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[林业工人和农民中由伯氏疏螺旋体引起的职业感染风险]

[Risk of occupational infections caused by Borrelia burgdorferi among forestry workers and farmers].

作者信息

Tokarska-Rodak Małgorzata, Plewik Dorota, Kozioł-Montewka Maria, Szepeluk Adam, Paszkiewicz Justyna

出版信息

Med Pr. 2014;65(1):109-17. doi: 10.13075/mp.5893.2014.017.

Abstract

BACKGROUND

The aim of the work was to analyze the incidence of infection with Borrelia burgdorferi in forestry workers and farmers, major groups occupationally exposed to tick bites.

MATERIAL AND METHODS

The study group included 275 workers (171 foresters and 104 farmers). The control group consisted of 45 people, who have not been occupationally exposed to tick bites. The screening Elisa and Wb tests for the presence of anti-Borrelia IgM/IgG antibodies were performed in all subjects of the study and control groups. Statistical analysis was performed using the Chi2 test.

RESULTS

The positive results denoting the presence of anti-Borrelia IgM/IgG antibodies were found in 55% of farmers and 28% of foresters occupationally exposed to Lyme borreliosis and coming from the area of South Podlasie Lowland and Lublin Polesie. The differences between the forestry workers and the control group (p < or = 0.00001) and between farmers and the control group (p < or = 0.001) were statistically significant. The species, such as B. spielmanii and B. bavariensis, which have not yet been reported in Poland, are significant etiologic agents of Lyme disease.

CONCLUSION

The risk of occupational exposure to the B. burgdorferi infection is high for foresters and farmers, and the infection with spirochetes is frequently confirmed on the basis of positive results of the Wb test. The presence of specific antibodies against protein antigens of B. spielmanii and B. bavariensis suggest that these bacteria can cause Lyme disease both independently and in participation with other Borrelia species, which influences the development of the clinical manifestations of infection.

摘要

背景

本研究旨在分析林业工人和农民这两个主要职业性暴露于蜱叮咬的群体中伯氏疏螺旋体感染的发生率。

材料与方法

研究组包括275名工人(171名林业工人和104名农民)。对照组由45名未职业性暴露于蜱叮咬的人员组成。对研究组和对照组的所有受试者进行了检测抗伯氏疏螺旋体IgM/IgG抗体的筛查酶联免疫吸附试验(ELISA)和免疫印迹法(Wb)检测。采用卡方检验进行统计分析。

结果

在来自南波德拉斯低地和卢布林波列西地区、职业性暴露于莱姆病螺旋体的农民中,55%检测出抗伯氏疏螺旋体IgM/IgG抗体呈阳性,林业工人中这一比例为28%。林业工人与对照组之间(p≤0.00001)以及农民与对照组之间(p≤0.001)的差异具有统计学意义。尚未在波兰报道过的施氏疏螺旋体和巴伐利亚疏螺旋体等菌种是莱姆病的重要病原体。

结论

林业工人和农民职业性暴露于伯氏疏螺旋体感染的风险较高,基于免疫印迹法检测结果呈阳性,经常可确诊螺旋体感染。针对施氏疏螺旋体和巴伐利亚疏螺旋体蛋白抗原的特异性抗体的存在表明,这些细菌既能独立引起莱姆病,也能与其他疏螺旋体菌种共同导致莱姆病,这会影响感染临床表现的发展。

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