Ngor Chamnab, Hall Lisa, Dean Judith A, Gilks Charles F
School of Public Health, The University of Queensland, Brisbane, Qld, Australia.
School of Public Health, The National Institute of Public Health, Phnom Penh, Cambodia.
Trop Med Int Health. 2021 Oct;26(10):1210-1219. doi: 10.1111/tmi.13669. Epub 2021 Aug 26.
Pyomyositis, an acute bacterial infection of skeletal muscle usually resulting in abscess formation, is well recognised in tropical regions where it can account for up to 4% of adult surgical admissions. It is increasingly being reported from high-income temperate countries. Pyomyositis occurs across all ages and in both sexes. Mortality ranges from 1% to 23%. Many risk factors have been suggested. We aimed to identify factors associated with pyomyositis.
We undertook a systematic review and meta-analysis, using PubMed, EMBASE, Scopus and the Cochran Library and hand-searching published papers. The random-effects model meta-analysis was used to calculate pooled estimated odd ratios with the corresponding 95% confidence interval.
All studies in the systematic review (n = 25) and the meta-analysis (n = 12) were hospital-based. Seven only included children. Relatively few studies have been published in the last decade, the majority of which are from high-income temperate settings. Staphylococcus aureus was the main organism isolated. Males under the age of 20 predominated, and mortality of up to 20% was reported. Factors associated with pyomyositis were HIV infection (OR = 4.82; 95% CI: 1.67-13.92) and fulfilling an AIDS surveillance definition (OR = 6.08; 95% CI: 2.79-13.23).
Our meta-analysis indicated significant associations between pyomyositis infection and HIV/AIDS. Major gaps in our understanding of the epidemiology, pathogenesis, clinical presentation, and outcome remain, highlighting the need for further research and more systematic studies. Pyomyositis merits consideration as a neglected tropical disease.
脓性肌炎是一种骨骼肌的急性细菌感染，通常会导致脓肿形成，在热带地区很常见，在成人外科住院患者中占比可达4%。高收入温带国家对其报道也日益增多。脓性肌炎可发生于各年龄段及两性。死亡率在1%至23%之间。已提出许多危险因素。我们旨在确定与脓性肌炎相关的因素。
我们利用PubMed、EMBASE、Scopus和Cochrane图书馆进行系统综述和荟萃分析，并手工检索已发表的论文。采用随机效应模型荟萃分析来计算合并估计比值比及相应的95%置信区间。
系统综述中的所有研究（n = 25）和荟萃分析中的研究（n = 12）均以医院为基础。其中7项研究仅纳入了儿童。在过去十年中发表的研究相对较少，其中大多数来自高收入温带地区。分离出的主要病原体是金黄色葡萄球菌。20岁以下男性占主导，报道的死亡率高达20%。与脓性肌炎相关的因素有HIV感染（比值比=4.82；95%置信区间：1.67 - 13.92）和符合艾滋病监测定义（比值比=6.08；95%置信区间：2.79 - 13.23）。
我们的荟萃分析表明脓性肌炎感染与HIV/AIDS之间存在显著关联。我们对其流行病学、发病机制、临床表现和结局的理解仍存在重大差距，这凸显了进一步研究和更系统研究的必要性。脓性肌炎值得被视为一种被忽视的热带疾病。
