Aetiology and Potential Animal Exposure in Central Nervous System Infections in Vietnam.
Aetiology and Potential Animal Exposure in Central Nervous System Infections in Vietnam.
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DOI：
10.1007/s10393-022-01611-w
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发表时间：
2022-12
期刊：
影响因子：
2.5
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中科院分区：
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据估计，73%的新发感染是人畜共患病，动物接触和侵犯其栖息地增加了溢出事件的风险。在越南，密切接触各种动物和动物产品可导致获得人畜共患病病原体，其中一些可引起中枢神经系统（CNS）感染。然而，研究表明，在大约一半的病例中，CNS感染的病因仍然未知。我们使用了入组越南人畜共患感染倡议多中心研究的CNS感染住院患者的样本和数据，以确定病因与动物接触之间的关联，包括病因不明的患者。在933例患者中，291例（31.2%，95% CI 28.3-34.3%）确定了病原体或对其的抗体应答。最常见的病原体是猪链球菌（n = 91（9.8%，8.0-11.9%））和日本脑炎病毒（JEV）（n = 72（7.7%，6.1-9.7%））。通常报告的动物接触包括饲养、饲养或处理（n = 364（39.0%，35.9-42.2%））和在症状发作前2周内处理、烹饪或食用生肉、血液或内脏（n = 371（39.8%，36.6-43.0%）），后者最常见于猪（n = 343（36.9%，33.8-40.1%））。在多变量logistic回归中，未知病因与动物暴露之间无相关性。进一步检测未知或未检测到的病原体可能会增加诊断率，但是，鉴于人畜共患病病原体的比例很高，存在风险因素，可以考虑提高公众对人畜共患病和预防措施的认识。在线版本包含补充材料，可通过10.1007/s10393-022-01611-w获得。
An estimated 73% of emerging infections are zoonotic in origin, with animal contact and encroachment on their habitats increasing the risk of spill-over events. In Vietnam, close exposure to a wide range of animals and animal products can lead to acquisition of zoonotic pathogens, a number of which cause central nervous system (CNS) infections. However, studies show the aetiology of CNS infections remains unknown in around half of cases. We used samples and data from hospitalised patients with CNS infections, enrolled into the Vietnam Initiative on Zoonotic Infections multicentre study, to determine the association between aetiology and animal contact including those in whom the cause was unknown. Among 933 patients, a pathogen or an antibody response to it was identified in 291 (31.2%, 95% CI 28.3–34.3%). The most common pathogens were Streptococcus suis (n = 91 (9.8%, 8.0–11.9%)) and Japanese encephalitis virus (JEV) (n = 72 (7.7%, 6.1–9.7%)). Commonly reported animal contact included keeping, raising or handling (n = 364 (39.0%, 35.9–42.2%)) and handling, cooking or consuming raw meat, blood or viscera in the 2 weeks prior to symptom onset (n = 371 (39.8%, 36.6–43.0%)), with the latter most commonly from pigs (n = 343 (36.9%, 33.8–40.1%). There was no association between an unknown aetiology and exposure to animals in a multivariate logistic regression. Further testing for unknown or undetected pathogens may increase diagnostic yield, however, given the high proportion of zoonotic pathogens and the presence of risk factors, increasing public awareness about zoonoses and preventive measures can be considered. The online version contains supplementary material available at 10.1007/s10393-022-01611-w.