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产志贺毒素大肠杆菌与溶血尿毒综合征:2022年土耳其疫情研究

Shiga Toxin-Producing E. coli and Hemolytic Uremic Syndrome: A Study of the 2022 Outbreak in Turkey.

作者信息

Zengin Oğuzhan, Göre Burak, Öztürk Oğuz, Göv Muhammet, Şahiner Enes Seyda, İnan Osman, Asfuroğlu Kalkan Emra, Kösal Cevher Şimal, Güneş Ahmet Kürşad, Özet Gülsüm, Ateş İhsan

机构信息

Department of Internal Medicine, Ankara Bilkent City Hospital, Ankara, Turkey.

Department of Gastroenterology, Ankara Bilkent City Hospital, Ankara, Turkey.

出版信息

Med Sci Monit. 2024 Dec 9;30:e946033. doi: 10.12659/MSM.946033.

Abstract

BACKGROUND Shiga toxin-producing Escherichia coli (STEC) causes serious bacterial illnesses from consuming undercooked meat and foods contaminated with feces. This study aimed to describe the characteristics of an STEC outbreak associated with hemolytic uremic syndrome (HUS) that emerged in Turkey and affected 21 adults. MATERIAL AND METHODS The medical records of 21 adult patients who were admitted to Ankara Bilkent City Hospital Internal Medicine Intensive Care Department with the diagnosis of HUS between July and September 2022 were retrospectively evaluated through the system. RESULTS While a positive correlation was detected between the length of hospital stay and N-terminus pro-B-type natriuretic peptide (NT-proBNP), lactate dehydrogenase (LDH), and troponin during hospitalization, a negative correlation was detected with glomerular filtration rate (GFR). Patients requiring plasmapheresis had higher creatinine, amylase, and LDH values at the time of admission. In patients given eculizumab, high NT-proBNP and creatinine levels and low GFR levels at the time of admission were found to be statistically significant. The use of antibiotics before admission did not change the length of hospital stay. CONCLUSIONS A statistically significant difference was detected between LDH, GFR, troponin, NT-proBNP parameters, and length of hospital stay. Creatine and LDH values of patients requiring eculizumab and plasmapheresis at the time of admission were found to be statistically high. It should be kept in mind that eculizumab and plasmapheresis treatment can be required for patients with elevated creatine and LDH at the time of admission.

摘要

背景 产志贺毒素大肠杆菌(STEC)可通过食用未煮熟的肉类和受粪便污染的食物引发严重的细菌性疾病。本研究旨在描述在土耳其出现的一起与溶血性尿毒症综合征(HUS)相关的STEC疫情的特征,该疫情影响了21名成年人。材料与方法 通过系统回顾性评估了2022年7月至9月间因诊断为HUS而入住安卡拉比尔肯特市医院内科重症监护病房的21名成年患者的病历。结果 住院期间,住院时间与N端前B型利钠肽(NT-proBNP)、乳酸脱氢酶(LDH)和肌钙蛋白之间呈正相关,与肾小球滤过率(GFR)呈负相关。需要进行血浆置换的患者入院时肌酐、淀粉酶和LDH值较高。在接受依库珠单抗治疗的患者中,入院时NT-proBNP和肌酐水平较高以及GFR水平较低具有统计学意义。入院前使用抗生素并未改变住院时间。结论 在LDH、GFR、肌钙蛋白、NT-proBNP参数和住院时间之间检测到统计学上的显著差异。发现需要依库珠单抗和血浆置换的患者入院时肌酸和LDH值在统计学上较高。应记住,入院时肌酸和LDH升高的患者可能需要依库珠单抗和血浆置换治疗。

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