Testing for coccidioidomycosis among patients with community-acquired pneumonia
Testing for coccidioidomycosis among patients with community-acquired pneumonia
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DOI：
10.3201/eid1407.070832
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发表时间：
2008-07-01
影响因子：
11.8
通讯作者：
Park, Benjamin J.
中科院分区：
文献类型：
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作者：
Chang, Douglas C.;Anderson, Shoana;Park, Benjamin J.
球孢子菌病是疾病流行地区社区获得性肺炎（CAP）的常见原因。由于检测率影响可报告疾病数据的解释和CAP患者护理的质量，我们确定了接受球孢子菌检测的CAP患者比例，确定了检测预测因子，并确定了球孢子菌病检测阳性患者的比例。队列研究，以确定流动CAP患者的比例谁是在凤凰城大都市的2个医疗保健系统检测发现检测率为2%和13%。一项病例对照研究确定了年龄>= 18岁、皮疹、胸痛和症状>= 14天是测试的重要预测因素。血清学检测证实球孢子菌病在9（15%）的60个测试的患者，这表明球孢子菌病引起的CAP的比例是相当大的。然而，由于Coccidioides spp. CAP患者中的检测不常见，依赖于阳性诊断检测结果的可报告疾病数据大大低估了真实的疾病患病率。
Coccidioidomycosis is a common cause of community-acquired pneumonia (CAP) in disease-endemic areas. Because testing rates influence interpretation of reportable-disease data and quality of CAP patient care, we determined the proportion of CAP patients who were tested for Coccidioides spp., identified testing predictors, and determined the proportion of tested patients who had positive coccidioidomycosis results. Cohort studies to determine the proportion of ambulatory CAP patients who were tested in 2 healthcare systems in metropolitan Phoenix found testing rates of 2% and 13%. A case-control study identified significant predictors of testing to be age >= 18 years, rash, chest pain, and symptoms for >= 14 days. Serologic testing confirmed coccidioidomycosis in 9 (15%) of 60 tested patients, suggesting that the proportion of CAP caused by coccidioidomycosis was substantial. However, because Coccidioides spp. testing among CAP patients was infrequent, reportable-disease data, which rely on positive diagnostic test results, greatly underestimate the true disease prevalence.