印度西部一家三级医院急性钩端螺旋体病的血清流行率

Bhumika Baveja, M. Palewar, Suverna Joshi, R. Karyakarte
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引用次数: 1

摘要

背景:钩端螺旋体病是一种广泛复发的人畜共患疾病,尤其在发展中国家。根据世界卫生组织的说法,尽管这种疾病很严重,但在大多数流行国家,由于缺乏对问题严重程度的信息和认识,这种疾病被忽视了。目的:研究马哈拉施特拉邦浦那普通人群中钩端螺旋体病的血清流行率和流行病学及其生化相关性。材料和方法:这是一项为期1年的回顾性观察性实验室研究,从2020年1月到12月,在印度西部的一家三级护理医院进行。使用酶联免疫吸附试验(ELISA)对1年内收到的561份用于诊断发烧的血液样本进行了钩端螺旋体IgM抗体处理。结果:在研究期间收到的561份血液样本中,共有111份检测出钩端螺旋体IgM抗体呈阳性。钩端螺旋体的血清流行率为19.78%。在血清阳性患者中,年龄从4岁到77岁不等。血清阳性率最高的是21-30岁年龄组(42%)。在那些检测呈阳性的人中,有34%(n=38)的男性和66%(n=73)的女性。浦那的血清流行率在6月至8月期间最高。44名(39.63%)患者的肾功能测试出现紊乱(血清肌酐>1.5 mL)。低钠血症和低钾血症的发生率分别为37.84%和21.62%。在肝功能测试中,36例(32.43%)患者的血清谷丙转氨酶(SGOT)和血清谷丙氨基转氨酶(SGPT)均出现紊乱(SGOT>40U/L;SGPT>56U/L),另有18例(48.64%)患者单独出现SGOT紊乱。65.45%的患者出现血清胆红素紊乱,和0.90%的患者。结论:由于这种感染的发病率很高,钩端螺旋体病的早期诊断至关重要,因为在疾病早期开始抗生素治疗会带来最大的益处。
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Seroprevalence of acute leptospirosis in a tertiary care hospital of western India
Background: Leptospirosis is a widespread re-emerging zoonotic disease, especially in developing countries. According to World Health Organization, despite being severe, the disease is neglected in most endemic countries because of a lack of information and awareness about the extent of the problem. Objective: The objective was to study the seroprevalence and epidemiology of leptospirosis with its biochemical correlation in the general population in Pune, Maharashtra. Materials and Methods: It is a retrospective observational laboratory-based study over 1 year from January to December 2020 in a tertiary care hospital in western India. A total of 561 blood specimens received during 1 year for the diagnosis of fever were processed for Leptospira IgM antibodies using enzyme-linked immunosorbent assay (ELISA). Results: A total of 111 of 561 blood specimens that were received during the study period tested positive for IgM antibody against Leptospira. The seroprevalence of Leptospira spp. was found to be 19.78%. In seropositive patients, the age ranged from 4 to 77 years. The highest seropositivity was observed in the age group of 21–30 years (42%). There were 34% (n = 38) males and 66% (n = 73) females, among those who tested positive. Seroprevalence in Pune was highest in the months of June–August. Renal function tests were deranged in 44 (39.63%) patients (serum creatinine > 1.5 mL). Hyponatremia and hypokalemia were observed in 37.84% and 21.62% of patients, respectively. In liver function tests, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) both were deranged (SGOT > 40 U/L; SGPT > 56 U/L) in 36 (32.43%) patients, whereas SGOT alone was deranged in additional 18 patients (48.64%). Serum bilirubin was deranged in 65.45%. Coinfection was observed with chikungunya, dengue, and malaria in 7.2%, 6.3%, and 0.90% of patients, respectively. Conclusion: Because morbidity is high in this infection, early diagnosis of leptospirosis is essential because antibiotic therapy provides the greatest benefit when initiated early in the course of illness.
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