Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Montero AJ[original query] |
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Clinical characteristics, health care utilization, and outcomes among patients in a pilot surveillance system for invasive mold disease-Georgia, United States, 2017-2019
Gold JAW , Revis A , Thomas S , Perry L , Blakney RA , Chambers T , Bentz ML , Berkow EL , Lockhart SR , Lysen C , Nunnally NS , Jordan A , Kelly HC , Montero AJ , Farley MM , Oliver NT , Pouch SM , Webster AS , Jackson BR , Beer KD . Open Forum Infect Dis 2022 9 (7) ofac215 BACKGROUND: Invasive mold diseases (IMDs) cause severe illness, but public health surveillance data are lacking. We describe data collected from a laboratory-based, pilot IMD surveillance system. METHODS: During 2017-2019, the Emerging Infections Program conducted active IMD surveillance at 3 Atlanta-area hospitals. We ascertained potential cases by reviewing histopathology, culture, and Aspergillus galactomannan results and classified patients as having an IMD case (based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group [MSG] criteria) or a non-MSG IMD case (based on the treating clinician's diagnosis and use of mold-active antifungal therapy). We described patient features and compared patients with MSG vs non-MSG IMD cases. RESULTS: Among 304 patients with potential IMD, 104 (34.2%) met an IMD case definition (41 MSG, 63 non-MSG). The most common IMD types were invasive aspergillosis (n=66 [63.5%]), mucormycosis (n=8 [7.7%]), and fusariosis (n=4 [3.8%]); the most frequently affected body sites were pulmonary (n=66 [63.5%]), otorhinolaryngologic (n=17 [16.3%]), and cutaneous/deep tissue (n=9 [8.7%]). Forty-five (43.3%) IMD patients received intensive care unit-level care, and 90-day all-cause mortality was 32.7%; these outcomes did not differ significantly between MSG and non-MSG IMD patients. CONCLUSIONS: IMD patients had high mortality rates and a variety of clinical presentations. Comprehensive IMD surveillance is needed to assess emerging trends, and strict application of MSG criteria for surveillance might exclude over one-half of clinically significant IMD cases. |
Increased deaths from fungal infections during the COVID-19 pandemic-National Vital Statistics System, United States, January 2020-December 2021.
Gold JAW , Ahmad FB , Cisewski JA , Rossen LM , Montero AJ , Benedict K , Jackson BR , Toda M . Clin Infect Dis 2022 76 (3) e255-e262 BACKGROUND: COVID-19-associated fungal infections cause severe illness, but comprehensive data on disease burden are lacking. We analyzed US National Vital Statistics System (NVSS) data to characterize disease burden, temporal trends, and demographic characteristics of persons dying from fungal infections during the COVID-19 pandemic. METHODS: Using NVSS's January 2018-December 2021 Multiple Cause of Death Database, we examined numbers and age-adjusted rates (per 100,000 population) of fungal deaths by fungal pathogen, COVID-19 association, demographic characteristics, and year. RESULTS: Numbers and age-adjusted rates of fungal deaths increased from 2019 (n = 4,833, rate 1.2, 95% confidence interval [CI] 1.2-1.3) to 2021 (n = 7,199, rate: 1.8, 95% CI = 1.8-1.8); of 13,121 fungal deaths during 2020-2021, 2,868 (21.9%) were COVID-19-associated. Compared with non-COVID-19-associated fungal deaths (n = 10,253), COVID-19-associated fungal deaths more frequently involved Candida (n = 776 [27.1%] versus n = 2,432 [23.7%]) and Aspergillus (n = 668 [23.3%] versus n = 1,486 [14.5%]) and less frequently involved other specific fungal pathogens. Fungal death rates were generally highest in non-White and non-Asian populations. Death rates from Aspergillus infections were approximately two times higher in the Pacific US census division compared with most other divisions. CONCLUSIONS: Fungal deaths increased during 2020-2021 compared with previous years, primarily driven by COVID-19-associated fungal deaths, particularly those involving Aspergillus and Candida. Our findings may inform efforts to prevent, identify, and treat severe fungal infections in COVID-19 patients, especially in certain racial/ethnic groups and geographic areas. |
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