现代格鲁吉亚钩端螺旋体病的临床表现和流行病学特征。

Q4 Medicine Georgian medical news Pub Date : 2024-09-01
T Megrelishvili, I Mikadze, N Kipiani, N Mamuchishvili, T Bochorishvili, T Imnadze, E Pachkoria, L Ratiani
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引用次数: 0

摘要

导言:钩端螺旋体病被认为是世界上最常见的人畜共患传染病之一,主要分布在亚热带和热带国家。在格鲁吉亚,钩端螺旋体病的发病率从 2011 年开始急剧上升,发病率增至 16.3%。在此期间,检测到的血清型也发生了变化:L.Pomona, L.icterohemorragiae, L.grippotyphosa, L.hebdomadis,其中最常见的是L.pomona,占45%:最近的一项研究旨在揭示钩端螺旋体病在现代阶段的临床和流行病学特征,特别是那些在 COVID-19 后发病率增加的病例。从 2023 年 1 月至 6 月,我们对 62 名长期发热(超过 5 天且无腹泻症状)患者进行了研究。这项队列研究在天水围第一大学诊所进行;他们都在第一大学诊所住院治疗。在卢加研究中心使用 ELISA 方法检测 Ig M 滴度,如果滴度可靠,则确诊为钩端螺旋体病:根据 2023 年(1 月至 6 月)在第一大学诊所进行的研究,40 例患者(64.5%)通过血清学分析确诊为钩端螺旋体病。患者年龄从17岁到80岁不等,女性占29%,男性占71%,来自城市和农村的比例几乎相同,分别为54.8%和45.2%。钩端螺旋体病的临床表现包括肺炎、魏氏病和神经系统疾病。有 12.9%的患者为传染性感染,87.1%的患者为单细胞感染;肺炎是最常见的临床综合征,占 35.5%,中枢神经系统损害症状(脑膜炎、脑膜脑炎、脑脊髓膜炎)各占 12.9%,1 名患者(2.5%)出现出血性中风。魏氏病占 23.6%。对 2013-2014 年至 2023 年的临床流行病学特征进行比较分析后发现,临床变异的频率和流行病学特征发生了变化。最近发现无黄疸型钩端螺旋体病的发病率有所上升 结论:该病的分布范围已扩大到城市地区,这表明该病的传播范围更广。由于钩端螺旋体病的临床表现多种多样,该研究强调了在长期发热病例中诊断钩端螺旋体病的重要性,钩端螺旋体病具有动态性和不断变化的临床模式,强调了持续监测不明原因发热、与其他疾病鉴别诊断和及时干预的重要性,尤其是在后科维德19时期。
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CLINICAL MANIFESTATION AND EPIDEMIOLOGICAL PECULIARITIES OF LEPTOSPIROSIS AT THE MODERN STAGE IN GEORGIA.

Introduction: Leptospirosis is considered one of the most common zoonotic infections in the world and is characterized by distribution in countries of subtropical and tropical zones. In Georgia A sharp increase in the frequency of leptospirosis began in 2011, and the morbidity rate increased to 16.3. Also, the landscape of detected serovars changed during this period: L.Pomona, L.icterohemorragiae, L.grippotyphosa, L.hebdomadis, among them the most frequently registered - L.pomona -45%.

Materials and methods: A recent study aimed to reveal clinical and epidemiological peculiarities of leptospirosis at the modern stage, particularly those with heightened instances post-COVID-19. From January to June 2023, we studied 62 individuals with prolonged fever (more than 5 days without catarrhal events). The cohort study was conducted at the First University Clinic of TSMU); They were hospitalized at the First University Clinic. Comparative analysis was done with previous study which was conducted in 2013-2014 The diagnosis of leptospirosis was confirmed in the case of a reliable, diagnostic Ig M titer using the ELISA method, which was performed at the Lugar Research Center.

Results: According to the study which was done at the First University Clinic in 2023(From January to June) leptospirosis was confirmed in 40 cases (64.5%) due to serological analysis. The age range varied from 17 to 80 years, females were 29 % and males 71% with almost equal representation from urban 54.8 % and rural 45.2% areas. The clinical spectrum of leptospirosis included pneumonia, Weil's disease, and neurological diseases. Icteric forms registered in 12.9 %, Unicteric forms in 87.1%; Pneumonia was the most common clinical syndrome in 35.5%, symptoms of CNS damage (meningitis, meningoencephalitis, meningomyelitis) were also registered 12.9% each. haemorrhagic stroke revealed in 1 (2.5% ) patient. Weil's disease in 23.6 % cases. Comparative analysis of clinical-epidemiological features from 2013-2014 to 2023 revealed changes in the frequency of clinical variants and epidemiological characteristics. Increased rate of anicteric forms of Leptospirosis have been noticed recently Conclusion: The disease has expanded its distribution to urban areas, indicating a wider reach. Because of various clinical manifestation of leptospirosis. the study emphasizes the importance of diagnosing leptospirosis in cases of prolonged fever, leptospirosis with its dynamic nature and changing clinical patterns, underscores the importance of ongoing surveillance of fever of unknown origin, differential diagnosis with other diseases and prompt intervention, especially in period of post-Covid 19.

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来源期刊
Georgian medical news
Georgian medical news Medicine-Medicine (all)
CiteScore
0.60
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207
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