目的:目的探讨布鲁氏菌的培养特点,诊断方法,和临床特征,为实验室提供布鲁氏菌病的诊断方法和预防治疗。
方法:对2012-2022年328例布氏杆菌病患者的资料进行分析,回顾性。细菌培养特点,临床诊断方法,并对并发症进行分析。采用受试者工作特征曲线ROC分析布鲁氏菌病的感染生物标志物。
结果:在328例布鲁氏菌病中,78.96%的病例为男性,患者的中位年龄为(45.21±13.49)岁,我们地区的年发病率为每年67/100000.诊断方法包括病原菌培养,血清学诊断,疑似病例占24.39%,47.56%,和28.05%,分别,联合检测标准凝集试验(SAT)和玫瑰红试验(RBT)的灵敏度为96.2%。在我们的工作中,通过细菌培养诊断出80例布鲁氏菌病,并鉴定为布鲁氏菌,血培养是主要方法(78.75%),平均阳性报警时间为80.74(21.6-129)h,全部在需氧瓶中检测,其次是滑液,骨髓,腰椎,和关节组织,穿刺液和腹水培养占6.25%,3.75%,5.00%,分别为5.00%和1.25%。伴并发症的布鲁氏菌病为腰椎病变,占41.46%,颈椎病变占4.60%,膝关节病变占12.8%,另一种是骨关节炎。患者院内死亡率为0.91%,均为脑膜炎患者。ROC分析显示CRP对布氏杆菌病具有较高的敏感性和特异性,当CRP为1.23mg/ml时,敏感性和特异性分别为0.727和0.718,U检验也表明CRP有显著差异,Z=5.054,p<0.001。
结论:布鲁氏菌病在40岁以上的男性中发病率较高,通过有氧血液培养被诊断出来,一般细菌培养,RBT和SAT,流行病学,通常伴有脊柱和关节病的并发症。
OBJECTIVE: Aim to investigate the brucella culture characteristics, diagnosis methods, and clinical characteristics, to provide the laboratory with diagnostic methods and prevention and treatment for brucellosis.
METHODS: Data of 328 cases of brucellosis from 2012 to 2022 was analyzed, retrospectively. The bacterial culture characteristics, the clinical diagnostic methods, and the complications were analyzed respectively. The infection biomarkers of the brucellosis were analyzed by Receiver operating characteristic curve ROC.
RESULTS: Among the 328 brucellosis, 78.96 % of cases were men, the median age of the patients was (45.21±13.49) years and the annual incidence in our region was 67/100 000 per year. The diagnostic methods included pathogenic bacteria culture, serological diagnosis, and suspect case were 24.39 %, 47.56 %, and 28.05 %, respectively, sensitivity of combined detection Standard agglutination test (SAT) and the Rose Bengal test (RBT) is 96.2 %. In our work, 80 cases of brucellosis were diagnosed by a bacterial culture which were been identified as Brucella melitensis, blood culture was the main method (78.75 %) and the average positive alarm time was 80.74 (21.6-129) h and all of them were detected in aerobic bottles, followed by synovial fluid, bone marrow, lumbar spine, and joint tissue, puncture fluid and ascites culture which were 6.25 %, 3.75 %, 5.00 %, 5.00 % and 1.25 % respectively. The brucellosis with complications was lumbar spine lesions at 41.46 % cervical spine lesions at 4.60 % and knee joint lesions at 12.8 % and another osteoarthritis. The in-hospital mortality rate of the patients was 0.91 % and all of them were meningitis patients. ROC analysis indicated CRP had high sensitivity and specificity for brucellosis, and when CRP was 1.23mg/ml, the sensitivity and specificity were 0.727 and 0.718 respectively, and the U test also indicated CRP had a significant difference, Z=5.054, p <0.001.
CONCLUSIONS: Brucellosis is frequently morbidity in 40 + age men, which has been diagnosed by aerobic blood culture, generally bacterial culture, RBT and SAT, epidemiological, and commonly with complications of spine and arthropathy.