Epidemiological, Clinical and Laboratory Characteristics of Patients with Brucella Infection in Anhui Province, China

Figures & data

Table 1 Demographic and Epidemiological Analysis of Brucellosis Patients (N = 109)

Variable	Overall (n = 109)	Bacteremic Group (n = 51)	Nonbacteremic Group (n = 58)	P value
Sex
Male	72 (66.1)	38 (74.5)	34 (58.6)	0.080
Female	37 (33.9)	13 (25.5)	24 (41.4)
Age (Average, years)	47.0 ± 17.1	46.3 ± 17.5	47.6 ± 16.7	0.679
0–18 years	7 (6.4)	4 (7.8)	3 (5.2)	0.832
19–45 years	36 (33.0)	16 (31.4)	20 (34.5)
46–65 years	53 (48.6)	26 (51.0)	27 (46.6)
>65 years	13 (11.9)	5 (9.8)	8 (13.8)
Occupation
Farmer and herdsman	58 (53.2)	27 (52.9)	31 (53.4)	0.761
Butcher	3 (2.8)	2 (3.9)	1 (1.7)
Veterinarian	3 (2.8)	2 (3.9)	1 (1.7)
Other occupation	45 (41.3)	20 (39.2)	25 (43.1)
Place of residence
Urban	18 (16.5)	8 (15.7)	10 (17.2)	0.827
Rural	91 (83.5)	43 (84.3)	48 (82.8)
Mean hospitalization time (day)	9 (6–13.5)	9 (7–13)	8 (5.8–15)	0.348
Medical history
Exposure and farming of sheep or cattle	59 (54.2)	29 (56.8)	30 (51.7)	0.591
Consumption history of raw meat or dairy	13 (11.9)	6 (11.8)	7 (12.1)	0.961
Unknown	37 (33.9)	16 (31.4)	21 (36.2)	0.595
Diagnosis season (month)
Spring (3–5)	36 (33.0)	19 (37.3)	17 (29.3)	0.357
Summer (6–8)	34 (31.2)	18 (35.3)	16 (27.6)
Autumn (9–11)	22 (20.2)	7 (13.7)	15 (25.9)
Winter (12–2)	17 (15.6)	7 (13.7)	10 (17.2)
Staging
Acute	78 (71.6)	43 (84.3)	35 (60.3)	0.016
Subacute	25 (22.9)	7 (13.7)	18 (31.0)
Chronic	6 (5.5)	1 (2.0)	5 (8.6)

Note: Data are expressed as number (%) of patients.

Table 2 Clinical Symptoms and Complications of Patients with Brucellosis

Variable	Overall (n = 109)	Bacteremic Group (n = 51)	Nonbacteremic Group (n = 58)	P value
Symptoms
Fever	97 (89.0)	49 (96.1)	48 (82.8)	0.027
Hyperhidrosis	28 (25.7)	12 (23.5)	16 (27.6)	0.629
Headache	13 (11.9	4 (7.8)	9 (15.5)	0.217
Arthralgia	53 (48.6)	30 (58.8)	23 (39.7)	0.046
Back pain	15 (13.8)	5 (9.8)	10 (17.2)	0.261
Myalgia	27 (24.8)	8 (15.7)	19 (32.8)	0.039
Cough	26 (23.9)	16 (31.4)	10 (17.2)	0.084
Sputum	14 (12.8)	8 (15.9)	6 (10.3)	0.406
Chills	57 (52.3)	26 (51.0)	31 (53.4)	0.797
Fatigue	31 (28.4)	13 (25.5)	18 (31.0)	0.522
Dizziness	7 (6.4)	3 (5.9)	4 (6.9)	1.000
Rash	2 (1.8)	0 (0.0)	2 (3.4)	0.497
Anorexia	28 (25.7)	18 (35.3)	10 (17.2)	0.031
Lose weight	33 (30.3)	18 (35.3)	15 (25.9)	0.285
Splenomegaly	20 (18.3)	11 (21.6)	9 (15.5)	0.415
Hepatomegaly	11 (10.1)	5 (9.8)	6 (10.3)	0.925
Hepatosplenomegaly	5 (4.6)	3 (5.9)	2 (3.4)	0.663
Lymphadenectasis	27 (24.8)	12 (23.5)	15 (25.9)	0.778
Complications
Pneumonia	16 (14.7)	6 (11.8)	10 (17.2)	0.420
Arthrophlogosis	5 (4.6)	3 (5.9)	2 (3.4)	0.663
Epididymo-orchitis	8 (7.3)	2 (3.9)	6 (10.3)	0.279
Spondylitis	15 (13.8)	5 (9.8)	10 (17.2)	0.261
Meningitis	3 (2.8)	2 (3.9)	1 (1.7)	0.596

Note: Data are expressed as number (%) of patients.

