The prevalence and clinical characteristics of tick-borne diseases at One Sentinel Hospital in Northeastern China
The prevalence and clinical characteristics of tick-borne diseases at One Sentinel Hospital in Northeastern China
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东北地区一哨点医院蜱传疾病流行情况及临床特征
DOI：
10.1017/s0031182018001178
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发表时间：
2019-02-01
期刊：
影响因子：
2.4
通讯作者：
Cao, Wu-Chun
中科院分区：
文献类型：
--
作者：
Liu, Hong-Bo;Ran-Wei;Cao, Wu-Chun
摘要我国东北地区蜱类资源丰富，蜱传病原体种类繁多，人群感染率高。尚未对该地区蜱传病原体引起的疾病谱进行客观评价，以进行临床管理，并与蜱传疾病常见的全球其他地区进行比较。本文根据临床症状、PCR、间接免疫荧光试验和（或）血涂片，对牡丹江市林业中心医院近期蜱叮咬患者的蜱传疾病进行了鉴定和描述。从2010年5月至2011年9月，42%（75/180）的患者被诊断患有特定的蜱传疾病，包括莱姆病、蜱传脑炎、人粒细胞无形体病、人巴贝虫病和斑点热群立克次体病。当我们比较临床和实验室特征以确定可能区分蜱传播感染和缺乏证据的感染的因素时，我们发现，在有和没有记录的病因之间，游走性红斑和神经系统表现存在统计学显著差异（P < 0.001，P = 0.003）。12例患者（6.7%，12/180）合并感染两种蜱传病原体。我们证明了临床医生识别特定蜱传疾病的能力很差。此外，有必要开发特定的实验室检测方法，以优化蜱传疾病的诊断。
Abstract Northeastern China is a region of high tick abundance, multiple tick-borne pathogens and likely human infections. The spectrum of diseases caused by tick-borne pathogens has not been objectively evaluated in this region for clinical management and for comparison with other regions globally where tick-transmitted diseases are common. Based on clinical symptoms, PCR, indirect immunofluorescent assay and (or) blood smear, we identified and described tick-borne diseases from patients with recent tick bite seen at Mudanjiang Forestry Central Hospital. From May 2010 to September 2011, 42% (75/180) of patients were diagnosed with a specific tick-borne disease, including Lyme borreliosis, tick-borne encephalitis, human granulocytic anaplasmosis, human babesiosis and spotted fever group rickettsiosis. When we compared clinical and laboratory features to identify factors that might discriminate tick-transmitted infections from those lacking that evidence, we revealed that erythema migrans and neurological manifestations were statistically significantly differently presented between those with and without documented aetiologies (P < 0.001, P = 0.003). Twelve patients (6.7%, 12/180) were co-infected with two tick-borne pathogens. We demonstrated the poor ability of clinicians to identify the specific tick-borne disease. In addition, it is necessary to develop specific laboratory assays for optimal diagnosis of tick-borne diseases.