Comparison between Emerging Q Fever in French Guiana and Endemic Q fever in Marseille, France
Comparison between Emerging Q Fever in French Guiana and Endemic Q fever in Marseille, France
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DOI：
10.4269/ajtmh.13-0164
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发表时间：
2014-05-01
影响因子：
3.3
通讯作者：
Raoult, Didier
中科院分区：
文献类型：
--
作者：
Edouard, Sophie;Mahamat, Aba;Raoult, Didier
Q 热是法属圭亚那的一种新发疾病。我们比较了四年期间来自卡宴、法属圭亚那和法国大都市马赛的患者的发病率、临床和血清学特征。卡宴确诊的急性 Q 热的年发病率 (17.5/100,000) 显着高于马赛 (1.9/100,000) (P = 0.0004)，但心内膜炎的年发病率则不然 (1.29 vs 0.34/100,000)。卡宴的大多数患者有发烧 (97%) 和肺炎 (83%)，而马赛的这一比例为 81% 和 8%（分别为 P < 0.0001 和 P < 0.0001），但转氨酶在马赛的患者中更为常见（54% 对 32%；P < 0.0001）。卡宴心血管感染患者的比例 (7%) 显着低于马赛 (17%) (P = 0.017)，尽管他们表现出更强的免疫反应，I 期 IgG 水平较高 (P = 0.024)。来自卡宴和马赛的患者不同的流行病学、临床和血清学反应表明不同的感染源和不同的伯内氏立克次体菌株。
Q fever is an emergent disease in French Guiana. We compared the incidence clinical and serologic profiles between patients from Cayenne, French Guiana and Marseille in metropolitan France during a four-year period. The annual incidence of diagnosed acute Q fever was significantly higher in Cayenne (17.5/100,000) than in Marseille (1.9/100,000) (P = 0.0004), but not the annual incidence of endocarditis (1.29 versus 0.34/100,000). Most patients had fever (97%) and pneumonia (83%) in Cayenne versus 81% and 8% in Marseille (P < 0.0001 and P < 0.0001, respectively) but transaminitis was more common in patients from Marseille (54% versus 32%; P < 0.0001). The proportion of patients with cardiovascular infections was significantly lower in Cayenne (7%) than in Marseille (17%) (P = 0.017), although they showed a stronger immune response with higher levels of phase I IgG (P = 0.024). The differing epidemiology, clinical, and serologic responses of patients from Cayenne and Marseille suggest a different source of infection and a different strain of Coxiella burnetii.