Epidemiology of Invasive Mold Infections in Lung Transplant Recipients
Epidemiology of Invasive Mold Infections in Lung Transplant Recipients
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DOI：
10.1111/ajt.12691
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发表时间：
2014-06-01
影响因子：
8.8
通讯作者：
Alexander, B. D.
中科院分区：
文献类型：
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作者：
Doligalski, C. T.;Benedict, K.;Alexander, B. D.
侵袭性霉菌感染（IMIs）是肺移植受者（LTR）发病率和死亡率的主要来源，但有关IMI在这一人群中的流行病学信息有限。从2001年到2006年，移植相关感染监测网络对LTR中的IMIs进行了多中心前瞻性监测。IMI的流行病学在队列中的所有LTR的报告。在美国15个中心监测的12%（143/ 1173）的LTR发生了IMI感染。IMI的12个月累计发生率为5.5%; 3个月全因死亡率为21.7%。曲霉菌引起大多数（72.7%）IMI;非曲霉菌感染（39，27.3%）包括Scedosporium（5，3.5%），毛霉菌病（3，2.1%）和“未指明”或“其他”霉菌感染（31，21.7%）。迟发性IMI很常见：52%发生在移植后1年内（中位数11个月，范围0-162个月）。IMI是LTR中常见的迟发性并发症，死亡率较高。应监测LTR中的迟发性IMI，并应根据可能的病原体优化预防药物。
Invasive mold infections (IMIs) are a major source of morbidity and mortality among lung transplant recipients (LTRs), yet information regarding the epidemiology of IMI in this population is limited. From 2001 to 2006, multicenter prospective surveillance for IMIs among LTR was conducted by the Transplant-Associated Infection Surveillance Network. The epidemiology of IMI among all LTRs in the cohort is reported. Twelve percent (143/ 1173) of LTRs under surveillance at 15 US centers developed IMI infections. The 12-month cumulative incidence of IMIs was 5.5%; 3-month all-cause mortality was 21.7%. Aspergillus caused the majority (72.7%) of IMIs; non-Aspergillus infections (39, 27.3%) included Scedosporium (5, 3.5%), mucormycosis (3, 2.1%) and "unspecified'' or "other'' mold infections (31, 21.7%). Late-onset IMI was common: 52% occurred within 1 year posttransplant (median 11 months, range 0-162 months). IMIs are common late-onset complications with substantial mortality in LTRs. LTRs should be monitored for late-onset IMIs and prophylactic agents should be optimized based on likely pathogen.