Vallabhaneni Snigdha, Benedict Kaitlin, Derado Gordana, Mody Rajal K
Mycotic Diseases Branch, Division for Food, Water, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Biostatistics and Information Management Office, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Open Forum Infect Dis. 2017 Jan 13;4(1):ofw268. doi: 10.1093/ofid/ofw268. eCollection 2017 Winter.
Invasive aspergillosis (IA) and mucormycosis contribute to substantial mortality, especially among immunocompromised persons, including those with hematopoietic stem cell transplant (HSCT), hematologic malignancy (HM), and solid organ transplant (SOT).
Using codes available in the National Inpatient Sample, a hospital discharge database, we estimated IA-related hospitalizations (IA-RH), mucormycosis-RH (M-RH), HSCT-RH, HM-RH, and SOT-RH during 2000-2013. United States census data were used to calculate overall M-RH and IA-RH rates and present trends; estimated annual numbers of HSCT-RH, HM-RH, and SOT-RH served as denominators to calculate M-RH and IA-RH rates occurring with these conditions. Weighted least-squares technique was used to test for linear trends and calculate average annual percentage change (APC).
There were an estimated 169 110 IA-RH and 9966 M-RH during 2000-2013. Overall, IA-RH and M-RH rates per million persons rose from 32.8 to 46.0 (APC = +2.9; < .001) and 1.7 to 3.4 (APC = +5.2%; < .001), respectively, from 2000 to 2013. Among HSCT-RH, there was no significant change in M-RH rate, but a significant decline occurred in IA-RH rate (APC = -4.6%; = .004). Among HM-RH, the rate of M-RH increased (APC = +7.0%; < .001), but the IA-RH rate did not change significantly (APC = +1.2%; = .073). Among SOT-RH, M-RH (APC = +6.3%; = .038) and IA-RH rates (APC = +4.1%; < .001) both increased.
Overall IA-RH and M-RH rates increased during 2000-2013, with a doubling of M-RH. Mucormycosis-related hospitalization occurring in conjunction with certain comorbidities increased, whereas IA-RH rates among patients with the comorbidities, decreased, remained stable, or increased to a lesser extent than M-RH.
侵袭性曲霉病（IA）和毛霉病导致大量死亡，尤其是在免疫功能低下者中，包括造血干细胞移植（HSCT）、血液系统恶性肿瘤（HM）和实体器官移植（SOT）患者。
利用国家住院患者样本（一个医院出院数据库）中的编码，我们估算了2000 - 2013年期间与IA相关的住院病例（IA - RH）、毛霉病相关住院病例（M - RH）、HSCT相关住院病例（HSCT - RH）、HM相关住院病例（HM - RH）和SOT相关住院病例（SOT - RH）。使用美国人口普查数据计算总体M - RH和IA - RH发生率及呈现趋势；估算的HSCT - RH、HM - RH和SOT - RH年度病例数作为分母，计算在这些情况下发生的M - RH和IA - RH发生率。采用加权最小二乘法检验线性趋势并计算平均年度百分比变化（APC）。
2000 - 2013年期间，估计有169110例IA - RH和9966例M - RH。总体而言，每百万人口的IA - RH和M - RH发生率分别从2000年的32.8升至46.0（APC = +2.9；P <.001）和从1.7升至3.4（APC = +5.2%；P <.001）。在HSCT - RH中，M - RH发生率无显著变化，但IA - RH发生率显著下降（APC = -4.6%；P =.004）。在HM - RH中，M - RH发生率增加（APC = +7.0%；P <.001），但IA - RH发生率无显著变化（APC = +1.2%；P =.073）。在SOT - RH中，M - RH（APC = +6.3%；P =.038）和IA - RH发生率（APC = +4.1%；P <.001）均增加。
2000 - 2013年期间，总体IA - RH和M - RH发生率增加，M - RH发生率翻倍。与某些合并症相关的毛霉病住院病例增加，而合并症患者中的IA - RH发生率下降、保持稳定或增加幅度小于M - RH。
