肺移植受者单中心队列中spp.和分离株的临床意义及治疗挑战
Clinical Significance and Therapeutic Challenges of spp. and Isolates in a Single-Center Cohort of Lung Transplant Recipients.
作者信息
García-Masedo Fernández Sarela, Laporta Rosalía, Aguilar Myriam, García Fadul Christian, Cabrera Pineda María, Alastruey-Izquierdo Ana, Royuela Ana, Sánchez Romero Isabel, Ussetti Gil Piedad
机构信息
Microbiology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain.
Pneumology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain.
出版信息
J Fungi (Basel). 2025 Apr 8;11(4):291. doi: 10.3390/jof11040291.
(1) Background: Emerging fungal infections associated with spp. and (S/L) are becoming more frequent and are very difficult to treat. Our objective was to analyze the frequency and management of S/L isolates in lung transplant (LTx) recipients, the patient outcomes and in vitro antifungal sensitivity. (2) Methods: We included all patients with S/L isolation during post-transplant follow-up. Data were collected from electronic medical records. All samples were cultivated on Sabouraud Chloramphenicol agar. Isolations of S/L were submitted to in vitro susceptibility tests. (3) Results: A total of 11 (2%) of the 576 LTx recipients included had at least one isolation of S/L. Classification for the 11 cases were colonization (4; 36%) and infection (7; 65%). Five infections were pulmonary (71%) and two were disseminated (29%). complex was the most frequently occurring isolation in patients with pulmonary disease while was the most frequent in patients with disseminated disease. Ten patients were treated. The most frequent antifungal drugs used were voriconazole (n = 8) and terbinafine (n = 6). Seven patients (70%) received more than one drug. The mortality rate associated with isolation was 50% for colonization and 100% for disseminated disease. (4) Conclusions: spp. and infections are associated with high morbidity and mortality rates. New diagnostic and therapeutic tools are required to reduce the impact of these infections.
(1) 背景:与曲霉属和镰刀菌属(S/L)相关的新发真菌感染日益频繁,且极难治疗。我们的目的是分析肺移植(LTx)受者中S/L分离株的频率及管理情况、患者预后以及体外抗真菌敏感性。(2) 方法:我们纳入了移植后随访期间所有有S/L分离情况的患者。数据从电子病历中收集。所有样本均在沙氏氯霉素琼脂上培养。S/L分离株进行体外药敏试验。(3) 结果:在纳入的576例LTx受者中,共有11例(2%)至少有一次S/L分离。11例病例的分类为定植(4例;36%)和感染(7例;65%)。5例感染为肺部感染(71%),2例为播散性感染(29%)。烟曲霉复合体是肺部疾病患者中最常出现的分离株,而镰刀菌属是播散性疾病患者中最常见的。10例患者接受了治疗。最常使用的抗真菌药物是伏立康唑(n = 8)和特比萘芬(n = 6)。7例患者(70%)接受了一种以上药物治疗。与S/L分离相关的死亡率,定植患者为50%,播散性疾病患者为100%。(4) 结论:曲霉属和镰刀菌属感染与高发病率和死亡率相关。需要新的诊断和治疗工具来降低这些感染的影响。