Wellcome Trust Major Overseas Programme - Oxford University Clinical Research Unit, 78 Giai Phong, Dong Da, Ha Noi, Viet Nam; Nuffield Department of Medicine, University of Oxford, Oxford OX1 3BD, UK.
Wellcome Trust Major Overseas Programme - Oxford University Clinical Research Unit, 78 Giai Phong, Dong Da, Ha Noi, Viet Nam.
J Infect. 2018 Feb;76(2):159-167. doi: 10.1016/j.jinf.2017.09.019. Epub 2017 Sep 29.
Streptococcus suis is a zoonotic cause of severe meningitis and sepsis in humans. We aimed to assess the long-term outcomes in patients who survived S. suis infection, in particular the progress and impact of vestibulocochlear sequelae.
This case-control study evaluated outcomes of S. suis infection at discharge and 3 and 9 months post-discharge for 47 prospectively enrolled cases and at 11-34 months for 31 retrospectively enrolled cases. Outcomes in patients were compared to 270 controls matched for age, sex and residency.
The prevalence ratio (PR) of moderate-to-complete hearing loss was 5.0(95%CI 3.6-7.1) in cases at discharge, 3.7(2.5-5.4) at 3 months, 3.2(2.2-4.7) at 9 months, and 3.1(2.1-4.4) in retrospective cases compared to controls. Hearing improvement occurred mostly within the first 3 months with a change in hearing level of 11.1%(95%CI 7.0-15.1%) compared to discharge. The PR of vestibular dysfunction was 2.4(95%CI 1.7-3.3) at discharge, 2.2(1.4-3.1) at 3 months, 1.8(1.1-2.5) at 9 months, and 1.8(1.1-2.6) for retrospective cases compared to controls. Cases also indicated more problems with mobility, self-care and usual activities.
Both hearing and vestibular impairment were common and persist in cases. Appropriate patient management strategies are needed to reduce the incidence and impact of these sequelae.
猪链球菌是人类严重脑膜炎和败血症的动物源性病原体。本研究旨在评估幸存的猪链球菌感染患者的长期预后,特别是前庭耳蜗后遗症的进展和影响。
这项病例对照研究评估了 47 例前瞻性纳入病例在出院时、出院后 3 个月和 9 个月以及 31 例回顾性纳入病例在 11-34 个月时的链球菌感染结局,并将患者的结局与 270 名年龄、性别和居住地匹配的对照进行比较。
出院时、出院后 3 个月、9 个月和回顾性病例时,病例组中度至完全听力损失的患病率比(PR)分别为 5.0(95%CI 3.6-7.1)、3.7(2.5-5.4)、3.2(2.2-4.7)和 3.1(2.1-4.4),与对照组相比。听力改善主要发生在出院后 3 个月内,听力水平变化为 11.1%(95%CI 7.0-15.1%)。出院时、出院后 3 个月、9 个月和回顾性病例时,前庭功能障碍的 PR 分别为 2.4(95%CI 1.7-3.3)、2.2(1.4-3.1)、1.8(1.1-2.5)和 1.8(1.1-2.6),与对照组相比。病例组还表示在行动、自理和日常活动方面存在更多问题。
听力和前庭功能障碍在病例中均很常见且持续存在。需要采取适当的患者管理策略来降低这些后遗症的发生率和影响。