2018 - 2019年9个州组织胞浆菌病强化监测
Enhanced Surveillance for Histoplasmosis-9 States, 2018-2019.
作者信息
Benedict Kaitlin, McCracken Stephanie, Signs Kimberly, Ireland Malia, Amburgey Victoria, Serrano Jose Antonio, Christophe Natalie, Gibbons-Burgener Suzanne, Hallyburton Sara, Warren Kimberly A, Keyser Metobo Alison, Odom Racheal, Groenewold Matthew R, Jackson Brendan R
机构信息
Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Michigan Department of Health and Human Services, Lansing, Michigan, USA.
出版信息
Open Forum Infect Dis. 2020 Aug 17;7(9):ofaa343. doi: 10.1093/ofid/ofaa343. eCollection 2020 Sep.
BACKGROUND
Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population.
METHODS
We conducted enhanced surveillance in 9 states during 2018-2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures.
RESULTS
Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0-269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2-3960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness.
CONCLUSIONS
Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.
背景
组织胞浆菌病常被描述为美国最常见的地方性真菌病，但关于其在普通人群中的流行病学情况仍有许多未知之处。
方法
我们在2018 - 2019年期间对9个州进行了强化监测，通过常规监测识别病例，并就301名患者的临床特征和暴露情况进行访谈。
结果
在接受组织胞浆菌病检测之前，60%的患者就诊≥3次，53%的患者接受过抗菌药物治疗。从寻求医疗服务到确诊的中位时间（范围）为23（0 - 269）天。49%的患者住院治疗，69%的患者表示组织胞浆菌病干扰了他们的日常活动（中位时间[范围]，56[2 - 3960]天）。可能的暴露因素包括接触植物（48%）和鸟类或蝙蝠粪便（24%）；22%的患者报告无特定暴露因素。只有15%的患者在患病前听说过组织胞浆菌病。
结论
组织胞浆菌病可能病情严重且病程迁延。需要进一步开展教育工作，以提高公众和医疗服务提供者的认识，并减少诊断延误。
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