Abstract：
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with a high case fatality rate. Few studies have been performed on bacterial or fungal coinfections or the effect of antibiotic therapy. A retrospective, observational study was performed to assess the prevalence of bacterial and fungal coinfections in patients hospitalized for SFTSV infection. The most commonly involved microorganisms and the effect of antimicrobial therapy were determined by the site and source of infection. A total of 1201 patients hospitalized with SFTSV infection were included; 359 (29.9%) had microbiologically confirmed infections, comprised of 292 with community-acquired infections (CAIs) and 67 with healthcare-associated infections (HAIs). Death was independently associated with HAIs, with a more significant effect than that observed for CAIs. For bacterial infections, only those acquired in hospitals were associated with fatal outcomes, while fungal infection, whether acquired in hospital or community, was related to an increased risk of fatal outcomes. The infections in the respiratory tract and bloodstream were associated with a higher risk of death than that in the urinary tract. Both antibiotic and antifungal treatments were associated with improved survival for CAIs, while for HAIs, only antibiotic therapy was related to improved survival, and no effect from antifungal therapy was observed. Early administration of glucocorticoids was associated with an increased risk of HAIs. The study provided novel clinical and epidemiological data and revealed risk factors, such as bacterial coinfections, fungal coinfections, infection sources, and treatment strategies associated with SFTS deaths/survival. This report might be helpful in curing SFTS and reducing fatal SFTS.
摘要：
严重发热伴血小板减少综合征（SFTS）是一种新兴的蜱传疾病，病死率高。很少有关于细菌或真菌合并感染或抗生素治疗效果的研究。回顾，我们进行了观察性研究,以评估因SFTSV感染而住院的患者中细菌和真菌合并感染的发生率.最常见的微生物和抗菌治疗的效果取决于感染的部位和来源。共纳入1201例SFTSV感染住院患者;359例(29.9%)有微生物学证实的感染,由292例社区获得性感染(CAIs)和67例医疗保健相关感染(HAIs)组成。死亡与HAIs独立相关，比CAIs观察到的效果更显著。对于细菌感染，只有在医院获得的那些与致命结局有关，而真菌感染，无论是在医院还是社区获得，与致命结局的风险增加有关。呼吸道和血液感染的死亡风险高于泌尿道感染。抗生素和抗真菌治疗与CAIs的生存率提高有关。而对于HAIs来说,只有抗生素治疗与提高生存率有关，没有观察到抗真菌治疗的效果。早期给予糖皮质激素与HAIs风险增加相关。该研究提供了新的临床和流行病学数据，并揭示了危险因素，如细菌合并感染，真菌感染,感染源,以及与SFTS死亡/生存相关的治疗策略。此报告可能有助于治愈SFTS并减少致命的SFTS。
