■免疫球蛋白水平和功能降低导致抗体缺乏,越来越容易受到,主要是,细菌感染。初级抗体缺乏包括B细胞生理学的内在缺陷,通常是由于继承的错误。血液恶性肿瘤或B细胞抑制疗法是二级抗体缺乏的主要原因。尽管免疫球蛋白替代疗法(IGRT)降低了抗体缺乏患者的感染负担,呼吸道感染仍然是一个巨大的健康负担。我们假设肺部病理和胃食管反流病(GORD)会增加抗体缺乏患者肺炎的风险,就像普通人群一样。
■对于我们的原发性抗体缺乏和继发性抗体缺乏的患者队列,我们回顾了他们的呼吸道感染负担以及肺部病变和GORD的影响.
■在三级转诊中心接受IGRT的231名患者的医疗记录,从2014年10月26日至2021年2月19日,我们进行了审查,以确定痰标本中的微生物分离株以及常见肺部病变和GORD的患病率。
■嗜血杆菌和假单胞菌代表了巨大的感染负担,在30.2%和21.4%的痰样本中发现了生长,分别;丝状真菌和分枝杆菌感染很少见。肺部病理诊断增加了假单胞菌患者的比例,克雷伯菌属,窄食单胞菌,和从痰中分离出的念珠菌,诊断为GORD的肠杆菌和念珠菌的比例增加。
■尽管存在IGRT,但一级抗体缺乏和二级抗体缺乏仍然存在细菌呼吸道感染负担。肺部病理促进对IGRT较不敏感的物种的生长,因此,专科呼吸医学的输入和额外的治疗,如吸入抗生素表明,以优化呼吸结果。
UNASSIGNED: Antibody deficiencies result from reduced immunoglobulin levels and function, increasing susceptibility to, primarily, bacterial infection. Primary antibody deficiencies comprise intrinsic defects in B-cell physiology, often due to inherited errors. Hematological malignancies or B-cell suppressive therapy are major causes of secondary antibody deficiency. Although immunoglobulin replacement therapy (IGRT) reduces infectious burden in antibody deficiency patients, respiratory tract infections remain a significant health burden. We hypothesize that lung pathology and gastroesophageal reflux disease (GORD) increase the risk of pneumonia in antibody deficiency patients, as in the general population.
UNASSIGNED: For our cohort of patients with primary antibody deficiency and secondary antibody deficiency, we reviewed their respiratory infectious burden and the impact of lung pathologies and GORD.
UNASSIGNED: The medical records of 231 patients on IGRT at a tertiary referral center, from October 26, 2014, to February 19, 2021, were reviewed to determine microbial isolates from sputum samples and prevalence of common lung pathologies and GORD.
UNASSIGNED: Haemophilus and Pseudomonas species represent a large infectious burden, being identified in 30.2% and 21.4% of sputum samples demonstrating growth, respectively; filamentous fungal and mycobacterial infections were rare. Diagnosed lung pathology increased the proportion of patients with Pseudomonas, Klebsiella, Stenotrophomonas, and Candida species isolated in their sputum, and diagnosed GORD increased the proportion with Enterobacter and Candida species isolated.
UNASSIGNED: Bacterial respiratory infectious burden remains in primary antibody deficiency and secondary antibody deficiency despite IGRT. Lung pathologies encourage growth of species less susceptible to IGRT, so specialist respiratory medicine input and additional treatments such as inhaled antibiotics are indicated to optimize respiratory outcomes.