Abstract

BackgroundHuman brucellosis has become a major public health problem in China. However, the available clinical data on brucellosis cases are limited.MethodsWe retrospectively reviewed medical charts of 2041 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. These patients were admitted to the Sixth People’s Hospital of the Xinjiang Uygur Autonomous region between 1st January and 31st December 2014. Data on these patients were collected from hospital medical records.ResultsMany patients presented with fatigue (67%), fever (64%), arthralgia (63%) and sweating (54%). High erythrocyte sedimentation rate (ESR) (69%), high C-reactive protein (CRP) (39%), high alanine aminotransferase (ALT) (33%) and high aspartate aminotransferase (AST) (20%) were the most common laboratory findings, especially in acute patients. There was evidence of focal involvement in 90% of patients. A total of 61.5% of brucellosis patients recovered. Multivariate logistic regression analyses suggested that the risk factors key to unfavorable prognosis were: age≥45 years (OR = 1.75, 95% CI 1.36–2.24), back pain (OR = 1.50, 95% CI 1.16–1.94) and joint tenderness (OR = 1.73, 95% CI 1.13–2.65). The increasing duration of the illness increased the risk of poor prognosis.ConclusionPatients with brucellosis showed different characteristics in different clinical stages. In China, the chronicity rate of human brucellosis is high. The risk of poor prognosis is increased in patients aged 45 years or older, patients who have had brucellosis for a substantial period of time, and patients with back pain or joint tenderness. The clinical management of brucellosis should be improved to include sensitive diagnostic methods for subacute and chronic brucellosis.

Highlights

  • Brucellosis, caused by bacteria of the genus Brucella, is a major zoonosis worldwide

  • Multivariate logistic regression analyses suggested that the risk factors key to unfavorable prognosis were: age 45 years (OR = 1.75, 95% CI 1.36–2.24), back pain (OR = 1.50, 95% CI 1.16–1.94) and joint tenderness (OR = 1.73, 95% CI 1.13–2.65)

  • The increasing duration of the illness increased the risk of poor prognosis

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Summary

Introduction

Brucellosis, caused by bacteria of the genus Brucella, is a major zoonosis worldwide. Human brucellosis is a major public health problem that has re-emerged in China since the mid-1990s, with the highest recorded number of cases (56,989 cases) in 2015 [3,4,5]. This may be due to the dynamic growth of animal husbandry in China, which enhances the chance of human infection. The national infectious disease surveillance system has reported an increased rate of human brucellosis [6]. Human brucellosis has become a major public health problem in China. The available clinical data on brucellosis cases are limited

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