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人畜共患孢子丝菌病疫情:巴西亚马逊州新出现的公共卫生威胁。

Zoonotic Sporotrichosis outbreak: Emerging public health threat in the Amazon State, Brazil.

作者信息

Mesquita Viviany Araujo, Talhari Sinesio, Leturiondo André Luiz, de Souza Guilherme Caldas, de Brito Euzenio Moreira, de Andrade Suanni Lemos, Fernandes Débora Cristina de Lima, Frota Maria Zeli Moreira, Cruz Rossilene Conceição da Silva, Guimarães Juliana de Andrade Rebouças, Miot Helio Amante, Talhari Carolina, Pedrosa Valderiza Lourenço

机构信息

Programa de Pós-Graduação em Ciências Aplicadas à Dermatologia, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.

Fundação Hospitalar Alfredo da Matta de Dermatologia, Manaus, Amazonas, Brazil.

出版信息

PLoS Negl Trop Dis. 2024 Jul 22;18(7):e0012328. doi: 10.1371/journal.pntd.0012328. eCollection 2024 Jul.

Abstract

BACKGROUND

Sporotrichosis is the most common subcutaneous mycosis caused by Sporothrix spp. Traditionally, it is transmitted through injuries involving plant debris. However, over the past few decades, there has been an epidemic increase in human cases resulting from contact with infected animals, particularly cats, in various regions of Brazil. In this report, we report a notable increase in both human and animal cases within the Brazilian Amazon state.

METHODOLOGY/PRINCIPAL FINDINGS: An ecological study was conducted by analyzing official records of human and animal sporotrichosis diagnosed in the state of Amazon from 2020 to 2023. Data including patient demographics, clinical manifestations, mycological examination results, and species identification through PCR confirmation were evaluated. During this period, a total of 950 human cases and 2,823 animal cases of sporotrichosis were reported at an exponential rate, since no human cases were registered in 2020. The spatial and temporal dispersion of human sporotrichosis followed that of animal cases, moving from downtown areas to the periphery. Contact with infected animals was reported in 77.7% of cases, with cats being the most commonly implicated (73.5%). Only 66.7% of individuals underwent mycological examination. Among the positive cultures for Sporothrix spp., 65.4% were identified as S. brasiliensis. All patients were treated with systemic antifungals.

CONCLUSIONS/SIGNIFICANCE: This study highlights a rising incidence of sporotrichosis among animals and humans in the Brazilian Amazon region over the past four years, with S. brasiliensis being the predominant agent. Collaborative efforts involving healthcare professionals, veterinarians, and public health authorities are crucial to implement effective control measures, educate populations at risk, and promote responsible guidance for pet guardians. These measures are essential to mitigate the burden of epidemic sporotrichosis in Brazil.

摘要

背景

孢子丝菌病是由孢子丝菌属引起的最常见的皮下真菌病。传统上,它通过涉及植物碎片的损伤传播。然而,在过去几十年中,巴西各个地区因接触受感染动物(尤其是猫)导致的人类病例呈流行趋势增加。在本报告中,我们报告了巴西亚马逊州人类和动物病例均显著增加。

方法/主要发现:通过分析2020年至2023年亚马逊州诊断的人类和动物孢子丝菌病的官方记录进行了一项生态学研究。评估了包括患者人口统计学、临床表现、真菌学检查结果以及通过PCR确认的菌种鉴定等数据。在此期间,共报告了950例人类孢子丝菌病病例和2823例动物病例,呈指数增长,因为2020年未登记人类病例。人类孢子丝菌病的时空分布与动物病例一致,从市中心地区向周边地区扩散。77.7%的病例报告有接触受感染动物的情况,其中猫是最常涉及的动物(73.5%)。只有66.7%的个体接受了真菌学检查。在孢子丝菌属的阳性培养物中,65.4%被鉴定为巴西孢子丝菌。所有患者均接受了全身抗真菌治疗。

结论/意义:本研究强调了过去四年巴西亚马逊地区动物和人类中孢子丝菌病发病率的上升,巴西孢子丝菌是主要病原体。医疗保健专业人员、兽医和公共卫生当局的合作努力对于实施有效控制措施、教育高危人群以及为宠物监护人提供负责任的指导至关重要。这些措施对于减轻巴西流行性孢子丝菌病的负担至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84cb/11293696/8a88fb2b1785/pntd.0012328.g001.jpg

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