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Testing for Blastomycosis, Coccidioidomycosis, and Histoplasmosis at a Major Commercial Laboratory, United States, 2019-2024.
Benedict, Kaitlin; Williams, Samantha L; Smith, Dallas J; Lindsley, Mark D; Lockhart, Shawn R; Toda, Mitsuru.
Afiliación
  • Benedict K; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Williams SL; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Smith DJ; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Lindsley MD; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Lockhart SR; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Toda M; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infect Dis ; 11(8): ofae448, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39135966
ABSTRACT

Background:

Blastomycosis, coccidioidomycosis, and histoplasmosis are environmentally acquired fungal diseases that clinically resemble bacterial and viral community-acquired pneumonia and require laboratory testing for diagnosis. Patients frequently present to primary care and experience diagnostic delays when a fungal etiology is not initially suspected. Current national-level public health surveillance for these diseases is limited and does not include laboratory data, so nationwide testing practices are unknown.

Methods:

We identified laboratory tests for blastomycosis, coccidioidomycosis, and histoplasmosis ordered during 1 March 2019-29 February 2024 and performed within a major national commercial laboratory system. We analyzed test results, patient and healthcare provider features, reasons for testing, and temporal trends.

Results:

Results included 5693 Blastomyces complement fixation tests (of those, 12% were positive), 71 858 immunodiffusion tests (0.1% positive), and 1186 serum enzyme immunoassay (EIA) tests (11% positive); 154 989 Coccidioides EIA immunoglobulin M results (5% positive) and 154 968 immunoglobulin G results (8% positive); and 46 346 Histoplasma complement fixation tests (30% positive), 49 062 immunodiffusion tests (1% positive), 35 506 serum EIA tests (4% positive), and 82 489 urine EIA tests (2% positive). Most histoplasmosis (58%-74%) and blastomycosis (42%-68%) tests were ordered from hospitals, whereas coccidioidomycosis tests were most frequently ordered by primary care providers (40%). A yearly average of 2727 positive tests were ordered by healthcare providers in states without public health surveillance for these diseases.

Conclusions:

Blastomycosis, coccidioidomycosis, and histoplasmosis are likely underdetected in primary care settings or by public health surveillance. Increased testing by primary care providers and expanded surveillance are needed to reduce disease burden.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Open Forum Infect Dis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Open Forum Infect Dis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos