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李斯特菌病的死亡风险因素——2006-2015 年英格兰非妊娠相关病例的 10 年回顾。

Mortality risk factors for listeriosis - A 10 year review of non-pregnancy associated cases in England 2006-2015.

机构信息

Reference Microbiology Services, National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.

Gastrointestinal Infections Department, National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.

出版信息

J Infect. 2019 Mar;78(3):208-214. doi: 10.1016/j.jinf.2018.11.007. Epub 2018 Dec 5.

Abstract

UNLABELLED

LISTERIOSIS: is a foodborne illness that can result in septicaemia, Central Nervous System (CNS) disease, foetal loss and death in high risk patients.

OBJECTIVES

To analyse the demographic trends, clinical features and treatment of non-perinatal listeriosis cases over a ten year period and identify mortality-associated risk factors.

METHODS

Reported laboratory-confirmed non-pregnancy associated cases of listeriosis between 2006 and 2015 in England were included and retrospectively analysed. Multivariate logistic regression analysis was performed to determine independent risk factors for mortality.

RESULTS

1357/1683 reported cases met the inclusion criteria. Overall all-cause mortality was 28.7%; however, mortality rates declined from 42.1% to 20.2%. Septicaemia was the most common presentation 69.5%, followed by CNS involvement 22.4%. CNS presentations were significantly associated with age < 50 years, and septicaemia with older age. Age > 80 years (OR 3.32 95% CI 1.92-5.74), solid-organ malignancy (OR 3.42 95% CI 2.29-5.11), cardiovascular disease (OR 3.30 95% CI 1.64-6.63), liver disease (OR 4.61 95% CI 2.47-8.61), immunosuppression (OR 2.12 95% CI 1.40-3.21) and septicaemia (OR 1.60 95% CI 1.17-2.20) were identified as independent mortality risk factors.

CONCLUSIONS

High risk groups identified in this study should be the priority focus of future public health strategies aimed at reducing listeriosis incidence and mortality.

摘要

未加标签

李斯特菌病:是一种食源性疾病,可导致败血症、中枢神经系统 (CNS) 疾病、胎儿流产和高危患者死亡。

目的

分析十年间非围产期李斯特菌病病例的人口统计学趋势、临床特征和治疗方法,并确定与死亡率相关的危险因素。

方法

纳入并回顾性分析了 2006 年至 2015 年期间英国报告的实验室确诊的非妊娠相关李斯特菌病病例。采用多变量逻辑回归分析确定死亡率的独立危险因素。

结果

1357/1683 例报告病例符合纳入标准。总体而言,所有原因的死亡率为 28.7%;然而,死亡率从 42.1%降至 20.2%。败血症是最常见的表现,占 69.5%,其次是中枢神经系统受累,占 22.4%。中枢神经系统表现与年龄 < 50 岁显著相关,而败血症与年龄较大相关。年龄 > 80 岁(OR 3.32 95% CI 1.92-5.74)、实体器官恶性肿瘤(OR 3.42 95% CI 2.29-5.11)、心血管疾病(OR 3.30 95% CI 1.64-6.63)、肝脏疾病(OR 4.61 95% CI 2.47-8.61)、免疫抑制(OR 2.12 95% CI 1.40-3.21)和败血症(OR 1.60 95% CI 1.17-2.20)被确定为独立的死亡风险因素。

结论

本研究中确定的高危人群应成为未来旨在降低李斯特菌病发病率和死亡率的公共卫生策略的重点。

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