在法属圭亚那的一项为期 12 年的多中心回顾性分析中，热带病在肾移植受者的感染性并发症中占比如何？

What Is the Part of Tropical Diseases Among Infectious Complications in Renal Transplant Recipients in the Amazon? A 12-Year Multicenter Retrospective Analysis in French Guiana.

机构信息

Infectious and Tropical Medicine Department, Hospital Center of Cayenne, Cayenne, French Guiana, France; Faculté de Médecine, Université de Paris, Paris, France.

Clinical Investigation Center in Clinical Epidemiology French Guiana « Inserm CIC 1424 », Hospital Center of Cayenne, Cayenne, French Guiana, France; EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Medicine University of the West Indies and French Guiana, Cayenne, French Guiana, France.

出版信息

Transplant Proc. 2021 Sep;53(7):2242-2251. doi: 10.1016/j.transproceed.2021.07.038. Epub 2021 Aug 31.

DOI:10.1016/j.transproceed.2021.07.038

PMID:34474909

Abstract

BACKGROUND

Infectious complications in kidney transplant recipients (KTRs) are well studied in temperate countries but remain barely known in tropical ones. The main objective of this study was to describe infection-related hospitalizations in patients living in the Amazon, where it has never been described.

METHODS

All KTRs residing in French Guiana between 2007 and 2018 were included retrospectively. Infection-related hospitalizations were collected in the main medical centers of the territory.

RESULTS

Eighty-two patients were included, and 42 were infected during the study period (51%). Eighty-seven infections were identified. The main sites of infection were urinary, in 29% of cases (25/87), and pulmonary, in 22% of cases (19/87). When documented (48/87), bacterial infections were predominant (35/48), followed by viral (8/48), fungal (4/48), and parasitic infections (1/48). Endemic so-called tropical infections accounted for 6% of infections (5/87). Histoplasma capsulatum was the most commonly isolated fungus (2/4).

CONCLUSIONS

This study suggests that the spectrum of infections in KTRs in French Guiana differs little from that of temperate countries. Nevertheless, some tropical infections are described. More studies on fungal infections in KTRs should be undertaken to clarify the weight of histoplasmosis in these patients.

摘要

背景

在温带国家，肾移植受者（KTR）的感染并发症已有大量研究，但在热带国家，此类并发症仍知之甚少。本研究的主要目的是描述生活在亚马逊地区的 KTR 患者的感染相关住院情况，该地区尚无此类描述。

方法

回顾性纳入 2007 年至 2018 年间居住在法属圭亚那的所有 KTR。在该地区的主要医疗中心收集与感染相关的住院信息。

结果

共纳入 82 例患者，其中 42 例（51%）在研究期间发生感染。共发现 87 例感染。感染的主要部位为泌尿系统，占 29%（25/87），其次为肺部，占 22%（19/87）。在有记录的感染中（48/87），细菌感染占主导地位（35/48），其次为病毒（8/48）、真菌（4/48）和寄生虫感染（1/48）。热带地区特有的所谓地方性感染占感染的 6%（5/87）。最常分离到的真菌为荚膜组织胞浆菌（2/4）。