Differences in epidemiological and clinical findings between localized and systemic osteoarticular infection caused by Sporothrix: a systematic review of individual participant data.

IF 2.3 3区 医学 Q3 INFECTIOUS DISEASES
Max Carlos Ramírez-Soto, Alexandro Bonifaz, Andrés Tirado-Sánchez, Yang Song, Alejandro Llanos-Cuentas
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Abstract

Knowledge of the clinical recognition and management of osteoarticular sporotrichosis is derived from case reports and limited series. Our aim was to perform a systematic review to evaluate the differences in epidemiologic and clinical findings between localized and systemic forms of osteoarticular sporotrichosis. We searched MEDLINE/PubMed, SCOPUS, Web of Science (WoS), Ovid, SCiELO, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Data, CQVIP and xueshu.baidu.com on 31 December 2023. The retrieved case data was divided into two groups: (1) localized osteoarticular infection and (2) systemic osteoarticular infection. We estimated differences between the two groups using generalized linear models with Poisson distribution for robust variances to estimate prevalence ratios (PRs) with 95% confidence intervals (95% CIs). A total of 111 cases of localized infection and 100 cases of systemic infection were included. Individuals with systemic infection were more likely to be from hyperendemic areas (adjusted prevalence ratio (aPR) = 1.64; 95% CI, 1.24-2.18; p = 0.001), have HIV infection (aPR = 2.33; 95% CI, 1.42-3.82; p = 0.001), and have cancer (aPR = 1.90; 95% CI, 1.09-3.31; p = 0.023). Arthritis (50.4%) and osteomyelitis (46.0%) were predominant in localized and systemic infections, respectively. Osteomyelitis in 2 or more bones was more common in individuals with a systemic infection (aPR = 10.3; 95% CI, 3.38-31.7; p < 0.0001). Most cases of localized infection were treated with combination antifungals and surgery (32.2%), combination antifungals (25.3%) and amphotericin B monotherapy (19.1%), and systemic infection with combination antifungals (49.4%). As for the outcome, there were better outcomes in localized than in systemic infection. Therefore, Sporothrix infection should be considered in the differential diagnosis of osteomyelitis or arthritis, especially in immunocompromised patients from hyperendemic areas.

孢子菌引起的局部和全身性骨关节感染的流行病学和临床表现的差异:对个体参与者数据的系统回顾。
骨关节孢子虫病的临床识别和管理知识来源于病例报告和有限的系列。我们的目的是进行一项系统综述,以评估局部和全身形式的骨关节孢子虫病在流行病学和临床表现上的差异。我们于2023年12月31日检索了MEDLINE/PubMed、SCOPUS、Web of Science (WoS)、Ovid、SCiELO、Cochrane、CNKI、万方数据、CQVIP和学书网。将检索到的病例数据分为两组:(1)局部骨关节感染和(2)全身骨关节感染。我们使用广义线性模型和泊松分布估计两组之间的差异,以95%置信区间(95% ci)估计患病率(pr)。局部感染111例,全身感染100例。全身性感染个体更有可能来自高流行地区(调整流行比(aPR) = 1.64;95% ci, 1.24-2.18;p = 0.001),艾滋病毒感染(4月= 2.33;95%可信区间,1.42 - -3.82;p = 0.001),和癌症(4月= 1.90;95%可信区间,1.09 - -3.31;p = 0.023)。局部感染以关节炎(50.4%)为主,全身感染以骨髓炎(46.0%)为主。2块或2块以上骨骼的骨髓炎在全身性感染的个体中更为常见(aPR = 10.3; 95% CI, 3.38-31.7; p
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来源期刊
Medical mycology
Medical mycology 医学-兽医学
CiteScore
5.70
自引率
3.40%
发文量
632
审稿时长
12 months
期刊介绍: Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.
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