Zardaryan Eduard, Paronyan Lusine, Bakunts Vahe, Gevorgyan Zaruhi, Asoyan Vigen, Apresyan Hripsime, Hovhannisyan Alvard, Palayan Karo, Kuchuloria Tinatin, Rivard Robert G, Bautista Christian T
The Nork Infectious Clinical Hospital, Yerevan, Armenia.
National Center for Disease Control and Prevention, Yerevan, Armenia.
J Community Health. 2016 Oct;41(5):939-45. doi: 10.1007/s10900-016-0174-x.
In the past, several enteric outbreaks in 1996, 1998, 1999, and 2003 caused by Salmonella typhi, a Gram-negative bacterium, have occurred in Armenia. This study describes the demographic, epidemiological, and clinical characteristics of febrile hospitalized patients with intestinal infections in Armenia. Using a chart review study design, medical data from adult patients who were hospitalized at the Nork hospital during 2010-2012 were reviewed. A total of 600 medical charts were reviewed. Of these, 51 % were diagnosed with intestinal infections. Among these patients, 59 % had an intestinal infection of known etiology, with three main pathogens identified: Salmonella sp. (32 %), Shigella sp. (32 %), and Staphylococcus aureus (18 %). After controlling for the calendar year, age in years, and gender, patients detected with Salmonella sp. were more likely to reported the presence of a family member with similar signs or symptoms [odds ratio (OR) 9.0; 95 % CI 2.4-33.7] and the lack of a water tap at home (OR 3.9; 95 % CI 1.7-9.5). Evidence indicates that Salmonella sp., Shigella sp., and S. aureus as the most common etiologies reported among febrile hospitalized patients. A high percentage of patients had intestinal infections of unknown etiology; thus, improvement in laboratory capacity (enabling more advanced tests, such as polymerase chain reaction) would increase the identification of the enteropathogens causing disease in Armenia.
过去,亚美尼亚曾在1996年、1998年、1999年和2003年发生过几起因革兰氏阴性菌伤寒沙门氏菌引起的肠道疫情。本研究描述了亚美尼亚发热住院的肠道感染患者的人口统计学、流行病学和临床特征。采用图表回顾研究设计,对2010 - 2012年期间在诺尔克医院住院的成年患者的医疗数据进行了回顾。共查阅了600份病历。其中,51%被诊断为肠道感染。在这些患者中,59%患有已知病因的肠道感染,确定了三种主要病原体:沙门氏菌属(32%)、志贺氏菌属(32%)和金黄色葡萄球菌(18%)。在控制了日历年、年龄和性别因素后,检测出沙门氏菌属的患者更有可能报告有家庭成员出现类似体征或症状[比值比(OR)9.0;95%置信区间2.4 - 33.7]以及家中没有水龙头(OR 3.9;95%置信区间1.7 - 9.5)。有证据表明,沙门氏菌属、志贺氏菌属和金黄色葡萄球菌是发热住院患者中报告的最常见病因。很大一部分患者患有病因不明的肠道感染;因此,提高实验室能力(能够进行更先进的检测,如聚合酶链反应)将增加对亚美尼亚致病肠道病原体的识别。