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实体器官移植患者感染的治疗

Therapy of Infections in Solid Organ Transplant Patients.

作者信息

Osman Lubna, Lopez Christopher, Natori Yoichiro, Anjan Shweta, Bini Viotti Julia, Simkins Jacques

机构信息

Infectious Diseases, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140, USA.

Department of Medicine, Division of Infectious Diseases, University of Miami School of Medicine, 1120 NW 14th Street, Miami, FL 33019, USA.

出版信息

Microorganisms. 2024 Mar 16;12(3):596. doi: 10.3390/microorganisms12030596.

Abstract

complex (MABC), a rapidly growing , is one of the most common causes of non-tuberculous mycobacteria (NTM) infections in the United States of America, and it has been associated with a wide spectrum of infections in immunocompetent and immunosuppressed individuals. Eradicating MABC is very challenging, even with prolonged combination therapies. The management of MABC infections in solid organ transplant (SOT) patients is usually complex given their net state of immunosuppression, associated comorbidities, and potential drug-drug interactions, among other things. In this manuscript, we discussed the antimicrobial management of pulmonary and extrapulmonary MABC infections. In addition, we reviewed promising novel therapies such as clofazimine, omadacycline, bedaquiline, and inhaled tigecycline that could join the existing antimicrobial armamentarium to fight this infection associated with significant morbidity and mortality. However, further studies are needed, especially among the immunocompromised host.

摘要

脓肿分枝杆菌复合体(MABC)是一种快速生长的细菌,是美国非结核分枝杆菌(NTM)感染最常见的病因之一,并且它与免疫功能正常和免疫抑制个体的广泛感染有关。即使采用延长的联合疗法,根除MABC也极具挑战性。鉴于实体器官移植(SOT)患者的免疫抑制净状态、相关合并症以及潜在的药物相互作用等因素,其MABC感染的管理通常很复杂。在本手稿中,我们讨论了肺部和肺外MABC感染的抗菌治疗。此外,我们还综述了一些有前景的新型疗法,如氯法齐明、奥马环素、贝达喹啉和吸入性替加环素,这些疗法可能会加入现有的抗菌药物库来对抗这种具有显著发病率和死亡率的感染。然而,还需要进一步研究,尤其是在免疫受损宿主中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccf6/10975720/df403c2e96df/microorganisms-12-00596-g001.jpg

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