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巴尔通体病、“同一健康”与所有生物,无论大小。

Bartonellosis, One Health and all creatures great and small.

作者信息

Breitschwerdt Edward B

机构信息

Department of Clinical Sciences, The Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.

出版信息

Vet Dermatol. 2017 Feb;28(1):96-e21. doi: 10.1111/vde.12413.

Abstract

BACKGROUND

Bartonellosis is a zoonotic infectious disease of worldwide distribution, caused by an expanding number of recently discovered Bartonella spp.

OBJECTIVES

This review serves as an update on comparative medical aspects of this disease, including the epidemiology, pathogenesis, clinical diagnosis, treatment and challenges.

RESULTS

Of comparative medical importance, Bartonella spp. are transmitted by several arthropod vectors, including fleas, keds, lice, sand flies, ticks and, potentially, mites and spiders. Prior to 1990, there was only one named Bartonella species (B. bacilliformis), whereas there are now over 36, of which 17 have been associated with an expanding spectrum of animal and human diseases. Recent advances in diagnostic techniques have facilitated documentation of chronic bloodstream and dermatological infections with Bartonella spp. in healthy and sick animals, in human blood donors, and in immunocompetent and immunocompromised human patients. The field of Bartonella research remains in its infancy and is rich in questions, for which patient relevant answers are badly needed. Directed Bartonella research could substantially reduce a spectrum of chronic and debilitating animal and human diseases, and thereby reduce suffering throughout the world.

CONCLUSION

A One Health approach to this emerging infectious disease is clearly needed to define disease manifestations, to establish the comparative infectious disease pathogenesis of this stealth pathogen, to validate effective treatment regimens and to prevent zoonotic disease transmission.

摘要

背景

巴尔通体病是一种分布于全球的人畜共患传染病,由最近发现的越来越多的巴尔通体菌种引起。

目的

本综述旨在更新该疾病的比较医学方面内容,包括流行病学、发病机制、临床诊断、治疗及挑战。

结果

在比较医学方面具有重要意义的是,巴尔通体菌种可通过多种节肢动物媒介传播,包括跳蚤、蜱蝇、虱子、白蛉、蜱,可能还有螨虫和蜘蛛。1990年之前,仅有一种命名的巴尔通体菌种(杆菌状巴尔通体),而现在有超过36种,其中17种与范围不断扩大的动物和人类疾病有关。诊断技术的最新进展有助于记录健康和患病动物、人类献血者以及免疫功能正常和免疫功能低下的人类患者中巴尔通体菌种引起的慢性血液和皮肤感染。巴尔通体研究领域仍处于起步阶段,存在诸多问题,急需与患者相关的答案。有针对性的巴尔通体研究可大幅减少一系列慢性和使人衰弱的动物和人类疾病,从而减轻世界各地的痛苦。

结论

显然需要采取“同一健康”方法来应对这种新兴传染病,以确定疾病表现,确立这种隐匿性病原体的比较传染病发病机制,验证有效的治疗方案并预防人畜共患病传播。

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