Table 3 Laboratory Result of Brucellosis Patients

Variable	Overall (n = 109)	Bacteremic Group (n = 51)	Non-Bacteremic Group (n = 58)	P value
Anemia^a	71 (65.1)	35 (68.2)	36 (62.1)	0.473
Hb (g/L)	121.0 (108.0–128.0)	120.0 (108.0–125.0)	121.5 (107.8–130)	0.455
Leukopenia (<3.5×10^9/L)	27 (24.8)	16 (31.4)	11 (19.0)	0.026
Leukocytosis (>9.5×10^9/L)	13 (11.9)	5 (9.8)	8 (13.8)	0.521
WBC count (×10^9 cells/L)	5.4 (3.5–7.3)	4.7 (3.4–6.9)	5.6 (4.0–7.5)	0.278
PLT count (×10^9platelets/L)	203.0 (138.5–261.5)	168.0 (131.0–234.0)	216.5 (162.0–278.0)	0.012
Elevated CRP (>10 mg/L)	100 (91.7)	49 (96.1)	51 (87.9)	0.233
CRP (mg/L)	28.3 (13.8–51.6)	31.9 (19.0–53.3)	26.4 (12.5–50.4)	0.199
Elevated PCT (>0.50 ng/mL)	28 (25.7)	13 (25.5)	15 (25.9)	0.965
Elevated ESR^b	94 (86.2)	43 (84.3)	51 (87.9)	0.584
ESR (mm/h)	45.3 ± 26.0	41.0 ± 21.7	48.8 ± 27.3	0.167
Elevated ALT^c	40 (36.7)	20 (39.2)	20 (34.5)	0.609
ALT (U/L)	38.0 (23.0–69.5)	38.0 (27.0–77.0)	38.5 (19.0–67.8)	0.343
Elevated AST^d	44 (40.4)	26 (51.0)	18 (31.0)	0.034
AST (U/L)	39.0 (23.5–58.5)	43.0 (25.0–72.0)	36.0 (19.0–55.0)	0.124
Elevated GGT^e	48 (44.0)	23 (45.1)	25 (43.1)	0.620
GGT (U/L)	46.0 (22.5–97.0)	47.0 (25.0–92.0)	45.0 (21.0–102.8)	0.853
Elevated LDH (>250 U/L)	47 (43.1)	26 (51.0)	21 (36.2)	0.120
LDH (U/L)	288.0 (202.0–476.5)	332.0 (209.0–553.0)	258.5 (186.8–442.5)	0.027
TP (g/L)	66.9 ± 6.5	65.8 ± 6.6	67.8 ± 6.4	0.100
ALB (g/L)	36.8 (34.5–39.9)	36.0 (33.9–38.2)	38.0 (35.1–42.2)	0.047
GLO (g/L)	30.1 (26.6–32.5)	30.3 (26.5–34.0)	29.7 (26.6–31.6)	0.255
A/G	1.3 (1.1–1.4)	1.2 (1.1–1.4)	1.3 (1.1–1.5)	0.193
TBIL (µmol/L)	11.9 (8.9–16.4)	13.0 (10.1–17.3)	10.9 (8.2–14.2)	0.034
DBIL (µmol/L)	4.5 (3.2–6.7)	5.4 (3.3–8.3)	4.3 (3.0–5.2)	0.049
Creatinine (μmol/L)	57.1 (47.3–67.2)	62.7 (46.5–72)	54.0 (48.0–64.7)	0.107
Urea (mmol/L)	4.3 (3.3–5.2)	4.3 (3.2–5.1)	4.3 (3.4–5.2)	0.548
APTT (s)	41.3 (37.1–47.1)	43 (37.8–47.9)	40 (34.1–46.9)	0.144
PT (s)	13.9 (13–14.5)	13.9 (13.4–14.5)	13.7 (12.4–14.5)	0.320
INR	1.08 (1.01–1.14)	1.10 (1.04–1.14)	1.07 (0.99–1.14)	0.216
D‐D (μg/mL)	1.3 (0.8–2.2)	1.4 (0.9–2.4)	1.2 (0.7–2.1)	0.138
FDP (μg/mL)	4.6 (3.3–6.7)	4.8 (3.3–7.5)	3.9 (3.2–5.7)	0.203
FIB (g/L)	4.9 ± 1.6	4.6 ± 1.5	5.0 ± 1.7	0.217
TT (s)	17.1 (16.2–18.1)	17.6 (16.7–18.6)	16.8 (15.9–17.8)	0.020

