Epidemiology of cat-scratch disease hospitalizations among children in the United States
Epidemiology of cat-scratch disease hospitalizations among children in the United States
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DOI：
10.1097/01.inf.0000172185.01939.fc
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发表时间：
2005-08-01
影响因子：
3.6
通讯作者：
Steiner, CA
中科院分区：
文献类型：
--
作者：
Reynolds, MG;Holman, RC;Steiner, CA
背景：猫抓病（CSD）由汉赛巴尔通体感染引起，影响儿童和成人，但主要是一种儿科疾病。典型的 CSD 通常是良性的、自限性的，其特征是局部淋巴结肿大伴发热。然而，感染可能伴有局灶性或弥漫性炎症反应（非典型 CSD），涉及神经系统、器官（肝/脾）、淋巴或骨骼系统。方法：使用 2000 年儿童住院数据库检查了因 CSD 诊断而住院的儿童。对 18 岁以下患者的全国 CSD 相关住院估计、住院率和各种住院统计数据进行了检查。结果： 2000 年，美国 18 岁以下儿童中估计有 437 例 (SE 43) 儿童因 CSD 住院。全国 CSD 相关住院率为 0.60/100,000 名 18 岁以下儿童（95% 置信区间，0.49-0.72）和 0.86/100,000 名 5 岁以下儿童（95% CI 0.64-1.07）。伴随诊断包括神经系统并发症（12%）、器官（肝/脾）受累（7%）和“其他”（5%）。非典型 CSD 占 CSD 相关住院治疗的 24%。在美国，与 CSD 相关的住院费用中位数为 6140 美元，每年住院费用总额约为 350 万美元。 结论：2000 年美国儿童与 CSD 相关的住院费用似乎与 1980 年代美国的估计相似，尽管在此期间猫的拥有量显着增加。建议对儿童 CSD 进行早期血清学和分子检测，以尽量减少不必要的干预，并在需要支持措施时促进最佳有效的护理。
Background: Cat-scratch disease (CSD), caused by infection with Bartonella henselae, affects both children and adults but is principally a pediatric disease. Typical CSD is generally benign and self-limited and is characterized by regional lymphadenopathy with fever. Infections can, however, be accompanied by focal or diffuse inflammatory responses (atypical CSD) involving neurologic, organ (liver/spleen), lymphatic or skeletal systems.Methods: Pediatric hospitalizations with CSD listed as a diagnosis were examined using the Kids' Inpatient Database for the year 2000. National estimates of CSD-associated hospitalizations, hospitalization rates and various hospitalization statistics were examined for patients younger than 18 years of age.Results: During 2000, an estimated 437 (SE 43) pediatric hospitalizations associated with CSD occurred among children younger than 18 years of age in the United States. The national CSD-associated hospitalization rate was 0.60/100,000 children younger than 18 years of age (95% confidence interval, 0.49-0.72) and 0.86/100,000 children younger than 5 years of age (95% CI 0.64-1.07). Accompanying diagnoses included neurologic complications (12%), organ (liver/spleen) involvement (7%) and "other" (5%). Atypical CSD accounted for similar to 24% of the CSD-associated hospitalizations. The median charge for a CSD-associated hospitalization was $6140 with total annual hospital charges of similar to$3.5 million among children in the United States.Conclusions: The CSD-associated hospitalization rate among children during 2000 appeared similar to those estimated for the 1980s in the United States, despite significant increases in cat ownership in the intervening time. Early serologic and molecular testing for CSD in children is suggested to minimize unnecessary interventions and promote optimally effective care when supportive measures are required.