Inoue Yuji, Ono Tomomichi, Matsui Tamano, Miyasaka Jiro, Kinoshita Yoshihiro, Ihn Hironobu
Department of Dermatology, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
J Dermatol. 2008 Mar;35(3):129-39. doi: 10.1111/j.1346-8138.2008.00432.x.
The frequency of Vibrio vulnificus infection is very rare and there are many questions regarding its epidemiology in Japan. To investigate the clinical course and epidemiology of V. vulnificus infection in Japan, we performed a retrospective questionnaire survey in which 1693 hospitals from all over Japan were surveyed, including advanced life saving emergency centers and dermatology institutions. Of the 1693 hospitals, we received answers from 1045. Ninety-four cases were confirmed as V. vulnificus infections during 1999 and 2003. Sixty-eight (72.3%) of the 94 patients had the septic type infection with a mortality rate of 75.0% (51/68 patients died). The prognosis of patients with the septic type was worse than that of the wound type (P < 0.001). V. vulnificus infections occurred from June to November and none occurred in winter. Many infections occurred in western Japan with the majority of infections (50/94) occurring in Kyushu. In particular, 43 infections occurred in marine coastal areas of the Ariake and Yatsushiro Seas, which have many tidelands. Seventy-seven of 89 patients (86.5%) had liver function impairment as an underlying disease, and 53 (59.6%) had liver cirrhosis, of whom nine (10.1%) suffered from liver cancer. The incidence of V. vulnificus infection was different according to districts. Geographic and climatic factors also contributed to the occurrence of V. vulnificus infection.
创伤弧菌感染的频率非常低，关于其在日本的流行病学仍存在许多问题。为了调查日本创伤弧菌感染的临床病程和流行病学情况，我们进行了一项回顾性问卷调查，调查对象包括日本各地的1693家医院，其中有高级生命救助急救中心和皮肤科机构。在这1693家医院中，我们收到了1045家医院的回复。1999年至2003年期间共确诊94例创伤弧菌感染病例。94例患者中有68例（72.3%）为败血症型感染，死亡率为75.0%（68例中有51例死亡）。败血症型患者的预后比伤口型患者差（P<0.001）。创伤弧菌感染发生在6月至11月，冬季无感染病例。许多感染发生在日本西部，其中大多数感染病例（94例中的50例）发生在九州。特别是，有43例感染发生在有许多潮滩的有明海和八代海的沿海地区。89例患者中有77例（86.5%）有肝功能损害这一基础疾病，53例（59.6%）有肝硬化，其中9例（10.1%）患有肝癌。创伤弧菌感染的发病率因地区而异。地理和气候因素也促成了创伤弧菌感染的发生。
