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严重李斯特菌感染恢复后早期死亡的相关危险因素:一项多中心 17 年纵向研究。

Risk factors associated with early mortality after recovery from severe listeriosis: a multicentre 17-year longitudinal study.

机构信息

Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación 11, 18016, Granada, Spain.

Section of Epidemiology, Provincial Health Delegation of Granada, Granada, Spain.

出版信息

Infection. 2023 Feb;51(1):181-191. doi: 10.1007/s15010-022-01872-1. Epub 2022 Jun 26.

Abstract

BACKGROUND

Listeriosis presents high rates of mortality but prognostic factors for early prevention are not well established. The aim of this study was to analyse factors associated with in-hospital and early mortality of adults after recovery from severe infection caused by Listeria monocytogenes.

METHODS

All cases of listeriosis notified in the province of Granada from January 2005 to December 2021, including 9 centres, were included. Only laboratory confirmed non-neonatal cases were considered. Follow-up was conducted by accessing medical records and epidemiological data. Bivariate and multivariate analyses were conducted to detect potential risk factors associated to in-hospital mortality, 1-year, and 5-year early death after recovery. Multivariate Cox regression models were performed. A total of 206 patients were identified.

RESULTS

The mean age was 62.6 years (sd, 18.8). A high frequency of comorbidities (88.3%) was observed, and 42 patients (20.4%) died during hospitalisation. Of the patients who recovered from acute infection, 26 (15.9%) died during the following year and 47 (28.7%) died during the following 5 years. The main factors associated with early mortality after recovery were age (HR: 1.03; 95% CI 1.02-1.07), diabetes mellitus (HR 1.86, 95% CI 1.01-3.44), chronic kidney disease (HR 3.96, 95% CI 1.87-8.38), liver disease (HR 3.62, 95% CI 1.64-8.51), and cancer (HR 3.76, 95% CI 1.90-7.46).

CONCLUSION

Listeriosis is associated with high early post-recovery mortality. Our study describes the main prognostic factors, which may help to improve preventive follow-up strategies of adults with severe listeriosis.

摘要

背景

李斯特菌病的死亡率很高,但早期预防的预后因素尚未得到很好的确定。本研究旨在分析李斯特菌单核细胞增生李斯特菌严重感染后恢复成人住院和早期死亡的相关因素。

方法

纳入 2005 年 1 月至 2021 年 12 月期间格拉纳达省报告的所有李斯特菌病病例,包括 9 个中心。仅考虑实验室确诊的非新生儿病例。通过访问病历和流行病学数据进行随访。进行了单变量和多变量分析,以检测与住院死亡率、恢复后 1 年和 5 年早期死亡相关的潜在危险因素。进行了多变量 Cox 回归模型。共确定了 206 例患者。

结果

平均年龄为 62.6 岁(标准差,18.8)。观察到合并症的发生率很高(88.3%),42 例(20.4%)患者在住院期间死亡。在从急性感染中恢复的患者中,26 例(15.9%)在接下来的一年死亡,47 例(28.7%)在接下来的 5 年死亡。恢复后早期死亡的主要相关因素是年龄(HR:1.03;95%CI 1.02-1.07)、糖尿病(HR 1.86,95%CI 1.01-3.44)、慢性肾病(HR 3.96,95%CI 1.87-8.38)、肝病(HR 3.62,95%CI 1.64-8.51)和癌症(HR 3.76,95%CI 1.90-7.46)。

结论

李斯特菌病与恢复后早期高死亡率相关。我们的研究描述了主要的预后因素,这可能有助于改善严重李斯特菌病成人的预防随访策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0623/9879814/e6894891eecf/15010_2022_1872_Fig1_HTML.jpg

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