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与冷缺血时间及肺移植其他选定方面相关的供体到受体病原体传播分析——单中心经验

Analysis of Donor to Recipient Pathogen Transmission in Relation to Cold Ischemic Time and Other Selected Aspects of Lung Transplantation-Single Center Experience.

作者信息

Piotrowska Maria, Wojtyś Małgorzata Edyta, Kiełbowski Kajetan, Bielewicz Michał, Wasilewski Piotr, Safranow Krzysztof, Grodzki Tomasz, Kubisa Bartosz

机构信息

Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland.

Students' Scientific Circle of the Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland.

出版信息

Pathogens. 2023 Feb 12;12(2):306. doi: 10.3390/pathogens12020306.

Abstract

BACKGROUND

Infections are one of the leading causes of death in the early postoperative period after lung transplantation (LuTx).

METHODS

We analyzed 59 transplantations and culture results of the donor bronchial aspirates (DBA), graft endobronchial swabs (GES), and recipient cultures (RC) before and after the procedure (RBA). We correlated the results with a cold ischemic time (CIT), recipient intubation time, and length of stay in the hospital and intensive care unit (ICU), among others.

RESULTS

CIT of the first and second lungs were 403 and 541 min, respectively. Forty-two and eighty-three percent of cultures were positive in DBA and GES, respectively. Furthermore, positive results were obtained in 79.7% of RC and in 33.9% of RBA. Longer donor hospitalization was correlated with Gram-negative bacteria isolation in DBA. Longer CIT was associated with Gram-positive bacteria other than in GES and it resulted in longer recipient stay in the ICU. Furthermore, longer CIT resulted in the development of the new pathogens in RBA.

CONCLUSION

Results of GES brought more clinically relevant information than DBA. Donor hospitalization was associated with the occurrence of Gram-negative bacteria. Positive cultures of DBA, GES, and RBA were not associated with recipient death.

摘要

背景

感染是肺移植(LuTx)术后早期死亡的主要原因之一。

方法

我们分析了59例移植手术以及供体支气管吸出物(DBA)、移植肺支气管内拭子(GES)和术后受体培养物(RC)(受体支气管吸出物[RBA])的培养结果。我们将结果与冷缺血时间(CIT)、受体插管时间以及在医院和重症监护病房(ICU)的住院时间等进行了关联分析。

结果

第一侧肺和第二侧肺的CIT分别为403分钟和541分钟。DBA和GES培养物的阳性率分别为42%和83%。此外,RC的阳性率为79.7%,RBA的阳性率为33.9%。供体住院时间延长与DBA中革兰氏阴性菌分离有关。CIT延长与GES中除[具体革兰氏阳性菌未提及]外的革兰氏阳性菌有关,并且导致受体在ICU的住院时间延长。此外,CIT延长导致RBA中出现新的病原体。

结论

GES的结果比DBA提供了更多具有临床相关性的信息。供体住院与革兰氏阴性菌的出现有关。DBA、GES和RBA的阳性培养结果与受体死亡无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9f0/9961556/72f504c29d04/pathogens-12-00306-g001.jpg

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