Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Barcelona Institute for Global Health, (ISGlobal, University of Barcelona), Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden.
Travel Med Infect Dis. 2023 Nov-Dec;56:102666. doi: 10.1016/j.tmaid.2023.102666. Epub 2023 Nov 15.
Since Strongyloides can persist in its host for decades, and cause life threatening infections data on prevalence, the burden and risk factors for infection is crucial in migrant populations.
In this observational retrospective cohort study, we describe the epidemiological, clinical, and microbiological characteristics of imported strongyloidiasis diagnosed at the Karolinska University Hospital, Stockholm, Sweden, during 2010-2021.
We identified 98 individuals with strongyloidiasis, 89 (90.8%) born in endemic and 9 (9.2%) in non-endemic countries. Sub-Saharan Africa was the most common origin among the group born in endemic countries (62, 69.7%), (p < 0.005). There were 22 individuals with an underlying immunosuppressive condition. Gastrointestinal symptoms (53/98, 54.1%) were the symptoms most frequently described, and were more frequent in adults (57.0%) vs children (0%) (p = 0.013). Eosinophilia was detected in 74 (75.5%), being more frequent in the endemic-borne group (79.8% vs 33.3%, p = 0.002). Eight persons developed complications of strongyloidiasis because of either hyperinfection or disseminated disease. No people living with HIV with CD4 <500/mm (n = 6) developed severe strongyloidiasis.
A limited number of strongyloidiasis cases was identified, with few complicated cases in immunosuppressed patients. Further studies focusing on identifying and exploring the risk of complicated strongyloidiasis in immunosuppressed patients are needed.
由于旋毛虫可以在宿主体内潜伏数十年，并导致危及生命的感染，因此移民人群中感染的流行率、负担和危险因素的数据至关重要。
在这项观察性回顾性队列研究中，我们描述了 2010 年至 2021 年期间在瑞典斯德哥尔摩卡罗林斯卡大学医院诊断出的输入性旋毛虫病的流行病学、临床和微生物学特征。
我们确定了 98 例旋毛虫病患者，其中 89 例（90.8%）出生于流行地区，9 例（9.2%）出生于非流行地区。在出生于流行地区的人群中，撒哈拉以南非洲是最常见的起源地（62 例，69.7%）（p<0.005）。有 22 名患者存在潜在的免疫抑制状况。胃肠道症状（53/98，54.1%）是最常描述的症状，在成年人中更为常见（57.0%）而不是儿童（0%）（p=0.013）。74 例（75.5%）检测到嗜酸性粒细胞增多症，在流行地区出生的人群中更为常见（79.8% vs 33.3%，p=0.002）。有 8 人因过度感染或播散性疾病而发生旋毛虫病并发症。没有 HIV 感染者 CD4<500/mm（n=6）出现严重的旋毛虫病。
确定了数量有限的旋毛虫病病例，免疫抑制患者中并发症较少。需要进一步研究，以确定和探索免疫抑制患者中复杂旋毛虫病的风险。
