PDF(Pubmed)
Abstract：
Human strongyloidiasis is a potentially life-threatening parasitic disease among immunocompromised hosts. We aim to determine the factors and mortality associated with disseminated strongyloidiasis. We conducted a U.S.-based multicenter retrospective cohort study to determine 90-day clinical outcomes for people diagnosed with Strongyloides infection in the TriNetX patient database. We identified adult patients with the International Classification of Diseases (10th revision, clinical modification) code for Strongyloides infection (B78) or a positive Strongyloides IgG antibody test and captured outcomes at 90 days. We identified 5,434 patients with strongyloidiasis, of whom 48 had disseminated strongyloidiasis for 0.9% prevalence of disseminated disease. Systemic connective tissue disorders, pulmonary eosinophilia, liver cirrhosis, blood disorders (monoclonal gammopathy, aplastic anemia, and lymphoid malignancy), malnutrition, alcohol use disorder, and transplantation status were frequent in patients with disseminated disease. Mortality was significantly higher in people with disseminated disease at 30 days (21%). The 90-day risk of hospitalization, bacteremia, and acute respiratory distress syndrome (ARDS) was higher in those with disseminated infection. People with disseminated strongyloidiasis had a heightened risk of hospitalization, bacteremia, acute respiratory distress syndrome, and mortality. The population at risk for severe strongyloidiasis infection is evolving, reflecting conditions in which glucocorticoids or additional immunosuppressive medications are commonly used for treatment.
摘要：
人类圆线虫病是免疫受损宿主中潜在威胁生命的寄生虫病。我们的目的是确定与播散性圆线虫病相关的因素和死亡率。我们进行了一项基于美国的多中心回顾性队列研究，以确定TriNetX患者数据库中被诊断为类圆线虫感染的患者的90天临床结局。我们确定了符合国际疾病分类的成年患者(第10次修订，临床修改）代码为类圆线虫感染（B78）或阳性的类圆线虫IgG抗体测试和在90天捕获的结果。我们确定了5,434例圆线虫病患者，其中48人患有播散性圆线虫病，播散性疾病患病率为0.9％。系统性结缔组织疾病，肺嗜酸性粒细胞增多,肝硬化,血液疾病（单克隆丙种球蛋白病，再生障碍性贫血,和淋巴恶性肿瘤)，营养不良,酒精使用障碍,在播散性疾病患者中，移植状态很常见。播散性疾病患者在30天时的死亡率明显更高（21％）。90天的住院风险，菌血症,播散性感染患者的急性呼吸窘迫综合征（ARDS）较高。散发性线虫病患者住院风险增加,菌血症,急性呼吸窘迫综合征,和死亡率。有严重线虫病感染风险的人群正在演变,反映了糖皮质激素或其他免疫抑制药物通常用于治疗的情况。
