Çelik Mehmet, Çiçek Yeliz, Atalay Ebru, Altındağ Deniz, Akgül Fethiye, Ürkmez Fatma Yekta, Gürbüz Esra, Şahin Ahmet, Özdemir Al Sevda, Atlı Seval Bilgiç, Alkan Sevil, İpek Davut, Mızrakçı Serpil Oğuz, Ceylan Mehmet Reşat, Atasoy Pınar Yürük, Karahocagil Mustafa Kasım
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Harran, Şanlıurfa, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Bingol State Hospital, Bingol, Turkey.
Iran J Public Health. 2024 Apr;53(4):799-808. doi: 10.18502/ijph.v53i4.15556.
Brucellosis is one of the most common zoonotic infections. Although culture is the gold standard diagnostic method, bacterial growth in blood cultures may not always occur due to various factors. We aimed to investigate demographic, clinical, and laboratory findings that may have predictive significance for bacteremia in brucellosis.
Patients older than 18 years of age followed up with a diagnosis of brucellosis between 2012 and 2022 were included in this retrospective multicenter study. They were divided into two main subgroups according to their species reproductive status as bacteremic and non-bacteremic.
A total of 743 patients, 370 (49.80%) bacteremic and 373 (50.20%) non-bacteremic brucellosis patients, were enrolled. The mean age of the bacteremic group (36.74 years) was lower than the non-bacteremic group (43.18 yr). High fever, chills/cold, sweating, nausea, vomiting, and weight loss were more common in the bacteremic group. In the bacteremic group, white blood cell count, platelet count, hemoglobin level, mean platelet volume, eosinophil, and neutrophil counts were lower, and lymphocyte, erythrocyte sedimentation rate, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and ferritin levels were higher. According to the receiver operating characteristic (ROC) analysis, when the cut-off value of ferritin was considered 67, it was the parameter with the strongest predictive significance in bacteremia.
High ferritin level, low eosinophil count, and increased erythrocyte sedimentation rate were determined as the most critical laboratory findings in predicting bacteremia in brucellosis.
布鲁氏菌病是最常见的人畜共患感染之一。尽管培养是金标准诊断方法，但由于各种因素，血培养中细菌生长并非总能出现。我们旨在调查对布鲁氏菌病菌血症可能具有预测意义的人口统计学、临床和实验室检查结果。
本回顾性多中心研究纳入了2012年至2022年期间随访诊断为布鲁氏菌病的18岁以上患者。根据其菌血症状态分为两个主要亚组，即菌血症组和非菌血症组。
共纳入743例患者，其中370例（49.80%）为菌血症性布鲁氏菌病患者，373例（50.20%）为非菌血症性布鲁氏菌病患者。菌血症组的平均年龄（36.74岁）低于非菌血症组（43.18岁）。高热、寒战/发冷、出汗、恶心、呕吐和体重减轻在菌血症组中更为常见。菌血症组的白细胞计数、血小板计数、血红蛋白水平、平均血小板体积、嗜酸性粒细胞和中性粒细胞计数较低，而淋巴细胞、红细胞沉降率、天冬氨酸转氨酶、丙氨酸转氨酶、乳酸脱氢酶和铁蛋白水平较高。根据受试者工作特征（ROC）分析，当铁蛋白的临界值为67时，它是菌血症中预测意义最强的参数。
高铁蛋白水平、低嗜酸性粒细胞计数和红细胞沉降率升高被确定为预测布鲁氏菌病菌血症的最关键实验室检查结果。
