67例血培养阳性成人布鲁菌感染者的临床特征

目的 探究血培养阳性成人布鲁菌感染者临床特征。 方法 回顾性分析2015年1月至2020年1月收治的67例于血培养阳性成人布鲁菌感染者的临床资料,描述该类患者临床特征,同时按布鲁菌试管凝集试验抗体效价1∶400分为两组,定义高效价组(≥1∶400),低效价组(<1∶400),比较两组患者上述临床特征差异。 结果 67例患者急性期占86.15%,无发热症状患者4例(5.97%),并发肝损伤56例(83.58%),血清学检查阴性者4例(5.97%)。对两组不同布鲁菌试管凝集试验抗体效价组比较,高效价组男性占比较多(62.96% vs 37.04%,P=0.009),淋巴细胞比例更高［34.08±11.87 vs 28.45±10.42,95%CI: 5.64(-11.16~0.12),P=0.045］,余一般资料、临床症状、并发症、实验室检查、血培养报阳时间方面两组情况差异均无统计学意义(P>0.05)。 结论 收治的血培养阳性成人布鲁菌感染者临床分期以急性期为主,并发肝损伤概率较高,且有少部分患者无发热或血清学检查阴性,血培养检查可减少漏诊;布鲁菌试管凝集试验高效价组较低效价患者组男性更多,淋巴细胞比例更高。

Clinical characteristics of 67 adult cases of blood culture-positive Brucella infection

Objective To investigate the clinical characteristics of adult Brucella infection with positive blood culture. Methods The clinical data of 67 adult patients with blood culture-positive Brucella infection admitted to our hospital during Jan. 2015 and Jan. 2020 were retrospectively analyzed, and the clinical characteristics were described. According to the antibody titer of Brucella serum agglutination test(SAT)1∶400, the patients were divided into high-titer group(≥1∶400)and low-titer group(<1∶400). The differences in the clinical characteristics were compared between the two groups. Results The acute stage accounted for 86.15% of all patients, 4(5.97%)had no fever symptoms, 56(83.58%)were complicated with liver injury, and 4(5.97%)had negative serological tests. SAT indicated that the high-titer group had more males(62.96% vs 37.04%, P=0.009), and higher lymphocyte ratio ［34.08±11.87 vs 28.45±10.42, 95%CI: 5.64(-11.16-0.12), P=0.045］. There was no statistical difference between the two groups in general information, clinical symptoms, complications, laboratory tests, and positive blood culture time(P>0.05). Conclusion Most adult cases of Brucella infection with positive blood culture are in the acute stage with high risk of liver injury. As a few patients have no fever, or have negative serological test results, blood culture test can reduce missed diagnosis. Compared with the low-titer group, the high-titer group has more males and a higher proportion of lymphocytes.