Comparative analysis of clinical features of brucellosis in Kashi and Guangzhou: a retrospective multicentre study.

Objective: In this study, we conducted a comparative analysis of brucellosis cases from two distinct regions of China to investigate the similarities and differences in clinical characteristics between endemic and non-endemic areas. Our objective was to summarise the clinical characteristics of brucellosis and improve clinicians' understanding and diagnostic accuracy of the disease.

Methods: This was a retrospective, multicentre, cross-sectional study. Patients with brucellosis admitted to the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2023 and the Kashi Affiliated Hospital of Sun Yat-sen University from 2019 to 2023, respectively, were included. The clinical data, laboratory tests, and other case data of the two groups of patients were compared and analysed. Patients with a diagnosis of brucellosis were primarily included, and cases with excessive missing clinical information (> 20%) were excluded. This study was statistically analysed using SPSS.26 software.

Results: There were 658 and 126 patients with brucellosis in Kashi and Guangzhou, respectively, and the proportion of patients with complications was 316 (48.02%) and 73 (57.94%), respectively. Organ involvement was dominated by single system involvement in patients from both places, 289 cases (91.46%) in Kashi and 69 cases (94.52%) in Guangzhou, and both were dominated by osteoarticular involvement (Kashi: 226, 78.20%; Guangzhou: 54, 78.26%) and neurological involvement (Kashi: 19, 6.57%; Guangzhou: 7, 10.14%). 34.19% (225/658) and 50.79% (64/126) of the patients in Kashi and Guangzhou, respectively, had a definite history of exposure to animals and animal products. Patients with Brucellosis in Guangzhou presented mainly with fever, fatigue, and chills, while those in Kashi presented mainly fatigue, fever and low back pain. The main laboratory findings in patients with brucellosis at both sites were normal white blood cells, neutrophil ratio, lymphocyte ratio, platelets, alanine amiotransferase, and albumin-globulin ratio, with a significant increase in C-reactive protein and a decrease in creatinine. The patients at both sites were diagnosed by pathogenetic or (and) serological methods. Most of the patients at both sites were treated with anti-Brucella therapy, mainly doxycycline in combination with rifampicin.

Conclusion: The clinical characteristics of brucellosis patients in Guangzhou and Kashi are generally similar, but there are some differences in epidemiological history, symptoms, methods of diagnosis confirmation, and treatment options. In clinical practice, the characteristics of local cases should be combined and thoroughly analysed to reduce misdiagnosis and underdiagnosis of brucellosis.