Antecedent Infectious Spectrum And Clinical Features Of Patients With Guillain-Barr（?） Syndrome In Southwest Of Shandong

Objective: To investigate the spectrum of antecedent infections in patients with Guillain-Barré syndrome（GBS）in southwest of Shandong province and analyze the infections-related clinical features.Methods: In this study,226 GBS patients in southwest of Shandong province,226 age-and sex-matched non-GBS neurological diseases control group and 226 healthy control group were included.They were performed to investigate antecedent infections of 14 pathogens and anti-glycolipid antibodies serologically.The clinical data during hospitalization and 1 year after onset were collected.Results: In 226 cases of GBS patients,54% had a positive serology for recent infection,including Campylobacter jejuni（24%）,influenza A（21%）and B（16%）,Mycoplasma pneumoniae（7%）,hepatitis A virus（5%）,dengue virus（4%）,herpes simplex virus（4%）,cytomegalovirus（2%）,Epstein-Barr virus（2%）,varicella-zoster virus（2%）.Serology for infections of rubella virus,hepatitis E virus,Haemophilus influenzae,and Zika virus was negative.In this study,Campylobacter jejuni,influenza A virus,and influenza B virus were the most common antecedent infections of GBS in southwest of Shandong province.There exists strong correlation between Campylobacter jejuni infection and anti-GM1 and anti-GD1 b antibodies（P=0.013,P=0.005,respectively）.Conclusion: 54% of patients with GBS in southwest of Shandong province had antecedent infection based on serological evidence,and the most common pathogen was Campylobacter jejuni.The positive rate of anti-GM1 and anti-GD1 b antibodies in patients after Campylobacter jejuni infection was significantly higher than that in GBS patients without infection.Differences in the infectious spectrum worldwide may contribute to the geographical clinical heterogeneity of GBS.