Hospital-based surveillance for acute febrile illness in Egypt: A focus on community-acquired bloodstream infections
Hospital-based surveillance for acute febrile illness in Egypt: A focus on community-acquired bloodstream infections
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DOI：
10.4269/ajtmh.2005.73.392
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发表时间：
2005-08-01
影响因子：
3.3
通讯作者：
Mahoney, F
中科院分区：
文献类型：
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作者：
Afifi, S;Earhart, K;Mahoney, F
急性发热性疾病（AFI）是埃及的一种常见综合征。然而，其病因尚未得到很好的表征。为了确定病原体病因学的相对频率并可能改善诊断，临床管理和公共卫生措施，我们在埃及各地的传染病医院网络中实施了基于实验室的监测。入院的AFI患者提供了背景资料和血液样本进行细菌培养和血清学分析。病例定义基于实验室结果。在1999年至2003年期间评估的10，130名患者中，5%的肠道沙门氏菌血清型伤寒培养阳性，3%的布鲁氏菌培养阳性，2%的其他病原体培养阳性。另外18%的患者伤寒血清学结果阳性，11%的患者布鲁氏菌病血清学结果阳性。风险因素分析表明，城市供水的可用性显着（P < 0.05）与预防伤寒。动物接触和食用生乳制品与布鲁氏菌病显著相关。监测网络确定伤寒和布鲁氏菌病是埃及AFI最常见的细菌原因，可以更好地描述其流行病学，并可能导致制定有针对性的预防战略。
Acute febrile illness (AFI) is a common syndrome in Egypt. However its etiologies are not well characterized. To determine the relative frequency of pathogen etiologies and possibly improve diagnostic, clinical management and public health measures, we implemented laboratory-based surveillance in a network of infectious disease hospitals throughout Egypt. Admitted patients with AFI provided background details and a blood sample for bacterial culture and serologic analysis. Case definitions were based on laboratory results. Of 10,130 patients evaluated between 1999 and 2003, 5% were culture positive for Salmonella enterica serogroup Typhi, 3% for Brucella, and 2% for other pathogens. An additional 18% of patients had positive serologic results for typhoid and 11% for brucellosis. Risk factor analysis identified availability of municipal water to be significantly (P < 0.05) associated with protection against typhoid. Animal contact and consumption of raw dairy products were significantly associated with brucellosis. The surveillance network identified typhoid fever and brucellosis as the most common bacterial causes of AFI in Egypt, allowed better description of their epidemiology, and may lead to the development of targeted prevention strategies.