Genomic characterization of recurrent mold infections in thoracic transplant recipients.
Genomic characterization of recurrent mold infections in thoracic transplant recipients.
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胸腔移植受者复发性霉菌感染的基因组特征。
DOI：
10.1111/tid.12935
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Perfect,JohnR
中科院分区：
文献类型：
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作者：
Messina,JuliaA;Wolfe,CameronR;Hemmersbach-Miller,Marion;Milano,Carmelo;Todd,JamieL;Reynolds,John;Alexander,BarbaraD;Schell,WileyA;Cuomo,ChristinaA;Perfect,JohnR
胸部器官移植受者的侵袭性霉菌病是一种公认的并发症，但霉菌在人体内的长期存留和宿主防御的逃避尚未得到充分描述。我们报告了 2 例胸部移植受者的侵袭性霉菌病（疣状疣和烟曲霉）病例，这些受者在侵袭性疾病出现前数年就培养了相同的霉菌。使用全基因组测序对两名患者的指示感染和复发感染的配对分离株进行比较，以确定同一菌株是否引起指示感染和复发感染。在案例 1 中，发现分离株属于同一菌株，表明移植前鉴定出的初始定植分离株最终在移植后引起侵袭性霉菌病，而在案例 2 中，2 个分离株不属于同一菌株。这些结果表明，在侵袭性霉菌病发生之前，霉菌很可能在人体内持续存在多年，或者存在一种以上菌株反复、持续感染的长期风险。鼓励对 IMD 的长期分子流行病学和移植受者霉菌持续存在的危险因素进行进一步研究。
Invasive mold disease in thoracic organ transplant recipients is a well‐recognized complication, but the long‐term persistence of molds within the human body and evasion of host defenses has not been well‐described. We present 2 cases of invasive mold disease (Verruconis gallopavaandAspergillus fumigatus) in thoracic transplant recipients who had the same mold cultured years prior to the invasive disease presentation. The paired isolates from the index and recurrent infections in both patients were compared using whole‐genome sequencing to determine if the same strain of mold caused both the index and recurrent infections. In Case 1, the isolates were found to be of the same strain indicating that the initial colonizing isolate identified pre‐transplant eventually caused invasive mold disease post‐transplant while in Case 2, the 2 isolates were not of the same strain. These results demonstrate the distinct possibility of molds both persisting within the human body for years prior to invasive mold disease or the long‐term risk of recurrent, persistent infection with more than one strain. Further studies of long‐term molecular epidemiology of IMD and risk factors for mold persistence in transplant recipients are encouraged.