Sökning: WFRF:(Plymoth Martin) >
Targeting tularemia :
Targeting tularemia : clinical, laboratory, and treatment outcomes from an 11-year retrospective observational cohort in northern sweden
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- Plymoth, Martin (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi,Department of Infectious Diseases, Westmead Hospital, Sydney, New South Wales, Australia
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- Lundqvist, Robert (författare)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Sunderby Research Unit, Umeå University, Umeå, Sweden
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- Nystedt, Anders (författare)
- Department of Communicable Disease Control, County Council of Norrbotten , Luleå , Sweden
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- Sjöstedt, Anders (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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- Gustafsson, Tomas N. (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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(creator_code:org_t)
- Oxford University Press, 2024
- 2024
- Engelska.
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Ingår i: Clinical Infectious Diseases. - : Oxford University Press. - 1058-4838 .- 1537-6591. ; 78:5, s. 1222-1231
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Tularemia is an important re-emerging disease with a multimodal transmission-pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden.Methods: Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011-2021 were collected through review of electronic medical records and participant questionnaires; with 415 out of 784 accepting participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or PCR). A multivariable logistic regression model was used to investigate variables associated with re-treatment.Results: Median age of participants was 54 years (IQR 41.5-65) and 49.2% were female. While ulceroglandular tularemia was the predominant form (n=215, 65.7%), there were several cases of pulmonary tularemia (n=40; 12.2%). Inflammatory markers were largely non-specific, with monocytosis frequently observed (n=36/75; 48%). Tularemia was often misdiagnosed upon presentation (n=158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics, and 102 (31.2%) re-treated. Persistent lymphadenopathy was infrequent (n=22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with re-treatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR 3.25-20.75] vs. 7 [IQR 4-11.25] days; adjusted p=0.076), and doxycycline-based treatment regimen (vs. ciprofloxacin; adjusted p=0.084), although not significant after correction for multiple comparisons.Conclusion: We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis and timely commencement of treatment for an appropriate duration.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- Francisella tularensis
- doxycycline
- ciprofloxacin
- treatment
- outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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