Wielders Cornelia C H, Boerman Anneroos W, Schimmer Barbara, van den Brom René, Notermans Daan W, van der Hoek Wim, Schneeberger Peter M
Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
PLoS One. 2015 Jan 20;10(1):e0116937. doi: 10.1371/journal.pone.0116937. eCollection 2015.
Little is known about the development of chronic Q fever in occupational risk groups. The aim of this study was to perform long-term follow-up of Coxiella burnetii seropositive veterinarians and investigate the course of IgG phase I and phase II antibodies against C. burnetii antigens and to compare this course with that in patients previously diagnosed with acute Q fever.
Veterinarians with IgG phase I ≥ 1:256 (immunofluorescence assay) that participated in a previous seroprevalence study were asked to provide a second blood sample three years later. IgG antibody profiles were compared to a group of acute Q fever patients who had IgG phase I ≥ 1:256 twelve months after diagnosis.
IgG phase I was detected in all veterinarians (n = 76) and in 85% of Q fever patients (n = 98) after three years (p<0.001). IgG phase I ≥ 1:1,024, indicating possible chronic Q fever, was found in 36% of veterinarians and 12% of patients (OR 3.95, 95% CI: 1.84-8.49).
IgG phase I persists among veterinarians presumably because of continuous exposure to C. burnetii during their work. Serological and clinical follow-up of occupationally exposed risk groups should be considered.
关于职业风险群体中慢性Q热的发展情况，人们了解甚少。本研究的目的是对伯氏考克斯体血清反应阳性的兽医进行长期随访，调查针对伯氏考克斯体抗原的IgG I期和II期抗体的变化过程，并将此过程与先前诊断为急性Q热的患者进行比较。
邀请参与先前血清流行率研究且IgG I期≥1:256（免疫荧光法）的兽医在三年后提供第二份血样。将IgG抗体谱与一组诊断后十二个月时IgG I期≥1:256的急性Q热患者进行比较。
三年后，所有兽医（n = 76）和85%的Q热患者（n = 98）检测到IgG I期（p<0.001）。36%的兽医和12%的患者中发现IgG I期≥1:1,024，表明可能患有慢性Q热（比值比3.95，95%置信区间：1.84 - 8.49）。
兽医中IgG I期持续存在，推测是因为他们在工作中持续接触伯氏考克斯体。应考虑对职业暴露风险群体进行血清学和临床随访。
