Mucormycosis in renal transplant recipients: review of 174 reported cases.
Mucormycosis in renal transplant recipients: review of 174 reported cases.
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肾移植受者毛霉菌病：174 例报告病例回顾
DOI：
10.1186/s12879-017-2381-1
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发表时间：
2017-04-18
影响因子：
3.7
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Song Y;Qiao J;Giovanni G;Liu G;Yang H;Wu J;Chen J
背景毛霉菌病是一种高致死性真菌感染，尤其是在免疫功能低下的individuals. MethodsTo审查的流行病学，诊断和治疗毛霉菌病在肾移植recipients. ResultsA肾移植recipients. ResultsA共174例肾移植recipients. ResultsA肾移植recipients. ResultsA肾移植recipients.大多数病例（76%）为男性。主要基础疾病为糖尿病（43.1%）。感染部位以鼻脑最多见（33.3%），病原菌以根霉菌最多见（59.1%）。其中播散性毛霉菌病（76.0%）和移植肾（55.6%）的死亡率高于其他部位感染。手术清创联合抗真菌B/泊沙康唑治疗组的总生存率（70.2%）高于单纯抗真菌治疗组（32.4%）、单纯手术组（36.4%）和未治疗组（0%）（p< 0.001）。接受泊沙康唑和脂质体阿霉素B治疗的患者的总生存率高于接受脱氧胆酸盐制剂的患者（92.3%和73.4%vs47.4%.ConclusionsMucoromycosis是肾移植受者的严重感染。手术清创联合抗真菌药物，特别是脂质体阿替西霉素B和泊沙康唑，可以显著提高患者的总体生存率。
BackgroundMucormycosis is a highly lethal fungal infection especially in immunocompromised individuals.MethodsIn order to review the epidemiology, diagnosis, and treatment of mucormycosis in renal transplant recipients we searched publications of mucormycosis cases in renal transplant recipients in PUBMED database up to December 2015.ResultsA total of 174 cases in renal transplant recipients were included in this review. Most of the cases (76%) were male. Major underlying diseases were diabetes mellitus (43.1%). Rhinocerebral was the most common site of infection (33.3%).Rhizopusspecies was the most frequent fungus (59.1%) in patients with pathogen identified to species level. The mortality rates of disseminated mucormycosis (76.0%) and graft renal (55.6%) were higher than infection in other sites. The overall survival in patients received surgical debridement combined with amphotericin B/posaconazole (70.2%) was higher than those who received antifungal therapy alone (32.4%), surgery alone (36.4%) or without therapy (0%) (p< 0.001). The overall survivals in patients receiving posaconazole and lipid amphoterincin B were higher than that receiving deoxycholate formulation (92.3% and 73.4% vs 47.4%).ConclusionsMucormycosis is a severe infection in renal transplant recipients. Surgical debridement combined with antifungals, especially liposomal amphotericin B and posaconazole, can significantly improve patient’s overall survival.