506 例血流感染中与牛链球菌生物型相关的临床流行病学和恶性肿瘤。
The clinical epidemiology and malignancies associated with Streptococcus bovis biotypes in 506 cases of bloodstream infections.
机构信息
Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
出版信息
J Infect. 2015 Sep;71(3):317-25. doi: 10.1016/j.jinf.2015.05.005. Epub 2015 May 14.
OBJECTIVES
To determine the incidence of Streptococcus bovis (Sb) biotypes causing bacteraemia and associated malignancies.
METHODS
This is a retrospective analysis of patients with Sb bacteraemia, pulled out from a prospective surveillance protocol of bacteraemia cases, in three areas of Spain (1990-2013): a cattle area (Lugo), a fishing area (Ferrol) and an urban area (Barcelona). Colonoscopy and Sb biotypes (Sb-I and Sb-II) were determined in most cases.
RESULTS
506 patients with Sb bacteraemia; mean age 68.1 (±14.1) years, and 66.2% were males. The cattle area, compared with the fishing and urban areas, had higher incidence of bacteraemia by SbI (40.29 vs 9.38 vs 6.15 cases/10(6) person-years, P < 0.001) and bacteraemia by Sb-II (29.07 vs 9.84 vs 13.37 cases/10(6) person-years, P < 0.001). The Sb-I cases (n = 224), compared with Sb-II cases (n = 270), had greater rates of endocarditis (77.6% vs 9.6%, P < 0.001) and colorectal neoplasm (CRN) (50.9% vs 16.6%, P < 0.001), and smaller rates of biliary tract infection (2.2% vs 29.6%, P < 0.001) and non-colorectal malignancy (8.9% vs 31.4%, P < 0.001).
CONCLUSION
There was a link between the cattle area and higher incidence of Sb bacteraemia. Sb-I differed from Sb-II cases in clinical findings and associated malignancies. Colonoscopy is mandatory in cases of endocarditis or bacteraemia caused by Sb-I.
目的
确定导致菌血症和相关恶性肿瘤的牛链球菌（Sb）生物型的发生率。
方法
这是对西班牙三个地区（1990-2013 年）进行 Sb 菌血症前瞻性监测方案中提取的 Sb 菌血症患者的回顾性分析：一个牛区（卢戈）、一个渔业区（费罗尔）和一个城市区（巴塞罗那）。大多数情况下都进行了结肠镜检查和 Sb 生物型（Sb-I 和 Sb-II）测定。
结果
506 例 Sb 菌血症患者；平均年龄 68.1（±14.1）岁，66.2%为男性。与渔业区和城市区相比，牛区 SbI 所致菌血症的发生率更高（40.29 比 9.38 比 6.15 例/106 人年，P < 0.001），Sb-II 所致菌血症的发生率更高（29.07 比 9.84 比 13.37 例/106 人年，P < 0.001）。与 Sb-II 病例（n = 270）相比，Sb-I 病例（n = 224）的心脏病（77.6%比 9.6%，P < 0.001）和结直肠癌（CRN）（50.9%比 16.6%，P < 0.001）发生率更高，胆道感染（2.2%比 29.6%，P < 0.001）和非结直肠癌恶性肿瘤（8.9%比 31.4%，P < 0.001）发生率更低。
结论
牛区与 Sb 菌血症发生率较高有关。与 Sb-II 病例相比，Sb-I 病例的临床表现和相关恶性肿瘤不同。对于 Sb-I 引起的心内膜炎或菌血症，必须进行结肠镜检查。
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