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肺移植术后机会性感染:病毒、真菌和分枝杆菌。

Opportunistic Infections Post-Lung Transplantation: Viral, Fungal, and Mycobacterial.

机构信息

Columbia University Lung Transplant Program, Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, Columbia University Vagelos College of Physicians and Surgeons, 622 West 168th Street PH-14, New York, NY 10032, USA.

出版信息

Infect Dis Clin North Am. 2024 Mar;38(1):121-147. doi: 10.1016/j.idc.2023.12.001.

Abstract

Opportunistic infections are a leading cause of lung transplant recipient morbidity and mortality. Risk factors for infection include continuous exposure of the lung allograft to the external environment, high levels of immunosuppression, impaired mucociliary clearance and decreased cough reflex, and impact of the native lung microbiome in single lung transplant recipients. Infection risk is mitigated through careful pretransplant screening of recipients and donors, implementation of antimicrobial prophylaxis strategies, and routine surveillance posttransplant. This review describes common viral, fungal, and mycobacterial infectious after lung transplant and provides recommendations on prevention and treatment.

摘要

机会性感染是肺移植受者发病率和死亡率的主要原因。感染的危险因素包括肺移植持续暴露于外环境、高水平的免疫抑制、黏液纤毛清除功能受损和咳嗽反射减弱,以及单肺移植受者的固有肺微生物组的影响。通过仔细筛选受者和供者、实施抗菌预防策略以及移植后常规监测,可以降低感染风险。本文描述了肺移植后的常见病毒、真菌和分枝杆菌感染,并就预防和治疗提供了建议。

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