Leptospirosis in Franche-Comté (FRANCE): clinical, biological, and therapeutic data

Med Mal Infect. 2013 Sep;43(9):379-85. doi: 10.1016/j.medmal.2013.06.018. Epub 2013 Jul 30.

Abstract

Objectives and method: We report the patient data in 77 cases of leptospirosis confirmed by PCR and/or serology (micro-agglutination), observed between 1994 and 2008 at the Besançon teaching hospital. Our aim was to compare the epidemiological, clinical, biological, and therapeutic characteristics of leptospirosis in the Franche-Comté region, to those reported in other regions.

Results: The median age was 42years and 95% were male patients. Leptospirosis acquisition was likely related to aquatic leisure activities (50.6%), professional exposure (28.6%), building maintenance works (11.7%), or unknown (9.1%). Forty-eight cases were uncomplicated and 29 were severe presentations of leptospirosis. Among severe cases, eight patients had to be managed in an intensive care unit, and one patient died. L. grippotyphosa and L. icterohaemorrhagiae were the main serogroups involved. Age above 50years and serogroup L. icterohaemorrhagiae were positively associated with clinical severity. The outcome was favorable for 15 patients treated with ceftriaxone for less than 7days.

Conclusions: We recommended conducting clinical trials aiming at validating short courses of ceftriaxone to treat leptospirosis.

Keywords: Franche-Comté; Leptospirose; Leptospirosis; Procalcitonin; Procalcitonine.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amoxicillin / therapeutic use
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Ceftriaxone / therapeutic use
  • Child
  • Environmental Exposure
  • Female
  • France / epidemiology
  • Hospitals, Teaching
  • Humans
  • Leptospira interrogans / classification
  • Leptospira interrogans / isolation & purification*
  • Leptospirosis / drug therapy
  • Leptospirosis / epidemiology*
  • Leptospirosis / microbiology
  • Leptospirosis / transmission
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology
  • Occupational Diseases / microbiology
  • Retrospective Studies
  • Symptom Assessment
  • Travel
  • Water Microbiology
  • Young Adult
  • Zoonoses

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Amoxicillin