Transmission of Cryptococcus neoformans by Organ Transplantation
Transmission of Cryptococcus neoformans by Organ Transplantation
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DOI：
10.1093/cid/ciq216
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发表时间：
2011-02-01
影响因子：
11.8
通讯作者：
Bower, William A.
中科院分区：
文献类型：
--
作者：
Baddley, John W.;Schain, Denise C.;Bower, William A.
背景资料。本文介绍了固体器官移植传播新生隐球菌的方法。我们回顾了病历，并对分离株进行了分子基因分型，以确定隐球菌供者传播的可能性。在3例接受来自共同供者的器官的患者中被诊断为隐球菌病，患者死亡时患有未分化的神经系统疾病。后来在尸检中发现捐赠者患有隐球菌性脑膜脑炎。1例肝脏和1例肾移植受者出现隐球菌血症和肺炎，另1例肾移植受者出现隐球菌血症和脑膜炎；2例患者经长期抗真菌治疗后痊愈。对4株受体分离株进行多位点测序分型，发现它们具有相同的等位基因。我们的调查记录了新生隐球菌通过器官移植的传播。对有不明原因神经系统症状的供者进行隐球菌病的评估应予以高度重视。
Background. This article describes transmission of Cryptococcus neoformans by solid organ transplantation.Methods. We reviewed medical records and performed molecular genotyping of isolates to determine potential for donor transmission of Cryptococcus.Results. Cryptococcosis was diagnosed in 3 recipients of organs from a common donor with an undifferentiated neurologic condition at the time of death. Cryptococcal meningoencephalitis was later diagnosed in the donor at autopsy. The liver and 1 kidney recipient developed cryptococcemia and pneumonia and the other kidney recipient developed cryptococcemia and meningitis; 2 patients recovered with prolonged antifungal therapy. We tested 4 recipient isolates with multilocus sequence typing and found they had identical alleles.Conclusions. Our investigation documents the transmission of Cryptococcus neoformans by organ transplantation. Evaluation for cryptococcosis in donors with unexplained neurologic symptoms should be strongly considered.