Hernández Bustabad Alberto, Morales Arráez Dalia, González Alejandra, de Vera Antonia, Díaz-Flores Felicitas, Lecuona Fernández María, Gómez-Sirvent Juan Luís, Avellón Calvo Ana, Hernández-Guerra Manuel
Aparato Digestivo, Hospital Universitario de Canarias, España.
Aparato Digestivo, Hospital Universitario de Canarias.
Rev Esp Enferm Dig. 2020 Jun;112(6):448-455. doi: 10.17235/reed.2020.6687/2019.
there has been a global increase in the incidence of hepatitis A infection. The aim of this study was to examine the characteristics of the increase in our region and the degree of adherence to the recommended hygienic measures after discharge from hospital.
demographic, clinical and biochemical variables were collected from patients with acute hepatitis A in our health area. The patients were grouped as follows: January 2010 to December 2016 (historical cohort) and January 2017 to October 2017 (recent cohort). A phylogenetic analysis was also performed in the recent cohort. One month after discharge, bacterial growth was evaluated by a culture of the dominant hand imprint and were compared with a control group.
a total of 110 cases were registered with a median age of 36.3 years (range 3-89) and 77.3 % were male. The incidence was 0.82/100,000 inhabitants/year and 22.75/100,000 inhabitants/year in the historical and recent cohorts, respectively. Patients in the recent cohort were more frequently male (52.6 % vs. 82.4 %, p = 0.008) and younger (51.7 [3-89] vs. 33.4 [4-74] years, p < 0.001). In addition, 63.8 % of the recent cohort were men who had sex with other men and had unsafe sexual practices (37.5 %). Phylogenetic analysis showed a predominance of genotype A and a high frequency of the VRD 521-2016 sequence. A higher growth of enterobacteria was observed in patients with hepatitis A compared to the control group (7.3 % vs. 1.2 %, p = 0.005), despite specific hygienic measures given at discharge.
a recent outbreak of hepatitis A in our area was related with gender, younger age and sexual practices. Hepatitis A infected subjects showed a poor adherence to hygienic measures. Our data suggests the need for policies that encourage preventive actions, particularly vaccination in this high-risk group.
全球甲型肝炎感染发病率呈上升趋势。本研究旨在调查我们地区发病率上升的特征以及患者出院后对推荐卫生措施的遵守程度。
收集我们健康区域内急性甲型肝炎患者的人口统计学、临床和生化变量。患者分为以下两组：2010年1月至2016年12月（历史队列）和2017年1月至2017年10月（近期队列）。对近期队列还进行了系统发育分析。出院后一个月，通过优势手印记培养评估细菌生长情况，并与对照组进行比较。
共登记110例病例，中位年龄为36.3岁（范围3 - 89岁），77.3%为男性。历史队列和近期队列的发病率分别为0.82/10万居民/年和22.75/10万居民/年。近期队列中的患者男性比例更高（52.6%对82.4%，p = 0.008）且年龄更小（51.7[3 - 89]岁对33.4[4 - 74]岁，p < 0.001）。此外，近期队列中63.8%为与其他男性发生性行为且有不安全性行为的男性（37.5%）。系统发育分析显示基因型A占优势且VRD 521 - 2016序列频率较高。与对照组相比，甲型肝炎患者中观察到肠杆菌生长更高（7.3%对1.2%，p = 0.005），尽管出院时采取了特定的卫生措施。
我们地区近期的甲型肝炎暴发与性别、年龄较小和性行为有关。甲型肝炎感染患者对卫生措施的遵守情况较差。我们的数据表明需要制定鼓励预防行动的政策，特别是针对这一高危群体的疫苗接种。
