Clinical features of Vibrio vulnificus infections in the coastal areas of the Ariake Sea, Japan
Clinical features of Vibrio vulnificus infections in the coastal areas of the Ariake Sea, Japan
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DOI：
10.1007/s10156-010-0050-z
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发表时间：
2010-08-01
影响因子：
2.2
通讯作者：
Oishi, Hirotaka
中科院分区：
文献类型：
--
作者：
Matsumoto, Kouichi;Ohshige, Kenji;Oishi, Hirotaka
创伤弧菌感染可导致坏死性筋膜炎和败血症，并与高死亡率相关。大多数感染这种微生物的患者都有肝功能障碍作为基础疾病。然而，由于暴发和不明病例的散发性质，尚未对临床特征进行广泛评价并确定影响预后的因素。我们回顾性分析了1984年至2008年日本的37例病例，以回顾临床特征并确定与预后相关的风险因素。临床特征（患者的特征、初始临床实验室数据、入院时的症状和其他风险指标）和预后之间的统计学差异通过使用卡方检验或Mann-Whitney U检验进行分析。还进行了多变量logistic回归分析，以评估可能影响住院死亡率的因素。死亡率为64.9%。在91.6%的患者中观察到基础肝病。肝硬化的存在往往与住院死亡率有关;然而，没有达到统计学意义。高龄、血小板计数较低和发病时存在广泛的皮肤病变对结局的影响具有统计学意义。这种疾病的预后很差，因为败血性休克和坏死性筋膜炎往往在几天内发展。创伤弧菌感染的早期诊断和治疗是改善预后的关键。
Vibrio vulnificus infection can result in necrotizing fasciitis and sepsis and is associated with high mortality. Most patients infected with this microbe have liver dysfunction as an underlying disease. However, because of the sporadic nature of outbreaks and unidentified cases, extensive evaluation of clinical features and identification of factors affecting prognosis have not been performed. We retrospectively analyzed 37 cases in Japan from 1984 to 2008 to review clinical features and to identify risk factors associated with prognosis. Statistical differences between clinical features (patient's characteristics, initial clinical laboratory data, symptoms upon admission, and other risk indicators) and prognosis were analyzed by use of the chi (2) test or the Mann-Whitney U test. Multivariate logistic regression analysis was also performed to assess factors which potentially affect hospital mortality. The mortality rate was 64.9%. An underlying liver disease was observed in 91.6% of the patients. The presence of liver cirrhosis tended to be related to hospital mortality; however, statistical significance was not achieved. Advanced age, lower platelet counts, and the presence of extensive skin lesions at onset affected outcomes with statistical significance. The prognosis of this disease is poor, because septic shock and necrotizing fasciitis often develop within a few days. Early diagnosis and treatment are needed to improve the prognosis of V. vulnificus infection.