Cargando…

Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study

In this retrospective cohort study of patients with tick-borne encephalitis (TBE), the clinical outcome in relation to co-infection with B. burgdorferi sensu lato (s.l.) and, specifically, the effect of antibiotic treatment on clinical outcome in patients with TBE who were seropositive for borreliae...

Descripción completa

Detalles Bibliográficos
Autores principales: Velušček, Maša, Blagus, Rok, Cerar Kišek, Tjaša, Ružić-Sabljić, Eva, Avšič-Županc, Tatjana, F Bajrović, Fajko, Stupica, Daša
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832614/
https://www.ncbi.nlm.nih.gov/pubmed/31635153
http://dx.doi.org/10.3390/jcm8101740
_version_ 1783466214439256064
author Velušček, Maša
Blagus, Rok
Cerar Kišek, Tjaša
Ružić-Sabljić, Eva
Avšič-Županc, Tatjana
F Bajrović, Fajko
Stupica, Daša
author_facet Velušček, Maša
Blagus, Rok
Cerar Kišek, Tjaša
Ružić-Sabljić, Eva
Avšič-Županc, Tatjana
F Bajrović, Fajko
Stupica, Daša
author_sort Velušček, Maša
collection PubMed
description In this retrospective cohort study of patients with tick-borne encephalitis (TBE), the clinical outcome in relation to co-infection with B. burgdorferi sensu lato (s.l.) and, specifically, the effect of antibiotic treatment on clinical outcome in patients with TBE who were seropositive for borreliae but who did not fulfil clinical or microbiologic criteria for proven co-infection, were assessed at a single university medical center in Slovenia, a country where TBE and Lyme borreliosis are endemic with high incidence. Among 684 patients enrolled during a seven-year period from 2007 through 2013, 382 (55.8%) had TBE alone, 62 (9.1%) had proven co-infection with borreliae and 240 (35.1%) had possible co-infection. The severity of acute illness was similar in all the groups. The odds for incomplete recovery decreased during a 12-month follow-up but were higher in women, older patients, and in those with more severe acute illness. Incomplete recovery was not associated with either proven (odds ratio (OR) 1.21, 95% confidence interval (CI) 0.49–2.95; p = 0.670) or possible co-infection (OR 0.95, 95% CI 0.55–1.65; p = 0.853). Among patients with possible co-infection, older patients were more likely to be prescribed antibiotics, but the odds for incomplete recovery were similar in those who received antibiotics and those who did not (OR 0.82, 95% CI 0.36–1.87; p = 0.630), suggesting that routine antibiotic treatment in patients with TBE and possible co-infection may not be warranted.
format Online
Article
Text
id pubmed-6832614
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-68326142019-11-25 Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study Velušček, Maša Blagus, Rok Cerar Kišek, Tjaša Ružić-Sabljić, Eva Avšič-Županc, Tatjana F Bajrović, Fajko Stupica, Daša J Clin Med Article In this retrospective cohort study of patients with tick-borne encephalitis (TBE), the clinical outcome in relation to co-infection with B. burgdorferi sensu lato (s.l.) and, specifically, the effect of antibiotic treatment on clinical outcome in patients with TBE who were seropositive for borreliae but who did not fulfil clinical or microbiologic criteria for proven co-infection, were assessed at a single university medical center in Slovenia, a country where TBE and Lyme borreliosis are endemic with high incidence. Among 684 patients enrolled during a seven-year period from 2007 through 2013, 382 (55.8%) had TBE alone, 62 (9.1%) had proven co-infection with borreliae and 240 (35.1%) had possible co-infection. The severity of acute illness was similar in all the groups. The odds for incomplete recovery decreased during a 12-month follow-up but were higher in women, older patients, and in those with more severe acute illness. Incomplete recovery was not associated with either proven (odds ratio (OR) 1.21, 95% confidence interval (CI) 0.49–2.95; p = 0.670) or possible co-infection (OR 0.95, 95% CI 0.55–1.65; p = 0.853). Among patients with possible co-infection, older patients were more likely to be prescribed antibiotics, but the odds for incomplete recovery were similar in those who received antibiotics and those who did not (OR 0.82, 95% CI 0.36–1.87; p = 0.630), suggesting that routine antibiotic treatment in patients with TBE and possible co-infection may not be warranted. MDPI 2019-10-20 /pmc/articles/PMC6832614/ /pubmed/31635153 http://dx.doi.org/10.3390/jcm8101740 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Velušček, Maša
Blagus, Rok
Cerar Kišek, Tjaša
Ružić-Sabljić, Eva
Avšič-Županc, Tatjana
F Bajrović, Fajko
Stupica, Daša
Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title_full Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title_fullStr Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title_full_unstemmed Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title_short Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study
title_sort antibiotic use and long-term outcome in patients with tick-borne encephalitis and co-infection with borrelia burgdorferi sensu lato in central europe. a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832614/
https://www.ncbi.nlm.nih.gov/pubmed/31635153
http://dx.doi.org/10.3390/jcm8101740
work_keys_str_mv AT veluscekmasa antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT blagusrok antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT cerarkisektjasa antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT ruzicsabljiceva antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT avsiczupanctatjana antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT fbajrovicfajko antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy
AT stupicadasa antibioticuseandlongtermoutcomeinpatientswithtickborneencephalitisandcoinfectionwithborreliaburgdorferisensulatoincentraleuropearetrospectivecohortstudy