Sheele Johnathan M, Libertin Claudia R, Pritt Bobbi S, Wysokinska Ewa M, Pietri Jose E
Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA.
Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL, USA.
Heliyon. 2021 Oct 1;7(10):e08107. doi: 10.1016/j.heliyon.2021.e08107. eCollection 2021 Oct.
Bed bugs are common urban pests. Unlike many other blood-feeding human ectoparasites, bed bugs are not known to be vectors of human infectious diseases, but clinical and epidemiological studies to directly interrogate this link have been limited. Here, we aimed to determine whether bed bugs were associated with infectious diseases in a set of infested patients presenting to emergency departments (ED) in the greater Cleveland, OH area. We performed a retrospective case-control study involving 332 ED patients with bed bugs and 4,952 control patients, seen from February 1, 2011, through February 1, 2017. Cases and controls were matched by age, sex, and the presenting ED. Additionally, data were adjusted for ≥20 sociodemographic variables, triage data, and comorbidities in multivariable regression analyses. Seventeen laboratory values, ten different ED and inpatient diagnoses, chest radiographs, infectious disease consults, and blood cultures were examined. The odds of bed bug infestation were significantly higher for patients that had positive blood cultures, had blood cultures growing coagulase-negative , were diagnosed with pneumonia, were diagnosed with cellulitis, received an infectious disease consult, received a chest radiograph, and had higher percentages of eosinophils in the blood ( < .05 for all). Additional investigations are needed to determine whether bed bugs directly contribute to disease by transmitting causative agents, whether bed bug exposure contributes secondarily contributes to infections, or whether these associations are better explained by other environmental and social determinants of health.
臭虫是常见的城市害虫。与许多其他吸食人血的体表寄生虫不同，臭虫并非已知的人类传染病传播媒介，但直接探究这种关联的临床和流行病学研究一直很有限。在此，我们旨在确定在俄亥俄州大克利夫兰地区就诊于急诊科（ED）的一组受臭虫侵扰的患者中，臭虫是否与传染病有关。我们进行了一项回顾性病例对照研究，涉及2011年2月1日至2017年2月1日期间就诊于急诊科的332例有臭虫的患者和4952例对照患者。病例和对照按年龄、性别和就诊的急诊科进行匹配。此外，在多变量回归分析中，对≥20个社会人口统计学变量、分诊数据和合并症进行了数据调整。检查了17项实验室指标、10种不同的急诊科和住院诊断、胸部X光片、传染病会诊以及血培养结果。血培养呈阳性、血培养有凝固酶阴性菌生长、被诊断为肺炎、被诊断为蜂窝织炎、接受传染病会诊、接受胸部X光检查以及血液中嗜酸性粒细胞百分比更高的患者，感染臭虫的几率显著更高（所有P值均<0.05）。需要进一步研究以确定臭虫是否通过传播病原体直接导致疾病发生，臭虫暴露是否继发导致感染，或者这些关联是否能更好地由其他健康的环境和社会决定因素来解释。
