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中国合肥市某三级医院感染患者的临床和实验室特征

Clinical and Laboratory Characteristics of Patients infected by at a Tertiary Hospital in Hefei City, China.

作者信息

Shi Cuixiao, Lv Dongmei, Zhou Kai, Jin Tengchuan, Wang Gang, Wang Bo, Li Yajuan, Xu Yuanhong

机构信息

Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China.

Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, People's Republic of China.

出版信息

Infect Drug Resist. 2021 Oct 25;14:4409-4419. doi: 10.2147/IDR.S334929. eCollection 2021.

Abstract

BACKGROUND

Human listeriosis is a severe foodborne infection caused by and the data of patients with this infection are largely limited for the Hefei population.

PURPOSE

This is a retrospective study that evaluated the clinical and laboratory data of patients with listeriosis at a tertiary hospital in Hefei City.

PATIENTS AND METHODS

A total of 24 listeriosis patients were admitted to the First Affiliated Hospital of Anhui Medical University from January 2003 to July 2021. Data from all patients were collected from the hospital's electronic medical records.

RESULTS

The most common symptom of all patients was fever (91.7%), followed by altered consciousness (50.0%), rashes (45.8%), respiratory distress symptoms (37.5%), nuchal rigidity (29.2%), and headaches (20.8%). Laboratory results also indicated elevated C-reactive protein (CRP) (79.1%), hypoproteinemia (75.0%), anemia (62.5%), leukocytosis (45.8%), and neutrophilia (45.8%). The mean value of 5.1 μg/mL (SD, 3.8) for D-dimer (D-D) was significantly higher than the normal value ((0.00-0.50) μg/mL), while both altered consciousness (6 vs 4, = 0.034) and headaches (4 vs 1, = 0.036) occurred more frequently in the neurolisteriosis group compared with the bacteremia one. Additionally, the mean maximal body temperature (°C) (40.5 ± 0.7) as well as white blood cell (WBC) (15.3 vs 7.5 ×10/L, = 0.014) and neutrophil (NEUT#) (13.2 vs 6.1 ×10/L, = 0.026) counts of neurolisteriosis patients were higher than those of bacteremia (39.4 ± 0.4) ( = 0.001). Of all patients, four (50%) from the maternal-neonatal group remained uncured.

CONCLUSION

Listeriosis is a rare disease with extremely variable clinical characteristics in Hefei City. Our data indicated that unexplained fever, altered consciousness, hypoproteinemia, anemia, elevated CRP and DD should be considered to assist diagnosis of listeriosis for early treatment interventions.

摘要

背景

人类李斯特菌病是一种由[病原体未提及]引起的严重食源性感染,而合肥地区该感染患者的数据在很大程度上有限。

目的

这是一项回顾性研究,评估了合肥市一家三级医院中李斯特菌病患者的临床和实验室数据。

患者与方法

2003年1月至2021年7月期间,共有24例李斯特菌病患者入住安徽医科大学第一附属医院。所有患者的数据均从医院电子病历中收集。

结果

所有患者最常见的症状是发热(91.7%),其次是意识改变(50.0%)、皮疹(45.8%)、呼吸窘迫症状(37.5%)、颈项强直(29.2%)和头痛(20.8%)。实验室结果还显示C反应蛋白(CRP)升高(79.1%)、低蛋白血症(75.0%)、贫血(62.5%)、白细胞增多(45.8%)和中性粒细胞增多(45.8%)。D - 二聚体(D - D)的平均值为5.1μg/mL(标准差,3.8),显著高于正常值((0.00 - 0.50)μg/mL),而与菌血症组相比,神经型李斯特菌病组意识改变(6例对4例,P = 0.034)和头痛(4例对1例,P = 0.036)的发生频率更高。此外,神经型李斯特菌病患者的平均最高体温(℃)(40.5 ± 0.7)以及白细胞(WBC)计数(15.3对7.5×10⁹/L,P = 0.014)和中性粒细胞(NEUT#)计数(13.2对6.1×10⁹/L,P = 0.026)均高于菌血症患者(39.4 ± 0.4)(P = 0.001)。在所有患者中,母婴组的4例(50%)未治愈。

结论

在合肥市,李斯特菌病是一种罕见疾病,临床特征差异极大。我们的数据表明,原因不明的发热、意识改变、低蛋白血症、贫血、CRP和D - D升高应被考虑用于辅助李斯特菌病的诊断,以便进行早期治疗干预。

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