Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain.
Unidade Local de Saúde de Guarda, Guarda, Portugal.
Int J Infect Dis. 2020 Jul;96:165-171. doi: 10.1016/j.ijid.2020.04.054. Epub 2020 Apr 27.
The aim of this study was to analyze the epidemiological impact of murine typhus in patients who required hospitalization in the National Health System (SNS) in Spain between 1997 and 2015.
Murine typhus (MT) is a zoonosis caused by Rickettsia typhi. MT is transmitted from rats, cats, dogs, and opossums to humans by their fleas. The clinical picture is characterized by headache, fever, rash, and liver function alteration. The prevalence of MT is considered underestimated since most cases are mild and self-limited. However, up to 10% of patients develop serious complications such as pneumonia or acute kidney injury and may even need admission to intensive care units.
This was a retrospective longitudinal descriptive study of inpatients diagnosed with Rickettsia typhi infection (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM], 081.0) in Spanish public hospitals between January 1, 1997, and December 31, 2015. Data were obtained from the Minimum Basic Data Set (MBDS, CMBD in Spanish), which includes information about inpatients admitted to the National Health System (NHS) hospitals provided by the Health Information Institute of the Ministry of Health and Equality.
Ninety-nine inpatients were included. The incidence rate of MT was 0.12 (95% CI, 0.09-0.14) cases per one million person-years. Cases were irregularly distributed throughout the period of study, with a slight upward trend between 2013 and 2015. The Canary Islands had the highest incidence rate: 2.17 (95% CI, 1.69-2.64) cases per one million person-years (80 cases). Most patients were men (63.6%). The mean age (±SD) was 46.4 years (±19). Five patients were under 15 years old. Approximately 85.9% of cases required urgent hospital admissions. The average hospital stay was 11 days (±9.9). Only 1 patient died.
Although considered uncommon, the incidence of MT seems to be increasing slowly. Most cases occurred in middle-aged men between late summer and early autumn in Spain. The Canary Islands and Andalusia registered the highest number of cases. The MBDS is an appropriate approach to study MT hospital management.
本研究旨在分析 1997 年至 2015 年间在西班牙国家卫生系统（SNS）住院的患者中，鼠型斑疹伤寒的流行病学影响。
鼠型斑疹伤寒（MT）是一种由伤寒立克次体引起的动物源性疾病。MT 通过老鼠、猫、狗和负鼠的跳蚤传播给人类。临床表现为头痛、发热、皮疹和肝功能改变。由于大多数病例为轻度和自限性，因此认为 MT 的患病率被低估了。然而，多达 10%的患者会出现严重并发症，如肺炎或急性肾损伤，甚至可能需要入住重症监护病房。
这是一项回顾性纵向描述性研究，纳入了 1997 年 1 月 1 日至 2015 年 12 月 31 日期间在西班牙公立医院中被诊断为伤寒立克次体感染（国际疾病分类，第九版，临床修订版[ICD-9-CM]，081.0）的住院患者。数据来自最低基本数据集（MBDS，西班牙语中的 CMBD），该数据集包括卫生部平等健康信息研究所提供的国家卫生系统（NHS）医院住院患者的信息。
共纳入 99 例住院患者。MT 的发病率为 0.12（95%CI，0.09-0.14）/10 万人年。病例在整个研究期间分布不均，2013 年至 2015 年期间呈轻微上升趋势。加那利群岛的发病率最高：2.17（95%CI，1.69-2.64）/10 万人年（80 例）。大多数患者为男性（63.6%）。平均年龄（±标准差）为 46.4 岁（±19 岁）。有 5 例患者年龄小于 15 岁。约 85.9%的病例需要紧急住院治疗。平均住院时间为 11 天（±9.9 天）。仅 1 例患者死亡。
尽管 MT 被认为不太常见，但发病率似乎在缓慢上升。大多数病例发生在西班牙夏末至初秋期间的中年男性中。加那利群岛和安达卢西亚记录的病例数量最多。MBDS 是研究 MT 住院管理的合适方法。
