Amasya University Faculty of Medicine, Sabuncuoglu Serefeddin Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Amasya, Turkey.
Trabzon Kanuni Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Trabzon, Turkey.
J Infect Dev Ctries. 2024 Jul 29;18(7):1066-1073. doi: 10.3855/jidc.18977.
In our study, we aimed to evaluate the epidemiological features of brucellosis and the efficacy of different treatment options in patients with various organ involvements.
Patients diagnosed with brucellosis and treated in two different centers between 2009 and 2019 were retrospectively screened and evaluated regarding epidemiological and clinical features, laboratory findings, and treatment responses.
The study included 297 complete-data patients (76% of rural patients were farmers). Farming (76%) and raw dairy (69%) were the main transmission methods. Most patients (98.6%) had positive tube agglutination tests. Ninety-two patients' blood and bodily fluid cultures grew Brucella spp. The incidence of leukopenia was 18.8%, thrombocytopenia 10.7%, anemia 34.3%, and pancytopenia 4.3%. Doxycycline and rifampicin were the major treatments, with streptomycin utilized in osteoarticular patients. Pregnant women with neurobrucellosis took ceftriaxone and trimethoprim-sulfamethoxazole. After one year, 7.1% of patients relapsed. Doxycycline + streptomycin and doxycycline + rifampicin had similar relapse rates (p = 0.799). The double- and triple-antibiotic groups had identical recurrence rates (p = 0.252).
In uncomplicated brucellosis cases doxycycline + streptomycin and doxycycline + rifampicin treatments were equally effective. Again, there is no statistical difference in relapse development rates between double and triple combination treatments in uncomplicated brucellosis cases. Relapsed patients generally miss follow-ups, interrupt therapy, have osteoarticular involvement, and get short-term treatment. Patients with focused participation should be thoroughly checked at diagnosis and medicine, and treatment should be lengthy to prevent relapses.
在我们的研究中,我们旨在评估不同器官受累患者布鲁氏菌病的流行病学特征和不同治疗方案的疗效。
回顾性筛选了 2009 年至 2019 年在两个不同中心诊断为布鲁氏菌病并接受治疗的患者,评估其流行病学和临床特征、实验室检查结果以及治疗反应。
该研究纳入了 297 例完整数据患者(76%的农村患者为农民)。农业(76%)和生乳(69%)是主要的传播方式。大多数患者(98.6%)的试管凝集试验阳性。92 例患者的血液和体液培养出布鲁氏菌属。白细胞减少症的发生率为 18.8%,血小板减少症 10.7%,贫血 34.3%,全血细胞减少症 4.3%。多西环素和利福平是主要的治疗方法,链霉素用于骨关节炎患者。神经布鲁氏菌病的孕妇使用头孢曲松和复方磺胺甲噁唑。一年后,7.1%的患者复发。多西环素+链霉素和多西环素+利福平的复发率相似(p=0.799)。双联和三联抗生素组的复发率相同(p=0.252)。
在单纯性布鲁氏菌病病例中,多西环素+链霉素和多西环素+利福平治疗同样有效。同样,在单纯性布鲁氏菌病病例中,双联和三联联合治疗的复发率无统计学差异。复发患者通常会错过随访、中断治疗、发生骨关节炎并接受短期治疗。对于有明确参与的患者,应在诊断和用药时进行彻底检查,并延长治疗时间以防止复发。