Infections in solid-organ transplant recipients

摘要

Despite remarkable progress and dramatic improvement in surgical techniques, immunosup-pressive therapy, and postoperative management, infections remain a significant complication and a major cause of death after transplantation. The spectrum of infectious complications in organ transplant recipients, however, has continued to evolve. For example, a decrease in cytomegalo-virus (CMV)-associated deaths (attributable largely to effective therapy and improved prophylaxis) and a marked decline in the incidence of Pneumocystis carinii pneumonia (as a result of routine use of prophylaxis) have been documented in recent years. In contrast, the incidence of infections caused by gram-positive cocci (van-comycin-resistant enterococci and methicillin-resistant Staphylococcus aureus) has increased, and opportunistic mycoses (e.g., invasive asper-gillosis) continue to be associated with very high mortality rates. New (or previously unrecognized) pathogens have also been reported in transplant recipients. This report is an overview of the current knowledge of infections in organ transplant recipients with emphasis on advances in diagnosis and prevention.