脑炎发病特征的变化：法国四年研究结果。

Changing profile of encephalitis: Results of a 4-year study in France.

机构信息

Santé Publique France, Saint-Maurice, France; ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland.

Infectious diseases and internal medicine department, Axium clinic, Aix-en-Provence, France.

出版信息

Infect Dis Now. 2022 Feb;52(1):1-6. doi: 10.1016/j.idnow.2021.11.007. Epub 2021 Dec 9.

DOI:10.1016/j.idnow.2021.11.007

PMID:34896660

Abstract

CONTEXT

In 2007, we performed a nationwide prospective study to assess the epidemiology of encephalitis in France. We aimed to evaluate epidemiological changes 10years later.

METHODS

We performed a 4-year prospective cohort study in France (ENCEIF) from 2016 to 2019. Medical history, comorbidities, as well as clinical, biological, imaging, and demographic data were collected. For the comparison analysis, we selected similar data from adult patients enrolled in the 2007 study. We used Stata statistical software, version 15 (Stata Corp). Indicative variable distributions were compared using Pearson's Chi test, and means were compared using Student's t-test for continuous variables.

RESULTS

We analyzed 494 cases from 62 hospitals. A causative agent was identified in 65.7% of cases. Viruses represented 81.8% of causative agents, Herpesviridae being the most frequent (63.6%). Arboviruses accounted for 10.8%. Bacteria and parasites were responsible for respectively 14.8% and 1.2% of documented cases. Zoonotic infections represented 21% of cases. When comparing ENCEIF with the 2007 cohort (222 adults patients from 59 hospitals), a higher proportion of etiologies were obtained in 2016-2019 (66% vs. 53%). Between 2007 and 2016-2019, the proportions of Herpes simplex virus and Listeria encephalitis cases remained similar, but the proportion of tuberculosis cases decreased (P=0.0001), while tick-borne encephalitis virus (P=0.01) and VZV cases (P=0.03) increased. In the 2016-2019 study, 32 causative agents were identified, whereas only 17 were identified in the 2007 study.

CONCLUSION

Our results emphasize the need to regularly perform such studies to monitor the evolution of infectious encephalitis and to adapt guidelines.

摘要

背景

2007 年，我们进行了一项全国性前瞻性研究，以评估法国脑炎的流行病学情况。我们旨在评估 10 年后的流行病学变化。

方法

我们于 2016 年至 2019 年在法国进行了一项为期 4 年的前瞻性队列研究（ENCEIF）。收集了病史、合并症以及临床、生物学、影像学和人口统计学数据。为了比较分析，我们从 2007 年研究中选择了相似的成年患者数据。我们使用 Stata 统计软件，版本 15（StataCorp）。使用 Pearson's Chi 检验比较指示变量分布，使用 Student's t 检验比较连续变量的平均值。

结果

我们分析了来自 62 家医院的 494 例病例。65.7%的病例确定了病因。病毒占病因的 81.8%，其中单纯疱疹病毒最常见（63.6%）。虫媒病毒占 10.8%。细菌和寄生虫分别占已确诊病例的 14.8%和 1.2%。人畜共患病感染占病例的 21%。将 ENCEIF 与 2007 年队列（59 家医院的 222 名成人患者）进行比较时，2016-2019 年获得的病因比例更高（66%比 53%）。在 2007 年至 2016-2019 年期间，单纯疱疹病毒和李斯特菌脑炎的比例保持不变，但结核病例的比例下降（P=0.0001），而蜱传脑炎病毒（P=0.01）和 VZV 病例（P=0.03）增加。在 2016-2019 年的研究中，确定了 32 种病原体，而在 2007 年的研究中仅确定了 17 种病原体。