continents) answered the survey (response rate 58%). S/L colonization was estimated to be detected in candidates by 48% of centers. Only 18% of the centers used a specific medium to detect S/L colonization. Scedosporium spp. colonization was a contraindication to transplantation in 10% of centers whereas L prolificans was a contraindication in 31%; 22% of centers declared having had 1-5 recipients infected with S/L in the past 5 years.

CONCLUSIONS

This survey gives an overview of the current practices regarding S/L colonization and infection in lung transplant centers worldwide and underscores the need of S/L culture procedure standardization before implementing prospective studies.

摘要

背景

在肺移植受者中,赛多孢菌属和多育镰刀菌(S/L)是继曲霉菌之后第二常见的侵袭性霉菌感染病因。

方法

2016年10月至2017年3月,我们通过一项国际实践调查,评估了大量肺移植中心在肺移植前后对下呼吸道S/L定植/感染的管理现状。

结果

来自45个肺移植中心(17个国家,4个大洲)的51名受访者回答了该调查(回复率58%)。据估计,48%的中心在候选者中检测到S/L定植。只有18%的中心使用特定培养基检测S/L定植。10%的中心将赛多孢菌属定植作为移植禁忌证,而31%的中心将多育镰刀菌作为移植禁忌证;22%的中心宣称在过去5年中有1 - 5名受者感染S/L。

结论

本次调查概述了全球肺移植中心目前关于S/L定植和感染的实践情况,并强调在开展前瞻性研究之前需要对S/L培养程序进行标准化。

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