Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection.
Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection.
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DOI：
10.1111/j.1469-0691.2011.03537.x
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Novel influenza A(H1N1) Study Group of Spanish Network for Research in Infectious Diseases (REIPI)
中科院分区：
文献类型：
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作者：
Cordero E;Pérez-Romero P;Moreno A;Len O;Montejo M;Vidal E;Martín-Dávila P;Fariñas MC;Fernández-Sabé N;Giannella M;Pachón J;Novel influenza A(H1N1) Study Group of Spanish Network for Research in Infectious Diseases (REIPI)
临床微生物感染2012；18：67-73实体器官移植受者面临严重流感相关并发症的风险。2009年甲型H1N1流感大流行合并呼吸道感染的影响尚不清楚。对南澳地区连续发生的甲型H1N1流感大流行病例进行了一项多中心前瞻性研究，以评估其临床特征和结局以及合并感染的危险因素。总体而言，纳入了51名患者。中位移植时间为3.7年 年，围手术期发生率为5.9%，院内获得率为7.8%。15例(29.4%)诊断为肺炎。重症10例(19.6%)：13.7%住进重症监护室，5.9%发生感染性休克，5.9%发生急性排斥反应，7.8%死亡。合并感染15例(29.4%)，其中8例为病毒感染，6例为细菌感染，1例为真菌感染。病毒混合感染并不影响结果。未合并病毒感染的患者预后更差：住院时间较长(26.2 ± 20.7比5.5 ± 10.2)，严重疾病发生率(85.7%比2.3%)和死亡率(42.8%比2.3%)更高。非病毒合并感染的独立危险因素有：糖尿病和感染性休克。其他与严重流感相关的因素还有：延迟的抗病毒治疗、糖尿病、移植后90 天和肺炎。总而言之，甲型流感大流行可能对SOTR造成重大的直接和间接影响，特别是在移植后的早期，应该及早治疗。临床医生应该意识到非病毒合并感染的可能性，主要是在糖尿病患者和重症病例中。应努力通过对患者和环境进行免疫来预防流感。
Clin Microbiol Infect 2012; 18: 67–73 Solid organ transplant recipients (SOTR) are at risk of serious influenza‐related complications. The impact of respiratory co‐infection in SOTR with 2009 pandemic influenza A(H1N1) is unknown. A multicentre prospective study of consecutive cases of pandemic influenza A(H1N1) in SOTR was carried out to assess the clinical characteristics and outcome and the risk factors for co‐infection. Overall, 51 patients were included. Median time from transplant was 3.7 years, 5.9% of the cases occurred perioperatively and 7.8% were hospital‐acquired. Pneumonia was diagnosed in 15 (29.4%) patients. Ten cases were severe (19.6%): 13.7% were admitted to intensive care units, 5.9% suffered septic shock, 5.9% developed acute graft rejection and 7.8% died. Co‐infection was detected in 15 patients (29.4%): eight viral, six bacterial and one fungal. Viral co‐infection did not affect the outcome. Patients with non‐viral co‐infection had a worse outcome: longer hospital stay (26.2 ± 20.7 vs. 5.5 ± 10.2) and higher rate of severe diseases (85.7% vs. 2.3%) and mortality (42.8% vs. 2.3%). Independent risk factors for non‐viral co‐infection were: diabetes mellitus and septic shock. Other factors associated with severe influenza were: delayed antiviral therapy, diabetes mellitus, time since transplantation <90 days and pneumonia. In conclusion, pandemic influenza A can cause significant direct and indirect effects in SOTR, especially in the early post‐transplant period, and should be treated early. Clinicians should be aware of the possibility of non‐viral co‐infection, mainly in diabetic patients and severe cases. An effort should be made to prevent influenza with immunization of the patient and the environment.
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影响因子：
14.6
作者：
Campbell, Alexia;Rodin, Rachel;Pelletier, Louise
通讯作者：
Pelletier, Louise
影响因子：
6.2
作者：
Seville, Maria Teresa A.;Blair, Janis E.;Kusne, Shimon
通讯作者：
Kusne, Shimon
DOI：
10.1016/s1473-3099(10)70133-x
发表时间：
2010-08
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Kumar D;Michaels MG;Morris MI;Green M;Avery RK;Liu C;Danziger-Isakov L;Stosor V;Estabrook M;Gantt S;Marr KA;Martin S;Silveira FP;Razonable RR;Allen UD;Levi ME;Lyon GM;Bell LE;Huprikar S;Patel G;Gregg KS;Pursell K;Helmersen D;Julian KG;Shiley K;Bono B;Dharnidharka VR;Alavi G;Kalpoe JS;Shoham S;Reid GE;Humar A;American Society of Transplantation H1N1 Collaborative Study Group
通讯作者：
American Society of Transplantation H1N1 Collaborative Study Group
影响因子：
14.2
作者：
Viasus, D.;Pano-Pardo, J. R.;Carratala, J.
通讯作者：
Carratala, J.
影响因子：
158.5
作者：
Fine, MJ;Auble, TE;Kapoor, WN
通讯作者：
Kapoor, WN