2015 - 2020年英国的输入性立克次体感染

Imported rickettsial infections to the United Kingdom, 2015-2020.

作者信息

Warrell Clare E, Osborne Jane, Nabarro Laura, Gibney Barry, Carter Daniel P, Warner Jennifer, Houlihan Catherine F, Brooks Timothy J G, Rampling Tommy

机构信息

Rare and Imported Pathogens Laboratory, Salisbury, UK; London School of Hygiene and Tropical Medicine, London, UK.

Rare and Imported Pathogens Laboratory, Salisbury, UK.

出版信息

J Infect. 2023 May;86(5):446-452. doi: 10.1016/j.jinf.2023.03.015. Epub 2023 Mar 21.

DOI:10.1016/j.jinf.2023.03.015

PMID:36948252

Abstract

OBJECTIVE

The burden of imported rickettsial infection in the UK is not previously described. This retrospective review identifies rickettsial cases diagnosed at the national reference laboratory between 2015 and 2022.

METHODS

Samples testing positive for spotted fever group, typhus group, and scrub typhus IgG/IgM on acute and convalescent blood samples, and/or PCR on tissue/blood were categorized as suspected, confirmed or past infection.

RESULTS

220 patients had rickettsioses, and the commonest import was acute spotted fever group infection (61%, 125/205), 54% (62/114) from South Africa. In acute typhus group cases, 60% (40/67) were from Southeast Asia. One patient with Rickettsia typhi bacteremia died. Scrub typhus group infections (5%, 10/205) were exclusively from Asia and the Western Pacific regions. Overall, 43% of confirmed cases (39/91) had not received doxycycline prior to results.

CONCLUSIONS

Rickettsial infections are important and under-recognized causes of imported fever in the UK. Thorough history, examination, and timely treatment with doxycycline should be considered if there is suspicion of Rickettsia infection before testing.

摘要

目的

此前未描述过英国输入性立克次体感染的负担情况。本回顾性研究确定了2015年至2022年期间在国家参考实验室确诊的立克次体病例。

方法

急性和恢复期血样中斑点热群、斑疹伤寒群和恙虫病IgG/IgM检测呈阳性的样本，和/或组织/血样的PCR检测结果被分类为疑似、确诊或既往感染。

结果

220例患者患有立克次体病，最常见的输入性感染是急性斑点热群感染（61%，125/205），其中54%（62/114）来自南非。在急性斑疹伤寒群病例中，60%（40/67）来自东南亚。1例伤寒立克次体菌血症患者死亡。恙虫病群感染（5%，10/205）仅来自亚洲和西太平洋地区。总体而言，43%的确诊病例（39/91）在结果出来之前未接受过强力霉素治疗。