Division of Nephrology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Clin J Am Soc Nephrol. 2022 Feb;17(2):286-295. doi: 10.2215/CJN.15971020. Epub 2021 Apr 20.
Infections remain a common complication of solid-organ transplantation. Most infections in the first month after transplant are typically health care-associated infections, whereas late infections, beyond 6-12 months, are community-acquired infections. Opportunistic infections most frequently present in the first 12 months post-transplant and can be modulated on prior exposures and use of prophylaxis. In this review, we summarize the current epidemiology of postkidney transplant infections with a focus on key viral (BK polyomavirus, cytomegalovirus, Epstein-Barr virus, and norovirus), bacterial (urinary tract infections and colitis), and fungal infections. Current guidelines for safe living post-transplant are also summarized. Literature supporting prophylaxis and vaccination is also provided.
感染仍然是实体器官移植的常见并发症。移植后第一个月的大多数感染通常是与医疗保健相关的感染,而 6-12 个月后的迟发性感染是社区获得性感染。机会性感染在移植后 12 个月内最常发生,并且可以根据既往暴露和预防用药情况进行调节。在这篇综述中,我们总结了肾移植后感染的当前流行病学情况,重点介绍了关键的病毒(BK 多瘤病毒、巨细胞病毒、Epstein-Barr 病毒和诺如病毒)、细菌(尿路感染和结肠炎)和真菌感染。还总结了移植后安全生活的现行指南。同时也提供了支持预防和疫苗接种的文献。