Survival of lung transplant patients with cystic fibrosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria
Survival of lung transplant patients with cystic fibrosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria
复制标题
DOI：
10.1016/j.healun.2007.05.018
复制
发表时间：
2007-08-01
影响因子：
8.9
通讯作者：
Keshavjee, Shaf
中科院分区：
文献类型：
--
作者：
Hadjiliadis, Denis;Steele, Mark P.;Keshavjee, Shaf
背景资料：parresistant细菌的影响，比洋葱伯克霍尔德氏菌，肺移植后的生存囊性fibrosis（CF）患者的影响仍然存在争议：方法：要确定泛耐药的CF患者对肺移植后的生存期的影响进行了回顾性多中心研究。所有肺移植受者与CF的移植前诊断，在多伦多大学（n = 53）和杜克大学（n = 50），包括在内。如果从患者的呼吸道分泌物中分离出至少一个标本，发现细菌对所有测试的抗生素类别具有耐药性或中间耐药性，则将患者纳入泛耐药组。敏感或耐药的B洋葱患者被排除在外，因为其对移植后survival.Results的不利影响：45 103（43.7%）患者窝藏泛耐药菌（43铜绿假单胞菌，我有嗜麦芽窄食单胞菌，和1有无色杆菌木糖氧化）。根据log-rank检验，与敏感菌患者相比，泛耐药菌患者的生存率降低（生存率：3个月时91 +/-14.2% vs 98.3 +/-1.7%; 1年时88.6 +/-4.8% vs 96.6 +/-2.4%; 3年时63.2 +/-8.6% vs 90.7 +/-4.0%; 5年时58.3 +/-9.2% vs 85.6 +/-5.2%; p = 0.016）。两个中心的结果没有显著差异。两组有类似或更好的生存率比CF患者报告的联合网络器官共享（UNOS）registry（1年，86.0%; 3年，65.4%; 5年，49.69%）。结论：CF窝藏泛耐药菌的患者生存率略有下降，但他们的生存率是可比的结果由UNOS注册。
Background: The impact of parresistant bacteria, other than Burkholderia cepacia, on the survival after lung transplantation in patients with cystic fibrosis (CF) remains controversial.Methods: To determine the impact of panresistant bacteria in CF patients on survival after lung transplantation a retrospective multicenter study was performed. All lung transplant recipients with a pre-transplant diagnosis of CF, at the University of Toronto (n = 53) and Duke University (n = 50), were included. Patients were included in the panresistant group if at least one specimen isolated, from their respiratory secretions grew bacteria resistant or intermediate to all classes of antibiotics tested. Patients with sensitive or resistant B cepacia were excluded because of its adverse impact upon post-transplant survival.Results: Forty-five of 103 (43.7%) patients harbored panresistant bacteria (43 had Pseudomonas aeruginosa, I had Stenotrophomonas maltophilia, and 1 had Achromobacter xylosoxidans). According to log-rank test, there was decreased survival in patients with panresistant bacteria compared to patients with sensitive bacteria (survival: 9 1 +/- 1 4.2% vs 98.3 +/- 1.7% at 3 months; 88.6 +/- 4.8% vs 96.6 +/- 2.4% at 1 year; 63.2 +/- 8.6% vs 90.7 +/- 4.0% at 3 years; 58.3 +/- 9.2% vs 85.6 +/- 5.2% at 5 years; p = 0.016). The results did not differ significantly between the two centers. Both groups had similar or better survival than CF patients as reported by the United Network of Organ Sharing (UNOS) registry (1-year, 86.0%; 3 years, 65.4%; 5 years, 49.69%).Conclusions: Patients with CF harboring panresistant bacteria have slightly decreased survival, but their survival is comparable to the results published by the UNOS registry.