实体器官移植术后隐球菌感染诊治的研究进展

杜安通1,2,周兆婧2,3,郭天阳1,2,廖万清2,方伟2,3

微生物与感染 ›› 2015, Vol. 10 ›› Issue (2) : 122-126.

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微生物与感染 ›› 2015, Vol. 10 ›› Issue (2) : 122-126.
综述

实体器官移植术后隐球菌感染诊治的研究进展

  • 杜安通1,2,周兆婧2,3,郭天阳1,2,廖万清2,方伟2,3
作者信息 +

Progress in diagnosis and treatment of cryptococcosis associated with solid organ transplantation

  • DU An-Tong1,2, ZHOU Zhao-Jing2,3, GUO Tian-Yang1,2, LIAO Wan-Qing2, FANG Wei2,3
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摘要

隐球菌是实体器官移植术后最常见的致病性真菌之一,主要通过呼吸道入侵机体并播散至全身,尤嗜中枢神经系统。隐球菌感染如不及时治疗,病死率极高。实体器官移植术后隐球菌感染的主要危险因素包括术前发热、术后免疫抑制剂和抗生素使用、术后导管留置时间、术后感染及大剂量糖皮质激素使用等。其临床症状缺少特异性,早期诊断较困难。实体器官移植术后抗隐球菌治疗主要包括两性霉素B、氟胞嘧啶、氟康唑等,具体方案通常视患者免疫状态和器官功能而定。本文综述了实体器官移植术后隐球菌病诊断和治疗方面的研究进展。

Abstract

Cryptococcus neoformans species complex is one of the most common fungal pathogens for solid organ transplantation, which invades the host mostly through respiratory tract and then disseminated to remote organs especially central nervous system. Without prompt treatment, cryptococcal infection has very high mortality and morbidity. The main risk factors include preoperative fever, postoperative application of antibiotics and immunosuppressors, postoperative bacterial and (or) viral infection, and the large dose use of glucocorticoid. Due to its lack of unique clinical features, it is difficult to make early diagnosis of cryptococcal infection. At present, amphotericin B, fluconazole and flucytosine are still the first-line drugs. The exact therapeutic regimen depends on the immune status and organ function of the host. This review mainly focuses on the progress in the diagnosis and treatment of cryptococcal infection after solid organ transplantation.

关键词

隐球菌病 / 实体器官移植 / 危险因素 / 诊断 / 治疗

Key words

Cyrptococcosis / Solid organ transplantation / Risk factor / Diagnosis;Therapy

引用本文

导出引用
杜安通1,2,周兆婧2,3,郭天阳1,2,廖万清2,方伟2,3. 实体器官移植术后隐球菌感染诊治的研究进展[J]. 微生物与感染. 2015, 10(2): 122-126
DU An-Tong1,2, ZHOU Zhao-Jing2,3, GUO Tian-Yang1,2, LIAO Wan-Qing2, FANG Wei2,3. Progress in diagnosis and treatment of cryptococcosis associated with solid organ transplantation[J]. Journal of Microbes and Infections. 2015, 10(2): 122-126

基金

国家重点基础研究发展计划(2013CB531601),上海市自然科学基金(12ZR1454400、12JC1411000),上海市医学真菌分子生物学实验室基金(14DZ2272900)


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