肺移植术后多重耐药菌感染的防治研究进展  

Research progress in the prevention and treatment of multidrug-resistant organisms infection after lung transplantation

作　　者：白镓玮 马承泰 吴淼[2] 杜贤进[1] BAI Jiawei;MA Chengtai;WU Miao;DU Xianjin(Dept,of Critical Care Medicine,Wuhan 430060,Hubei,China;Dept,of Emergency,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院重症医学科,湖北武汉430060 [2]武汉大学人民医院急诊科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2021年第4期551-557,共7页Medical Journal of Wuhan University

摘　　要：肺移植术后多重耐药菌(MDROs)感染的发病率逐年上升,高达39%以上,成为肺移植术后患者死亡的主要原因之一。肺移植术后最常见的多重耐药菌为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌,以上菌株的耐药率均逐年上升,甚至出现了新的天然耐药,临床可用的抗生素选择越来越少。因此肺移植术后多重耐药菌感染防控和治疗的研究具有十分重要的意义。肺移植术后的MDROs感染主要与肺移植手术特点及ICU住院环境相关,可以通过减少ICU内MDROs的传播及合理使用抗生素来降低肺移植术后患者MDROs感染的风险。对于肺移植术后MDROs感染的患者,吸入性黏菌素和噬菌体疗法有可能成为新的治疗方式。The incidence rate of multidrug-resistant organisms(MDROs) infection after lung transplantation has increased by years, reached more than 39%, which is one of the main causes of death after lung transplantation.Studies have shown that the most common MDROs after lung transplantation are Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae.The resistance rates of the above strains have been increasing year by year, and even new natural resistance has appeared, resulting in a further decrease in the available antibiotics.MDROs infection after lung transplantation is mainly related to the characteristics of lung transplantation and ICU environment.We can reduce the risk of MDROs infection by reducing the transmission of MDROs in ICU and using antibiotics reasonably.For patients with MDROs infection after lung transplantation, inhaling colistin and phage therapy may become new choices.

关 键 词：肺移植 多重耐药菌感染 危险因素 防治 

分 类 号：R617[医药卫生—外科学] R453.2[医药卫生—临床医学]