ArticlePLoS neglected tropical diseases2013
Risk factors and predictors of severe leptospirosis in New Caledonia.
Article in PLoS neglected tropical diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 1 of them a synthesis that pooled it.
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Who cites it
79 citing papers in PubMed, 1 synthesis or guideline pooled it, 153 citations in OpenAlex.
- A systematic review of human and animal leptospirosis in the Pacific Islands reveals pathogen and reservoir diversity.PLoS neglected tropical diseases · 2018Pooled it
- Deciphering the "Doxycycline Deficiency Syndrome": Defining the Characteristic Clinical, Laboratory and Imaging Findings in Patients Presenting with Leptospirosis, Q Fever and Rickettsial Diseases in Far North Queensland, Tropical Australia.Tropical medicine and infectious disease · 2026Article
- Clinical Predictors of Fatal Outcomes from Human Leptospirosis, Thailand, 2015-2024.Emerging infectious diseases · 2026Observational
- Host adaptation drives genome evolution and virulence diversification in a bacterial zoonotic pathogen.bioRxiv : the preprint server for biology · 2026Article
- Influence of Both La Nina and Island Isolation During COVID-19 on the Epidemiology of Infectious Diseases in New Caledonia.Epidemiologia (Basel, Switzerland) · 2026Article
- Early diagnosis and treatment of leptospirosis: Optimizing clinical outcomes.The Journal of infection · 2026Review
- Leptospirosis: An unusual cause of pulmonary haemorrhage and multi-organ failure.Lung India : official organ of Indian Chest Society · 2026Article
- The Characteristics of Patients That Develop Severe Leptospirosis: A Scoping Review.Pathogens (Basel, Switzerland) · 2025Article
- Lung Involvement in Patients with Leptospirosis in Tropical Australia; Associations, Clinical Course and Implications for Management.Tropical medicine and infectious disease · 2025Article
- Urine PCR testing as an effective method for early diagnosis of leptospirosis.Microbiology spectrum · 2025Article
- Anti-inflammatory cytokine profile and Jarisch-Herxheimer reaction in Leptospirosis patients: A prospective case-series study in New Caledonia.PLoS neglected tropical diseases · 2025Observational
- Shaping the future ofJournal of medical microbiology · 2025Review
- Epidemiological, temporal, and geographic trends of leptospirosis in the United States, 2014-2020.PLoS neglected tropical diseases · 2025Article
- Spatio-temporal risk prediction of leptospirosis: A machine-learning-based approach.PLoS neglected tropical diseases · 2025Article
- A Comparative Study of Human Leptospirosis between Mayotte and Reunion Islands Highlights Distinct Clinical and Microbial Features Arising from Distinct Inter-Island Bacterial Ecology.The American journal of tropical medicine and hygiene · 2024Article
- Corticosteroid Treatment for Leptospirosis: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Identification of Dominant Leptospira Serogroups among Leptospirosis Cases and Their Clinical Outcomes: A Prospective Hospital-Based Study in Mangaluru, India.The American journal of tropical medicine and hygiene · 2024Article
- ELISA for leptospiral 3-hydroxyacyl-CoA dehydrogenase in urine is a promising screening tool for acute leptospirosis.Access microbiology · 2024Article
- A 16-year-old man with leptospirosis and atypical disseminated intravascular coagulation: a case report.Journal of medical case reports · 2023Article
- Epidemiological Characteristics and Trends in the Incidence of Leptospirosis in Japan: A Nationwide, Observational Study from 2006 to 2021.The American journal of tropical medicine and hygiene · 2023Observational
19 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeptospirosis is a major public health concern in New Caledonia (NC) and in other tropical countries. Severe manifestations of the disease are estimated to occur in 5-15% of all human infections worldwide and factors associated with these forms are poorly understood. Our objectives were to identify risk factors and predictors of severe forms of leptospirosis in adults. METHODS AND
findingsWe conducted a retrospective case-control study of inpatients with laboratory-confirmed leptospirosis who were admitted to two public hospitals in NC in 2008-2011. Cases were patients with fatal or severe leptospirosis, as determined by clinical criteria. This approach was meant to be pragmatic and to reflect the routine medical management of patients. Controls were defined as patients hospitalized for milder leptospirosis. Risk and prognostic factors were identified by multivariate logistic regression. Among the 176 patients enrolled in the study, 71 had criteria of severity including 10 deaths (Case Fatality Rate = 14.1%). Three risk factors were independently associated with severe leptospirosis: current cigarette smoking (OR = 2.94 [CI 1.45-5.96]); delays >2 days between the onset of symptoms and the initiation of antibiotherapy (OR = 2.78 [CI 1.31-5.91]); and Leptospira interrogans serogroup Icterohaemorrhagiae as the infecting strain (OR = 2.79 [CI 1.26-6.18]). The following post-admission laboratory results correlated with poor prognoses: platelet count ≤50,000/µL (OR = 6.36 [CI 1.79-22.62]), serum creatinine >200 mM (OR = 5.86 [CI 1.61-21.27]), serum lactate >2.5 mM (OR = 5.14 [CI 1.57-16.87]), serum amylase >250 UI/L (OR = 4.66 [CI 1.39-15.69]) and leptospiremia >1000 leptospires/mL (OR = 4.31 [CI 1.17-15.92]).
conclusionsTo assess the risk of developing severe leptospirosis, our study illustrates the benefit for clinicians to have: i) the identification of the infective strain, ii) a critical threshold of qPCR-determined leptospiremia and iii) early laboratory results. In New Caledonia, preventative measures should focus on early presumptive antibacterial therapy and on rodent (reservoir of Icterohaemorrhagiae serogroup) control.
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