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法国一家大城市医院重症监护病房的钩端螺旋体病七年随访;实时PCR在快速急性诊断中的作用。

Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis.

作者信息

Bahuaud Olivier, Pastuszka Adeline, Le Brun Cécile, Ehrmann Stephan, Lanotte Philippe

机构信息

Service de Bactériologie-Virologie, CHRU de Tours, 37044 Tours, France.

Service de Médecine Intensive Réanimation, INSERM CIC 1415, CRICS-TriggerSep Research Network, F37044 Tours, France.

出版信息

J Clin Med. 2020 Sep 18;9(9):3011. doi: 10.3390/jcm9093011.

Abstract

(1) Background: Leptospirosis infection can lead to multiple organ failure, requiring hospitalization in an intensive care unit for supportive care, along with initiation of an adapted antibiotic therapy. Achieving a quick diagnosis is decisive in the management of these patients. (2) Methods: We present here a review of leptospirosis cases diagnosed in the intensive care unit of our hospital over seven years. Clinical and biological data were gathered, and we compared the differences in terms of diagnostic method. (3) Results: Molecular biology method by Polymerase Chain Reaction (PCR) allowed quick and reliable diagnosis when performed in the first days after the symptoms began. Moreover, we identified that sampling blood and urine for PCR was more efficient than performing PCR on only one type of biological sample. (4) Conclusions: Our results confirm the efficiency of PCR for the quick diagnosis of leptospirosis and suggest that testing both blood and urine early in the disease might improve diagnosis.

摘要

(1) 背景:钩端螺旋体感染可导致多器官功能衰竭,需要入住重症监护病房进行支持治疗,并启动适当的抗生素治疗。快速诊断对于这些患者的治疗至关重要。(2) 方法:我们在此对我院重症监护病房七年来诊断的钩端螺旋体病病例进行综述。收集了临床和生物学数据,并比较了诊断方法的差异。(3) 结果:症状出现后的头几天内进行聚合酶链反应(PCR)分子生物学方法能够实现快速可靠的诊断。此外,我们发现采集血液和尿液进行PCR比仅对一种生物样本进行PCR更有效。(4) 结论:我们的结果证实了PCR对钩端螺旋体病快速诊断的有效性,并表明在疾病早期同时检测血液和尿液可能会改善诊断。

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