Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.
PLoS One. 2020 Feb 4;15(2):e0228488. doi: 10.1371/journal.pone.0228488. eCollection 2020.
Streptococcus suis (S.suis) is an emerging zoonosis disease with a high prevalence in Southeast Asia. There are over 1,500 cases reported globally in which majority of cases are from Thailand followed by Vietnam. The disease leads to meningitis in human with sensorineural hearing loss (SNHL) as the most common complication suffered by the patients. Early diagnosis and treatment is important to prevent severe neurological complication. In this study, we aim to develop an easy-to-use risk score to promote early diagnosis and detection of S.suis in patients who potentially develop hearing loss.
Data from a retrospective review of 13-year S.suis patient records in a tertiary hospital in Chiang Mai, Northern, Thailand was obtained. Univariate and multivariate logistic regressions were employed to develop a predictive model. The clinical risk score was constructed from the coefficients of significant predictors. Area under the receiver operator characteristic curve (AuROC) was identified to verify the model discriminative performance. Bootstrap technique with 1000-fold bootstrapping was used for internal validation.
Among 133 patients, the incidence of hearing loss was 31.6% (n = 42). Significant predictors for S. suis hearing loss were meningitis, raw pork consumption, and vertigo. The predictive score ranged from 0-4 and correctly classified 81.95% patients as being at risk of S.suis hearing loss. The model showed good power of prediction (AuROC: 0.859; 95%CI 0.785-0.933) and calibration (AuROC: 0.860; 95%CI 0.716-0.953).
To our best knowledge, this is the first risk scoring system development for S.suis hearing loss. We identified meningitis, raw pork consumption and vertigo as the main risk factors of S.suis hearing loss. Future studies are needed to optimize the developed scoring system and investigate its external validity before recommendation for use in clinical practice.
猪链球菌(S.suis)是一种新兴的人畜共患病,在东南亚流行率很高。全球报告超过 1500 例,其中大多数病例来自泰国,其次是越南。该疾病可导致人类脑膜炎,其中感音神经性听力损失(SNHL)是患者最常见的并发症。早期诊断和治疗对于预防严重的神经并发症很重要。在这项研究中,我们旨在开发一种易于使用的风险评分系统,以促进对有听力损失风险的患者的早期诊断和检测。
从泰国清迈北部一家三级医院对 13 年的猪链球菌患者记录进行回顾性分析,获得了数据。采用单变量和多变量逻辑回归来建立预测模型。临床风险评分由显著预测因子的系数构建。采用接收者操作特征曲线下面积(AuROC)来验证模型的判别性能。采用 1000 次自举技术进行内部验证。
在 133 名患者中,听力损失的发生率为 31.6%(n=42)。猪链球菌听力损失的显著预测因子为脑膜炎、食用生猪肉和眩晕。预测评分范围为 0-4,正确分类了 81.95%的患者为猪链球菌听力损失风险。该模型具有良好的预测能力(AuROC:0.859;95%CI 0.785-0.933)和校准能力(AuROC:0.860;95%CI 0.716-0.953)。
据我们所知,这是首个针对猪链球菌听力损失的风险评分系统的开发。我们确定了脑膜炎、食用生猪肉和眩晕为猪链球菌听力损失的主要危险因素。需要进一步的研究来优化开发的评分系统,并在推荐用于临床实践之前评估其外部有效性。