Notes: Data are expressed as number (%) of patients. Percentages may not sum 100 because of rounding. ^aAnemia: male <130 g/L and female <115 g/L; ^bElevated ESR: male >15 mm/h and female > 20 mm/h; ^cElevated ALT: male >50 U/L and female > 40 U/L; ^dElevated AST: male > 40 U/L and female > 35 U/L; ^eElevated GGT: male > 60 U/L and female > 45 U/L. Range of normal values: Hb, male (130–175) g/L and female (115–150) g/L; WBC, (3.5–9.5)×10⁹/L; PLT, (125–350)×10⁹ g/L; CRP, (0.00–10.00) mg/L; PCT, (0.00–0.50) ng/mL; ESR, male (0–15) mm/h and female (0–20) mm/h; ALT, male (9–50) U/L and female (7–40) U/L; AST, male (15–40) U/L and female (13–35) U/L; GGT, male (10–60) U/L and female (7–45) U/L; LDH, (120–250) U/L; TP, (65.0–85.0)g/L; ALB, (40.0–55.0) g/L; GLO, (20.0–40.0) g/L; A/G, 1.20–2.40; TBIL, (0.0–23.0) µmol/L; DBIL, (0.0–8.0) µmol/L; Creatinine, male (57.0–97.0) µmol/L and female (41.0–73.0) µmol/L; Urea, male (3.10–8.00) mmol/L and female (2.60–7.50) mmol/L; APTT, (28–42) s; PT, (11–16) s; INR, 0.85–1.15; D‐D, (0.00–0.50) μg/mL; FDP, (0.00–5.00) μg/mL; FIB, (2.00–4.00) g/L; TT, (14–21) s.

Abbreviations: Hb, hemoglobin; WBC, white blood cell; PLT, platelet; PCT, procalcitonin; ESR, erythrocyte sedimentation rate; ALT, aspartate aminotransferase; AST, aspartate aminotransferase; GGT, γ-glutamyl transpeptidase; LDH, lactate dehydrogenase; CRP, C-reactive protein; TP, Total Protein; ALB, albumin; GLO, globulin; A/G, albumin/globulin ratio; TBIL, total bilirubin; DBIL, direct bilirubin; D‐D, D‐dimer; FDP, fibrinogen degradation products; INR, international normalized ratio; APTT, activated partial thromboplastin time; PT, prothrombin time; FIB, fibrinogen; TT, thrombin time.

Table 4 Comparative Analysis of Demographic, Clinical, and Laboratory Data in Acute, Subacute, and Chronic Phases of Brucellosis Patients

