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类鼻疽的预测全球分布及负担。

Predicted global distribution of and burden of melioidosis.

作者信息

Limmathurotsakul Direk, Golding Nick, Dance David Ab, Messina Jane P, Pigott David M, Moyes Catherine L, Rolim Dionne B, Bertherat Eric, Day Nicholas Pj, Peacock Sharon J, Hay Simon I

机构信息

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand ; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom.

出版信息

Nat Microbiol. 2016 Jan 1;1(1). doi: 10.1038/nmicrobiol.2015.8.

Abstract

a highly pathogenic bacterium that causes melioidosis, is commonly found in soil in Southeast Asia and Northern Australia. Melioidosis can be difficult to diagnose due to its diverse clinical manifestations and the inadequacy of conventional bacterial identification methods. The bacterium is intrinsically resistant to a wide range of antimicrobials, and treatment with ineffective antimicrobials may result in case fatality rates (CFRs) exceeding 70%. The importation of infected animals has, in the past, spread melioidosis to non-endemic areas. The global distribution of and burden of melioidosis, however, remain poorly understood. Here, we map documented human and animal cases, and the presence of environmental , and combine this in a formal modelling framework to estimate the global burden of melioidosis. We estimate there to be 165,000 (95% credible interval 68,000-412,000) human melioidosis cases per year worldwide, of which 89,000 (36,000-227,000) die. Our estimates suggest that melioidosis is severely underreported in the 45 countries in which it is known to be endemic and that melioidosis is likely endemic in a further 34 countries which have never reported the disease. The large numbers of estimated cases and fatalities emphasise that the disease warrants renewed attention from public health officials and policy makers.

摘要

一种导致类鼻疽的高致病性细菌,常见于东南亚和澳大利亚北部的土壤中。由于其临床表现多样以及传统细菌鉴定方法的不足,类鼻疽可能难以诊断。这种细菌对多种抗菌药物具有内在抗性,使用无效的抗菌药物进行治疗可能导致病死率超过70%。过去,受感染动物的进口已将类鼻疽传播到非流行地区。然而,类鼻疽在全球的分布情况以及疾病负担仍知之甚少。在此,我们绘制已记录的人类和动物病例以及环境中该细菌的存在情况,并将其纳入一个正式的建模框架中,以估计类鼻疽的全球负担。我们估计全球每年有16.5万例(95%可信区间为6.8万 - 41.2万例)人类类鼻疽病例,其中8.9万例(3.6万 - 22.7万例)死亡。我们的估计表明,在已知为类鼻疽流行的45个国家中,该疾病的报告严重不足,并且在另外34个从未报告过该疾病的国家中,类鼻疽可能也呈地方性流行。大量估计病例和死亡人数强调,该疾病值得公共卫生官员和政策制定者重新关注。

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