Walker D H, Barbour A G, Oliver J H, Lane R S, Dumler J S, Dennis D T, Persing D H, Azad A F, McSweegan E
Department of Pathology, University of Texas Medical Branch at Galveston 77555-0609, USA.
JAMA. 1996 Feb 14;275(6):463-9.
Among the etiologic agents of emerging infectious diseases are several bacterial organisms that naturally reside in animal and arthropod hosts. The most compelling emerging bacterial zoonotic and vector-borne diseases in the United States are Lyme disease; a Southern erythema migrans-like illness; human monocytic ehrlichiosis; human granulocytic ehrlichiosis; a novel cat flea-associated typhus group rickettsiosis; bartonelloses of immunocompetent and immunocompromised persons, particularly with AIDS; and sylvatic plague. Some of these antimicrobial-treatable infections are life threatening. During the acute stage of illness when antimicrobial agents are most effective, the flulike clinical signs and symptoms and available laboratory tests frequently do not point to a particular diagnosis. Epidemiological factors determined by the ecology of the bacteria are often the most useful diagnostic clues. The recognition of these evolving problems emphasizes the need for development of better laboratory diagnostic methods, for surveillance for and tracking of disease, and for continued research into factors contributing to transmission of the organisms. The continual appearance of previously unidentified bacterial infections requires prospective national strategies for timely recognition of the syndrome, identification of the agent, establishment of criteria and methods for diagnosis, optimization of the treatment regimen, and determination of successful approaches to prevention and control.
新发传染病的病原体中有几种细菌，它们自然存在于动物和节肢动物宿主中。在美国，最引人注目的新发细菌性人畜共患病和媒介传播疾病有莱姆病；一种类似南部游走性红斑的疾病；人单核细胞埃立克体病；人粒细胞埃立克体病；一种新型的与猫蚤相关的斑疹伤寒群立克次体病；免疫功能正常和免疫功能低下者（特别是艾滋病患者）的巴尔通体病；以及丛林鼠疫。其中一些可用抗菌药物治疗的感染会危及生命。在疾病的急性期，抗菌药物最为有效，但类似流感的临床体征和症状以及现有的实验室检查常常无法指向特定诊断。由细菌生态学决定的流行病学因素往往是最有用的诊断线索。认识到这些不断演变的问题凸显了开发更好的实验室诊断方法、监测和追踪疾病以及持续研究病原体传播相关因素的必要性。先前未被识别的细菌感染不断出现，这就需要制定前瞻性的国家战略，以便及时识别综合征、鉴定病原体、确立诊断标准和方法、优化治疗方案，并确定成功的预防和控制方法。
