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卡瑞霉素治疗10例实体器官移植后重症肺炎患者的疗效与安全性。

Efficacy and safety of carrimycin in ten patients with severe pneumonia following solid organ transplantation.

作者信息

Cui Xian-Quan, Zhang Lu-Wei, Zhao Peng, Feng Jing-Jing

机构信息

Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Department of Blood Purification, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

出版信息

World J Clin Cases. 2024 May 26;12(15):2542-2550. doi: 10.12998/wjcc.v12.i15.2542.

Abstract

BACKGROUND

The number of patients undergoing solid organ transplantation has increased annually. However, infections in solid organ transplant recipients can have a severe effect on patient survival owing to the continued use of immunosuppressants. Carrimycin is a novel macrolide antibiotic produced by genetically engineered streptomyces spiramyceticus harboring a 4''-O-isovaleryltransferase gene (ist) from streptomyces thermotoleran. Carrimycin has good antibacterial and antiviral effects. However, no relevant studies have been conducted on the efficacy and safety of carrimycin in patients with severe pneumonia (SP) after solid organ transplantation.

AIM

To explore the efficacy and safety of carrimycin in patients with SP after solid organ transplantation to provide a medication reference for clinical treatment.

METHODS

In March 2022, ten patients with SP following solid-organ transplantation were treated at our hospital between January 2021 and March 2022. When the condition was critical and difficult to control with other drugs, carrimycin was administered. These ten patients' clinical features and treatment protocols were retrospectively analyzed, and the efficacy and safety of carrimycin for treating SP following solid organ transplantation were evaluated.

RESULTS

All ten patients were included in the analysis. Regarding etiological agent detection, there were three cases of fungal pneumonia, two cases of bacterial pneumonia, two cases of Pneumocystis pneumonia, and three cases of mixed infections. After treatment with carrimycin, the disease in seven patients significantly improved, the course of the disease was significantly shortened, fever was quickly controlled, chest computed tomography was significantly improved, and oxygenation was significantly improved. Finally, the patients were discharged after curing. One patient died of acute respiratory distress syndrome, and two patients discontinued treatment.

CONCLUSION

Carrimycin is a safe and effective treatment modality for SP following solid organ transplantation. Carrimycin may have antibacterial and antiviral effects in patients with SP following solid organ transplantation.

摘要

背景

实体器官移植患者的数量逐年增加。然而,由于持续使用免疫抑制剂,实体器官移植受者的感染会对患者的生存产生严重影响。卡里霉素是一种新型大环内酯类抗生素,由携带来自耐热链霉菌4''-O-异戊酰基转移酶基因(ist)的基因工程螺旋链霉菌产生。卡里霉素具有良好的抗菌和抗病毒作用。然而,尚未对卡里霉素在实体器官移植后重症肺炎(SP)患者中的疗效和安全性进行相关研究。

目的

探讨卡里霉素在实体器官移植后SP患者中的疗效和安全性,为临床治疗提供用药参考。

方法

2022年3月,对我院2021年1月至2022年3月期间收治的10例实体器官移植后SP患者进行研究。当病情危急且难以用其他药物控制时,给予卡里霉素治疗。回顾性分析这10例患者的临床特征和治疗方案,评估卡里霉素治疗实体器官移植后SP的疗效和安全性。

结果

10例患者均纳入分析。病因检测方面,真菌性肺炎3例,细菌性肺炎2例,肺孢子菌肺炎2例,混合感染3例。使用卡里霉素治疗后,7例患者病情明显改善,病程明显缩短,发热迅速得到控制,胸部计算机断层扫描明显改善,氧合明显改善。最终,患者治愈出院。1例患者死于急性呼吸窘迫综合征,2例患者停止治疗。

结论

卡里霉素是治疗实体器官移植后SP的一种安全有效的治疗方式。卡里霉素在实体器官移植后SP患者中可能具有抗菌和抗病毒作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4619/11135438/1af2e7a40554/WJCC-12-2542-g001.jpg

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