Liang Chen, Wei Wei, Liang Xiuwen, De Enjin, Zheng Beiwen
Department of Brucellosis, Hulunbuir People's Hospital, Hulunbuir, People's Republic of China.
School of Medicine, Inner Mongolia University for Nationalities, Hulunbuir, People's Republic of China.
Infect Drug Resist. 2019 Jun 6;12:1565-1571. doi: 10.2147/IDR.S202440. eCollection 2019.
To investigate the demographic, epidemiological, clinical, and laboratory characteristics; treatment options; and outcome of human brucellosis with spine involvement at a major hospital in Hulunbuir, a brucellosis epidemic region of China. A total of 842 patients with human brucellosis treated in the Department of Brucellosis, Hulunbuir People's Hospital from January 2011 to December 2016 were included and analyzed in this study. The results of 67 brucellar spondylodiscitis (BS) cases were compared with those that were negative for spine involvements. The mean age of spinal brucellosis patients was 50.5±10.2 years (43 males and 24 females; age range 29-70). The risk factors for transmission are direct contact with animals, such as working in the farm, and consumption of unpasteurized milk or daily products. Back pain (92.5%), fever (85.1%), sweating (62.7%), and fatigue (52.8%) were the most common symptoms. Magnetic resonance imaging (MRI) was performed in all the patients with spondylodiscitis. The sites of involvement were lumbar (81.2%), thoracic (8.7%), cervical (4.3%), thoracolumbar (2.9%), and lumbosacral (2.9%). All isolates from blood culture were identified as , with 61% biovar 3 and 39% biovar 1 isolates. The antimicrobial therapy for BS lasted for at least 3 months. In the presence of paravertebral or epidural abscess, longer treatment was conducted to avoid possible sequelae. In endemic areas such as Hulunbuir, BS should be considered in patients with back pain and fever. MRI is a highly sensitive imaging modality that can be used to differentiate BS from other spinal infections. This study will be helpful to establish strategies for prevention, surveillance, and management of spinal brucellosis in China.
为调查中国布鲁氏菌病流行地区呼伦贝尔某大型医院脊柱受累型人类布鲁氏菌病的人口统计学、流行病学、临床和实验室特征、治疗选择及预后，本研究纳入并分析了2011年1月至2016年12月在呼伦贝尔市人民医院布鲁氏菌病科接受治疗的842例人类布鲁氏菌病患者。将67例布鲁氏菌性脊椎间盘炎（BS）病例的结果与脊柱未受累的病例结果进行比较。脊柱布鲁氏菌病患者的平均年龄为50.5±10.2岁（男43例，女24例；年龄范围29 - 70岁）。传播的危险因素包括直接接触动物，如在农场工作，以及食用未经巴氏消毒的牛奶或奶制品。背痛（92.5%）、发热（85.1%）、出汗（62.7%）和疲劳（52.8%）是最常见的症状。所有脊椎间盘炎患者均进行了磁共振成像（MRI）检查。受累部位为腰椎（81.2%）、胸椎（8.7%）、颈椎（4.3%）、胸腰椎（2.9%）和腰骶部（2.9%）。血培养分离出的所有菌株均鉴定为 ，其中生物变种3占61%，生物变种1占39%。BS的抗菌治疗持续至少3个月。若存在椎旁或硬膜外脓肿，则进行更长时间的治疗以避免可能的后遗症。在呼伦贝尔等流行地区，对于背痛和发热患者应考虑BS。MRI是一种高度敏感的成像方式，可用于鉴别BS与其他脊柱感染。本研究将有助于制定中国脊柱布鲁氏菌病的预防、监测和管理策略。
