Leake J A, Mosley D G, England B, Graham J V, Plikaytis B D, Ampel N M, Perkins B A, Hajjeh R A
Epidemic Intelligence Service, Epidemiology Program Office, and Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 2000 Apr;181(4):1435-40. doi: 10.1086/315400. Epub 2000 Apr 7.
Because of the increase in incidence of coccidioidomycosis among the elderly in Arizona between 1990 and 1996, a case-control study was conducted to look at risk factors for disease among these persons. Cases (n=89) were persons aged > or =60 years with laboratory-confirmed coccidioidomycosis; 2 control groups were selected, the first by use of random-digit dialing (geographic controls, n=91) and the second by use of lists of persons with negative serologic coccidioidomycosis tests (laboratory-negative controls, n=58). Elderly persons with coccidioidomycosis had spent significantly less time in Arizona than did persons in either control group and were more likely than geographic controls to have congestive heart failure or cancer, to have smoked, or to have taken corticosteroids. Elderly persons who recently have moved to Arizona or who have chronic illnesses and their physicians need to be aware of their higher risk for coccidioidomycosis in order to improve their chances of early diagnosis and treatment. These persons may benefit from vaccination, once an effective vaccine for coccidioidomycosis is developed.
由于1990年至1996年间亚利桑那州老年人球孢子菌病发病率上升，开展了一项病例对照研究以探究这些人群中该病的危险因素。病例组（n = 89）为年龄≥60岁且经实验室确诊的球孢子菌病患者；选取了2个对照组，第一个通过随机数字拨号选取（地理对照组，n = 91），第二个通过血清学球孢子菌病检测呈阴性者名单选取（实验室阴性对照组，n = 58）。患有球孢子菌病的老年人在亚利桑那州居住的时间显著少于任一对照组人员，且比地理对照组更有可能患有充血性心力衰竭或癌症、有吸烟史或服用过皮质类固醇。近期移居到亚利桑那州的老年人或患有慢性疾病的老年人及其医生需要意识到他们患球孢子菌病的风险更高，以便提高早期诊断和治疗的几率。一旦研发出有效的球孢子菌病疫苗，这些人可能会从接种疫苗中受益。