Variable	Acute (n = 78)	Subacute (n = 25)	Chronic (n = 6)	P value	Among Groups (Bonferroni Correction)
Demographics
Age, y	45.1 ± 17.7	51.6 ± 14.5	47.7 ± 17.0	0.245	n.s
Male sex	50 (64.1)	18 (72.0)	4 (66.7)	0.874	n.s
Clinical features
Fever	74 (94.9)	18 (72.0)	5 (83.3)	0.006	acute>subacute
Chills	42 (53.8)	13 (52.0)	2 (33.3)	0.624	n.s
Arthralgia	35 (44.9)	13 (52.0)	5 (83.3)	0.188	n.s
Lose weight	18 (23.1)	13 (52.0)	2 (33.3)	0.023	acute<subacute
Fatigue	18 (23.1)	11 (44.0)	2 (33.3)	0.109	n.s
Hyperhidrosis	17 (21.8)	8 (32.0)	3 (50.0)	0.186	n.s
Anorexia	19 (24.4)	9 (36.0)	0 (0.0)	0.202	n.s
Myalgia	21 (26.9)	4 (16.0)	2 (33.3)	0.529	n.s
Cough	18 (23.1)	7 (28.0)	1 (16.7)	0.852	n.s
Lymphadenectasis	19 (24.4)	7 (28.0)	1 (16.7)	0.925	n.s
Splenomegaly	15 (19.2)	5 (20.0)	0 (0.0)	0.686	n.s
Pneumonia	11 (13.9)	5 (20.0)	0 (0.0)	0.623	n.s
Laboratory signs
Hb	118.5 (107.8–128.25)	123.0 (110.5–128.0)	126.5 (99.0–137.5)	0.623	n.s
WBC	5.1 (3.4–7.2)	5.9 (3.7–7.5)	6.1 (1.9–10.7)	0.551	n.s
PLT	186.5 (130.5–254.8)	225.0 (163.0–340.0)	229.0 (138.7–343.0)	0.077	n.s
ESR	41.5 (25.5–59.8)	40.0 (28.5–74.0)	43.0 (26.8–68.3)	0.697	n.s
CRP	28.3 (15.5–49.1)	28.2 (7.7–54.2)	34.8 (22.3–65.3)	0.445	n.s
ALT	39.5 (27.0–67.5)	26.0 (17.5–66.0)	76.0 (29.5–136.3)	0.091	n.s
AST	38.5 (25.0–65.8)	35.0 (15.5–52.5)	60.5 (38.8–80.8)	0.094	n.s
LDH	316.0 (218.0–517.5)	209.0 (162.0–276.0)	256.5 (185.8–393.8)	<0.001	acute>subacute
GGT	44.5 (22.8–92.5)	56.0 (24.0–88.0)	114.5 (19.0–223.5)	0.594	n.s
Creatinine	57.2 (46.4–70.0)	55.0 (49.3–66.0)	58.5 (46.8–70.5)	0.983	n.s
Urea	4.1 (3.2–4.9)	4.8 (3.5–5.7)	4.2 (2.5–6.8)	0.254	n.s
APTT	41.2 (36.2–46.2)	43.5 (38.1–48.9)	33.1 (29.5–41.2)	0.049	subacute>chronic
PT	13.9 (13.1–14.5)	13.9 (13.0–14.7)	12.9 (11.2–14.0)	0.201	n.s
DD	1.4 (0.9–2.4)	1.2 (0.74–1.6)	0.9 (0.4–2.3)	0.146	n.s
FDP	4.8 (3.4–9.3)	3.7 (3.0–5.2)	3.7 (2.8–5.4)	0.157	n.s

Note: Data are expressed as number (%) of patients. n.s: adjusted P ≥ 0.05, not significant.

Table 5 Comparative Analysis of Demographic, Clinical, and Laboratory Data in Acute and Subacute Phase of Bacteremic Patients

Variable	Acute (n = 43)	Subacute (n = 7)	P value
Demographics
Age, y	45.7 ±18.0	48.6 ± 16.6	0.694
Male sex	32 (74.1)	5 (71.4)	1.000
Clinical manifestation
Fever	41 (95.3)	7 (100.0)	1.000
Chills	22 (51.2)	4 (57.1)	1.000
Arthralgia	24 (55.8)	5 (71.4)	0.684
Myalgia	7 (16.3)	0 (0.0)	0.573
Back pain	3 (7.0)	1 (1.4)	0.464
Splenomegaly	9 (20.9)	2 (28.6)	0.641
Lose weight	13 (30.2)	4 (57.1)	0.210
Cough	13 (30.2)	3 (42.9)	0.666
Laboratory signs
Hb	115.4 ±18.9	122.0 ± 12.2	0.380
WBC	4.7 (3.4–7.2)	3.5 (3.4–6.4)	0.758
PLT	187.8 ±84.6	132.7 ±62.8	0.107
ESR	43.7 ±24.7	28.8 ±18.8	0.174
CRP	38.7 (21.0–66.4)	8.2 (7.1–32.0)	0.010
ALT	41.0 (21.0–49.0)	26.0 (19.0–77.0)	0.114
AST	43.0 (25.0–76.0)	40.0 (22.0–54.0)	0.371
LDH	355.0 (215.0–517.0)	209.0 (180.0–216.0)	0.010
APTT	42.5 (37.5–47)	47.9 (40.2–56.4)	0.210
PT	13.9 (13.4–14.5)	14.6 (13.5–15.0)	0.253
DD	1.5 (1.0–2.5)	1.3 (0.4–1.7)	0.343
FDP	5.1 (3.5–9.4)	2.7 (1.5–4.8)	0.064

Note: Data are expressed as number (%) of patients.

Table 6 The Multivariate Logistic Regression Analysis for Bacteremic Patients

Variables	β	SE	Wald	OR (95% CI)	P
Fever	2.127	0.988	4.637	8.391 (1.210–58.170)	0.031

Note: CI, confidence interval; OR, odds ratio; SE, standard error.