Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
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新发感染网络中神经传染病调查的患病率和特征：22 年回顾性研究
DOI：
10.1093/ofid/ofaa163
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发表时间：
2020
影响因子：
4.2
通讯作者：
K. Thakur
中科院分区：
文献类型：
--
作者：
E. Matthews;Luisa A. Diaz;S. Beekmann;P. Polgreen;G. Waldrop;V. Yang;Kathryn Rimmer;A. Venkatesan;K. Thakur
为了监测新发传染病，美国疾病控制和预防中心和美国传染病学会建立了新发传染病网络（EIN），允许传染病专家发布有关临床病例的查询。我们描述了神经传染病相关询问的频率和特征。方法使用与神经系统疾病相关的检索词对1997年2月至2019年12月的EIN listserv进行回顾性分析。我们记录了病例摘要、疾病类型（即脑膜炎、脑炎）、询问类型（诊断方法、结果解释、管理决策）、独特的患者人群、暴露、病原体、最终诊断和基于应答的临床护理变化。结果2348例患者中，神经系统感染性疾病285例，占12.1%。大多数涉及脑膜炎（99，34.7%）或脑炎（56，19.6%）。115例询问（40%）与管理相关，34例（12%）与诊断检查相关，22例（8%）与结果解释相关。8例（2.8%）明确涉及脑脊液聚合酶链反应检测结果。63例（22.1%）涉及免疫抑制患者（29例人类免疫缺陷病毒阳性病例[46%]）。 最常见的病原体是梅毒螺旋体（19例，6.7%）和新型隐球菌（18例，6.3%）。在74例（25%）询问中，患者有神经系统症状，无明确感染，其中38例（51.3%）在鉴别诊断中包括非感染性神经系统病因。结论本研究表明，在传染病领域内，神经感染性疾病的诊断和管理面临着重大挑战。它还强调了策划论坛的重要性，以指导疑难病例的处理方法，特别是类似传染病的病例。最后，环境信息网的邮件列表服务器可协助确定研究和培训领域，以解决这些复杂问题。
Abstract Background To monitor emerging infectious diseases, the Centers for Disease Control and Prevention and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequency and characteristics of neuroinfectious disease-related inquiries. Methods The EIN listserv was retrospectively reviewed from February 1997 to December 2019 using search terms associated with neurologic diseases. We recorded case summaries, disease type (ie, meningitis, encephalitis), inquiry type (diagnostic approach, result interpretation, management decisions), unique patient populations, exposures, pathogens, ultimate diagnosis, and change in clinical care based on responses. Results Of 2348 total inquiries, 285 (12.1%) related to neuroinfectious diseases. The majority involved meningitis (99, 34.7%) or encephalitis (56, 19.6%). One hundred fifteen inquiries (40%) related to management, 34 (12%) related to diagnostic workup, and 22 (8%) related to result interpretation. Eight (2.8%) specifically involved results of cerebrospinal fluid polymerase chain reaction testing. Sixty-three (22.1%) involved immunosuppressed patients (29 human immunodeficiency virus-positive cases [46%]). The most common pathogens were Treponema pallidum (19, 6.7%) and Cryptococcus neoformans (18, 6.3%). In 74 (25%) inquiries, patients had neurologic symptoms without a clear infection, 38 (51.3%) of which included noninfectious neurologic etiologies in the differential diagnosis. Conclusions This study demonstrates the significant challenges of diagnosis and management of neuroinfectious diseases within the field of infectious diseases. It also highlights the importance of curated forums to guide the approach of difficult cases, in particular instances that mimic infectious diseases. Finally, the EIN listserv may assist in identifying areas for research and training to address these complexities.
影响因子：
158.5
作者：
Wilson, M. R.;Sample, H. A.;Chiu, C. Y.
通讯作者：
Chiu, C. Y.