布鲁氏菌培养特性、临床特征和人类布鲁氏菌病感染生物标志物。

Brucella cultures characteristics, clinical characteristics, and infection biomarkers of human Brucellosis.

机构信息

Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou 730050, China.

Department of Medica, The 940th Hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou 730050, China.

出版信息

J Infect Public Health. 2023 Mar;16(3):303-309. doi: 10.1016/j.jiph.2023.01.002. Epub 2023 Jan 3.

DOI:10.1016/j.jiph.2023.01.002

PMID:36641837

Abstract

OBJECTIVE

Aim to investigate the brucella culture characteristics, diagnosis methods, and clinical characteristics, to provide the laboratory with diagnostic methods and prevention and treatment for brucellosis.

METHODS

Data of 328 cases of brucellosis from 2012 to 2022 was analyzed, retrospectively. The bacterial culture characteristics, the clinical diagnostic methods, and the complications were analyzed respectively. The infection biomarkers of the brucellosis were analyzed by Receiver operating characteristic curve ROC.

RESULTS

Among the 328 brucellosis, 78.96 % of cases were men, the median age of the patients was (45.21±13.49) years and the annual incidence in our region was 67/100 000 per year. The diagnostic methods included pathogenic bacteria culture, serological diagnosis, and suspect case were 24.39 %, 47.56 %, and 28.05 %, respectively, sensitivity of combined detection Standard agglutination test (SAT) and the Rose Bengal test (RBT) is 96.2 %. In our work, 80 cases of brucellosis were diagnosed by a bacterial culture which were been identified as Brucella melitensis, blood culture was the main method (78.75 %) and the average positive alarm time was 80.74 (21.6-129) h and all of them were detected in aerobic bottles, followed by synovial fluid, bone marrow, lumbar spine, and joint tissue, puncture fluid and ascites culture which were 6.25 %, 3.75 %, 5.00 %, 5.00 % and 1.25 % respectively. The brucellosis with complications was lumbar spine lesions at 41.46 % cervical spine lesions at 4.60 % and knee joint lesions at 12.8 % and another osteoarthritis. The in-hospital mortality rate of the patients was 0.91 % and all of them were meningitis patients. ROC analysis indicated CRP had high sensitivity and specificity for brucellosis, and when CRP was 1.23mg/ml, the sensitivity and specificity were 0.727 and 0.718 respectively, and the U test also indicated CRP had a significant difference, Z=5.054, p <0.001.

CONCLUSIONS

Brucellosis is frequently morbidity in 40 + age men, which has been diagnosed by aerobic blood culture, generally bacterial culture, RBT and SAT, epidemiological, and commonly with complications of spine and arthropathy.

摘要

目的

探讨布鲁氏菌的培养特点、诊断方法和临床特点，为实验室提供布鲁氏菌病的诊断方法和防治方法。

方法

回顾性分析 2012 年至 2022 年收治的 328 例布鲁氏菌病患者的临床资料，分析细菌培养特点、临床诊断方法及并发症，采用受试者工作特征曲线（ROC）分析布鲁氏菌病的感染标志物。

结果

328 例布鲁氏菌病患者中，男性占 78.96%，患者中位年龄（45.21±13.49）岁，本地区年发病率为 67/10 万。诊断方法包括病原菌培养、血清学诊断和疑似病例分别为 24.39%、47.56%和 28.05%，联合检测标准凝集试验（SAT）和虎红平板凝集试验（RBT）的敏感性为 96.2%。本研究中，80 例布鲁氏菌病患者经细菌培养诊断为布鲁氏菌属，其中布鲁氏菌属鉴定为马耳他布鲁氏菌，血培养是主要方法（78.75%），平均阳性报警时间为 80.74（21.6-129）h，均在需氧瓶中检出，其次为滑液、骨髓、腰椎、关节组织，穿刺液和腹水培养分别占 6.25%、3.75%、5.00%、5.00%和 1.25%。合并并发症的布鲁氏菌病患者中，腰椎病变占 41.46%，颈椎病变占 4.60%，膝关节病变占 12.8%，另合并骨关节炎。患者住院死亡率为 0.91%，均为脑膜炎患者。ROC 分析表明，CRP 对布鲁氏菌病具有较高的灵敏度和特异性，当 CRP 为 1.23mg/ml 时，灵敏度和特异性分别为 0.727 和 0.718，U 检验也表明 CRP 差异有统计学意义，Z=5.054，p<0.001。