Clinical characteristics of Campylobacter enteritis after pediatric renal transplantation: A retrospective analysis from single center
Clinical characteristics of Campylobacter enteritis after pediatric renal transplantation: A retrospective analysis from single center
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小儿肾移植术后弯曲菌肠炎的临床特征：单中心回顾性分析
DOI：
10.1111/tid.13040
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发表时间：
2019
影响因子：
2.6
通讯作者：
Hattori Motoshi
中科院分区：
文献类型：
--
作者：
Ban Hideki;Miura Kenichiro;Ishizuka Kiyonobu;Kaneko Naoto;Taniguchi Yohei;Nagasawa Takeshi;Shirai Yoko;Yabuuchi Tomoo;Takagi Yoko;Goto Aeko;Hattori Motoshi
背景肾移植术后发生弯曲杆菌性肠炎的报道很少，仅发表了少数菌血症病例报道。尽管免疫功能低下的患者建议使用3 - 5天的抗生素治疗，但肾移植后弯曲杆菌肠炎的最佳治疗方法尚未确定。本研究旨在阐明小儿肾移植后弯曲杆菌肠炎的临床特点和治疗结果。Methods本回顾性研究包括2014年1月至2017年5月期间接受小儿肾移植并在粪便培养中发现弯曲杆菌的患者。肾移植时的中位年龄为14岁，移植与疾病发生之间的中位时间为4.6年。临床表现为腹痛8例，腹泻8例，发热7例，呕吐3例，头痛3例。抗生素作为初始治疗的中位给药期为7天（范围：4 - 11天）。然而，在完成抗生素治疗后，在4名患者中观察到临床复发。经历临床复发的患者需要第二个疗程的抗生素治疗，中位持续时间为7天（范围，5 - 10天）。结论小儿肾移植后弯曲杆菌肠炎患者临床复发的风险较高，可能需要比一般描述的抗生素治疗持续时间更长。
BackgroundThere are few reports of patients withCampylobacterenteritis after renal transplantation, and only a few case reports of bacteremia have been published. Although antibiotic therapy for 3‐5 days has been recommended for immunocompromised patients, the optimal treatment forCampylobacterenteritis after renal transplantation has not been established. This study aimed to clarify the clinical characteristics and treatment outcomes ofCampylobacterenteritis after pediatric renal transplantation.MethodsThis retrospective study included patients who underwent pediatric renal transplantation and were found to haveCampylobacterspecies in stool cultures between January 2014 and May 2017.ResultsThis study included eight patients who underwent pediatric renal transplantation. The median age at the time of renal transplantation was 14 years, and the median period between transplantation and disease occurrence was 4.6 years. Clinical symptoms were abdominal pain for eight patients, diarrhea for eight patients, fever for seven patients, vomiting for three patients, and headache for three patients.Campylobacter jejuniwas isolated from the stool cultures of all patients. The median administration period of antibiotics as initial therapy was 7 days (range, 4‐11 days). However, clinical relapse was observed in four patients after completing antibiotic therapy. Patients who experienced clinical relapse required a second course of antibiotic therapy for a median duration of 7 days (range, 5‐10 days).ConclusionsPatients withCampylobacterenteritis after pediatric renal transplantation are at high risk for clinical relapse and may require a longer duration of antibiotic therapy than that generally described.