云南省不明原因发热病人巴尔通体感染调查

Investigation of Bartonella infection in patients with fever of unknown origin in Yunnan province

目的掌握云南省不明原因发热病人巴尔通体的感染状况。方法选择4个调查点,用间接免疫荧光法定性检测不明原因发热病人和对照人群血清抗汉塞巴尔通体和抗五日热巴尔通体的Ig G抗体,对抗体阳性率进行比较分析。结果共检测不明原因发热病人血清232份,对照人群血清80份。不明原因发热病人抗汉塞巴尔通体Ig G抗体阳性率30.17%,抗五日热巴尔通体阳性率18.10%,混合感染率14.22%。对照人群抗汉塞巴尔通体抗体阳性率13.75%,抗五日热巴尔通体阳性率6.25%,混合感染率2.5%。三项指标不明原因发热病人均明显高于对照人群,同一人群的汉塞巴尔通体阳性率亦高于五日热巴尔通体阳性率。结论部分不明原因发热病人是因为感染了汉塞巴尔通体和/或五日热巴尔通体而引起的发热,且两种巴尔通体的混合感染率也较高。部分对照人群也存在汉塞巴尔通体和/或五日热巴尔通体的隐性感染或既往感染。在不明原因发热的病因诊断中,进行巴尔通体感染的鉴别诊断是十分有必要的。

Objective To master the situation of bartonella infection in patients with fever of unknown origins （FUO） in Yunnan province. Methods Indirect immunofluorescence assay（IFA） was applied to qualitatively test the serum B. henselae and B. quintana antibody of patients with FUO and control group in four survey sites selected from Yunnan province, then,the serum antibody positive rates of them were comparatively analyzed. Results Totally 232 samples of patients with FUO and 80 of control group were tested. The B. henselae antibody positive rate, B. quintana antibody positive rate and mixed infection rate among the patients with FUO were 30.17% ,18.10% and 14.22% ,respectively. The B. henselae antibody positive rate, B. quintana antibody positive rate and mixed infection rate among the case of control group were 13.75%,6.25% and 2.5%, respectively. The three indexes of patients with FUO were significantly higher than those of control group. The positive rate of B. benselae antibody was higher than that of B. quintana antibody among patients with FUO and control group. Conclusion B. henselae and/or B. quintana infection may be the main cause of fever in some patients with FUO, whose mixed infection rate was relatively high. In addition, some of control group had latent or previous infection with B. henselae and/or B. quintana. Thus screening of bartonella is of importance in the diagnosis of FUO.