Department of Burns, The First Affiliated Hospital, Sun Yat-sen University, China.
Guangdong Engineering & Technology Research Center for Precise Diagnosis and Treatment of Burns and Wounds, China.
Jpn J Infect Dis. 2021 Nov 22;74(6):549-553. doi: 10.7883/yoken.JJID.2020.843. Epub 2021 Apr 30.
Vibrio vulnificus (V. vulnificus) infection is rare but potentially fatal. This study explored new atypical manifestations and prognostic factors of V. vulnificus-infected patients during hospitalization. We retrospectively reviewed the medical records of 33 patients diagnosed with V. vulnificus infection in Guangdong Province, China between 2010 and 2020. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were performed. The new atypical manifestations included cholangitis, urinary tract infection, and suppurative otitis media. Eleven of the 33 (33.3%) V. vulnificus-infected patients eventually died. Univariate analysis showed that patients with cardio-cerebrovascular diseases, lower platelet counts, and higher levels of C-reactive protein and procalcitonin (PCT) had statistically higher mortality. However, multivariate analysis showed that only the PCT level (P = 0.036) was statistically significant. In addition, the area under the ROC value estimate for PCT was 0.8816 (95% confidence interval (CI), 0.759-1.000; P = 0.0009). More than half of the patients with V. vulnificus infection died when PCT was > 20 ng/mL, while no patient died when PCT was ≤ 20 ng/mL. This study found new atypical manifestations of V. vulnificus infection. In addition, PCT was an effective and independent predictor of mortality in patients with V. vulnificus infection, allowing clinicians to conduct early risk stratification and determine the best therapeutic strategies.
创伤弧菌（Vibrio vulnificus，V. vulnificus）感染较为罕见，但可能致命。本研究旨在探讨创伤弧菌感染患者住院期间的新非典型表现和预后因素。我们回顾性分析了 2010 年至 2020 年期间在中国广东省确诊为创伤弧菌感染的 33 例患者的病历资料。采用多因素逻辑回归和受试者工作特征（receiver operating characteristic，ROC）曲线分析。新的非典型表现包括胆管炎、尿路感染和化脓性中耳炎。33 例创伤弧菌感染患者中最终有 11 例死亡。单因素分析显示，伴有心脑血管疾病、血小板计数较低、C 反应蛋白和降钙素原（procalcitonin，PCT）水平较高的患者死亡率更高。然而，多因素分析显示，只有 PCT 水平（P = 0.036）具有统计学意义。此外，PCT 的 ROC 值估计曲线下面积为 0.8816（95%置信区间，0.759-1.000；P = 0.0009）。当 PCT ＞20 ng/mL 时，超过一半的创伤弧菌感染患者死亡，而当 PCT ≤20 ng/mL 时，没有患者死亡。本研究发现了创伤弧菌感染的新非典型表现。此外，PCT 是创伤弧菌感染患者死亡率的有效且独立的预测指标，有助于临床医生进行早期风险分层，并确定最佳治疗策略。
