Zheng H, Sun Y, Lin S, Mao Z, Jiang B
Institute of Digestive Diseases, Nanfang Hospital, Southern Medical University, Guangzhou (Canton), 510515, China.
Eur J Clin Microbiol Infect Dis. 2008 Aug;27(8):741-52. doi: 10.1007/s10096-008-0562-y. Epub 2008 Jun 25.
In this study, we hoped to provide valuable clinical information on yersiniosis for clinicians. Two thousand six hundred stool samples were collected from in- and outpatients with diarrhea, which were tested with both culture method and real-time polymerase chain reaction (RT-PCR). In total, 188 positive samples were detected by RT-PCR (178) and culture method (160), while the incidence was about 7.23%. The detection rate of RT-PCR was significantly higher than culture method and a higher incidence in autumn-winter was also noticeably identified than in spring-summer. Infection sources mostly focused on unboiled foods (101) and pets (45), while clinical manifestation mainly presented as gastroenteritis (156), pseudoappendicitis (32), and extraintestinal complications (46). The morbidity of extraintestinal complications in adults was significantly higher than in children and it was the same for high-risk patients between adults over the age of 60 years (4.7%) and children under the age of 3 years (1.4%), whereas the constituent ratio of children versus adults with yersiniosis in different systems was not significant. Of 160 isolates tested for antimicrobial susceptibility, the majority were susceptible to third-generation cephalosporins, aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole, whereas only a small portion was susceptible to the first-generation cephalosporins and penicillins. During autumn-winter months, clinicians should pay more attention to clinical manifestation, early diagnosis, and treatment with susceptible antibiotics of yersiniosis and its complications, targeting high-risk patients.
在本研究中，我们希望为临床医生提供有关耶尔森菌病的有价值的临床信息。从腹泻门诊和住院患者中收集了2600份粪便样本，采用培养法和实时聚合酶链反应（RT-PCR）进行检测。RT-PCR检测出178份阳性样本，培养法检测出160份阳性样本，总发病率约为7.23%。RT-PCR的检出率显著高于培养法，且秋冬季节的发病率明显高于春夏季节。感染源主要集中在未煮熟的食物（101例）和宠物（45例），临床表现主要为胃肠炎（156例）、假性阑尾炎（32例）和肠外并发症（46例）。成人肠外并发症的发病率显著高于儿童，60岁以上成人（4.7%）和3岁以下儿童（1.4%）的高危患者发病率相同，而不同系统中耶尔森菌病儿童与成人的构成比无显著差异。在160株进行药敏试验的分离株中，大多数对第三代头孢菌素、氨基糖苷类、氟喹诺酮类和甲氧苄啶-磺胺甲恶唑敏感，而只有一小部分对第一代头孢菌素和青霉素敏感。在秋冬季节，临床医生应更加关注耶尔森菌病及其并发症的临床表现、早期诊断以及对高危患者使用敏感抗生素进行治疗。
