解读和管理革兰氏阴性菌阳性的保存液。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2024-12-01 Epub Date: 2024-08-05 DOI:10.1097/QCO.0000000000001058
Maddalena Peghin, Elena Graziano, Paolo Antonio Grossi
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引用次数: 0

摘要

审查目的:移植前培养实体器官保存液并非标准化程序。在这篇综述中,我们旨在描述在这种有争议的情况下的最新文献证据,并特别关注革兰氏阴性菌(GNB):最近的研究结果:保存液污染很常见,但与保存液相关的感染却很少见,最常见的是由包括革兰氏阴性菌在内的高危病原体引起的感染。与 GNB 相关的保存液感染具有高发病率和高死亡率的特点。最近的研究显示,接受根据保存液培养结果定制的抗生素治疗的实体器官移植受者的预后有所改善,尤其是在发现耐多药 GNB 的情况下。摘要:培养保存液是预防供体源性感染的进一步措施。解读和处理 GNB 阳性需要一个具备特定技能的多学科团队。要深入了解保存液培养的真正作用、保存液阳性的作用以及抗菌治疗的影响,还需要进行标准化的随机试验。
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Interpreting and managing preservation fluids positive for Gram-negative bacteria.

Purpose of review: Culturing preservation fluids of solid organs before transplantation is not a standardized procedure. In this review, we aim to describe the state-of-the-art of literature evidence in this debated setting with a special focus on Gram-negative bacteria (GNB).

Recent findings: Contamination of preservation fluids is frequent, but preservation fluids related infections are rare and most commonly caused by high-risk pathogens, including GNB. GNB preservation fluids related infections are characterized by high morbidity and mortality. Recent studies showed improved outcomes in solid organ transplant recipients receiving antibiotic therapy tailored according to preservation fluids cultures especially when multidrug-resistant GNB are found. A robust procurement network is needed to alert recipients' centers in cases of positivity and the support of transplant infectious diseases specialists is essential to choose the best therapy.

Summary: Culturing preservation fluids is a further step into preventing donor-derived infections. Interpreting and managing GNB positivity require a multidisciplinary team with specific skills. Standardized randomized trials are needed for insight into the real utility of preservation fluids cultures, the role of preservation fluids positivity, and the impact of antimicrobial therapy.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
期刊最新文献
Effective strategies for managing trimethoprim-sulfamethoxazole and levofloxacin-resistant Stenotrophomonas maltophilia infections: bridging the gap between scientific evidence and clinical practice. The many faces of brucellosis: diagnostic and management approach. New antibiotics in clinical pipeline for treating infections caused by metallo-β-lactamases producing Gram-negative bacteria. When antimicrobial stewardship begins with microbiological test requests: the case of asymptomatic bacteriuria. Interpreting and managing preservation fluids positive for Gram-negative bacteria.
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