Meta-analysis to estimate the load of Leptospira excreted in urine: beyond rats as important sources of transmission in low-income rural communities.
Meta-analysis to estimate the load of Leptospira excreted in urine: beyond rats as important sources of transmission in low-income rural communities.
复制标题
荟萃分析以估计尿液中排泄的钩端螺旋体的负载：除了大鼠是低收入农村社区中重要传播源的大鼠。
DOI：
10.1186/s13104-017-2384-4
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发表时间：
2017-01-28
影响因子：
1.8
通讯作者：
Pearson T
中科院分区：
文献类型：
--
作者：
Barragan V;Nieto N;Keim P;Pearson T
钩端螺旋体病是一种分布广泛、危害严重的人畜共患病。带菌者动物主要通过尿液排泄致病性钩端螺旋体。当病原体通过粘膜或小的皮肤擦伤进入宿主时发生感染。人类和其他动物通过直接接触尿液、受污染的土壤或水而暴露于病原体。虽然许多因素影响环境循环和钩端螺旋体向人类的传播，但环境中致病性钩端螺旋体的负荷可能起主要作用。围产期大鼠通常被认为是人类疾病的潜在来源;然而，暴露于其他动物也是一个风险因素。本报告的目的是强调各种带菌者动物在钩端螺旋体散入环境的数量方面的重要性。为此，我们进行了系统的文献综述和荟萃分析的病原体的数量，各种动物在他们的尿液中脱落。在总共14篇研究文章中报告了牛、鹿、狗、人、小鼠和大鼠的病原体数量。我们估计了每种动物每单位体积排出的平均钩端螺旋体，并通过考虑每只携带者动物排泄的尿液总量来估计每日环境贡献。大鼠每毫升尿液中的钩端螺旋体排泄量最高（中位数= 5.7 × 106个细胞），但大型哺乳动物排泄更多的尿液，因此每天排出的钩端螺旋体显著更多（5.1 × 108至1.3 × 109个细胞）。在这里，我们说明了如何，在低收入的厄瓜多尔农村社区，宿主人口统计学，钩端螺旋体感染的患病率可以与棚钩端螺旋体的估计，建议peridomestic牛可能是更重要的比大鼠在环境循环，并最终传播给人类。本文的在线版本（doi：10.1186/s13104-017-2384-4）包含补充材料，可供授权用户使用。
Leptospirosis is a major zoonotic disease with widespread distribution and a large impact on human health. Carrier animals excrete pathogenic Leptospira primarily in their urine. Infection occurs when the pathogen enters a host through mucosa or small skin abrasions. Humans and other animals are exposed to the pathogen by direct contact with urine, contaminated soil or water. While many factors influence environmental cycling and the transmission of Leptospira to humans, the load of pathogenic Leptospira in the environment is likely to play a major role. Peridomestic rats are often implicated as a potential source of human disease; however exposure to other animals is a risk factor as well. The aim of this report is to highlight the importance of various carrier animals in terms of the quantity of Leptospira shed into the environment. For this, we performed a systematic literature review and a meta-analysis of the amount of pathogen that various animal species shed in their urine. The quantity of pathogen has been reported for cows, deer, dogs, humans, mice, and rats, in a total of 14 research articles. We estimated the average Leptospira per unit volume shed by each animal species, and the daily environmental contribution by considering the total volume of urine excreted by each carrier animal. Rats excrete the highest quantity of Leptospira per millilitre of urine (median = 5.7 × 106 cells), but large mammals excrete much more urine and thus shed significantly more Leptospira per day (5.1 × 108 to 1.3 × 109 cells). Here we illustrate how, in a low-income rural Ecuadorian community, host population demographics, and prevalence of Leptospira infection can be integrated with estimates of shed Leptospira to suggest that peridomestic cattle may be more important than rats in environmental cycling and ultimately, transmission to humans. The online version of this article (doi:10.1186/s13104-017-2384-4) contains supplementary material, which is available to authorized users.