Emerg Infect Dis. 2024 Aug;30(8):1514-1522. doi: 10.3201/eid3008.231562.
Leptospirosis is a common but underdiagnosed zoonosis. We conducted a 1-year prospective study in La Guaira State, Venezuela, analyzing 71 hospitalized patients who had possible leptospirosis and sampling local rodents and dairy cows. Leptospira rrs gene PCR test results were positive in blood or urine samples from 37/71 patients. Leptospira spp. were isolated from cultured blood or urine samples of 36/71 patients; 29 had L. interrogans, 3 L. noguchii, and 4 L. venezuelensis. Conjunctival suffusion was the most distinguishing clinical sign, many patients had liver involvement, and 8/30 patients with L. interrogans infections died. The Leptospira spp. found in humans were also isolated from local rodents; L. interrogans and L. venezuelensis were isolated from cows on a nearby, rodent-infested farm. Phylogenetic clustering of L. venezuelensis isolates suggested a recently expanded outbreak strain spread by rodents. Increased awareness of leptospirosis prevalence and rapid diagnostic tests are needed to improve patient outcomes.
钩端螺旋体病是一种常见但诊断不足的人畜共患病。我们在委内瑞拉拉瓜伊拉州进行了为期 1 年的前瞻性研究，分析了 71 名可能患有钩端螺旋体病的住院患者，并对当地啮齿动物和奶牛进行了采样。71 名患者中有 37 名血液或尿液样本的雷氏菌 rrs 基因 PCR 检测结果呈阳性。从 71 名患者中培养的血液或尿液样本中分离出 36 名/株钩端螺旋体；29 株为问号钩端螺旋体，3 株为中间型钩端螺旋体，4 株为委内瑞拉钩端螺旋体。结膜充血是最具鉴别特征的临床体征，许多患者有肝脏受累，30 名感染问号钩端螺旋体的患者中有 8 人死亡。在人类中发现的钩端螺旋体也从当地啮齿动物中分离出来；在附近的一个老鼠出没的农场中，从奶牛身上分离出了问号钩端螺旋体和委内瑞拉钩端螺旋体。委内瑞拉钩端螺旋体分离株的系统发育聚类表明，一种由啮齿动物传播的新近扩大的暴发菌株正在蔓延。需要提高对钩端螺旋体病流行率的认识，并采用快速诊断检测方法，以改善患者的预后。
