Fungal Pathogens as Causes of Acute Respiratory Illness in Hospitalized Veterans: Frequency of Fungal Positive Test Results Using Rapid Immunodiagnostic Assays
Abstract
:1. Introduction
2. Materials and Methods
- Influenza-like disease, influenza, upper respiratory infection (URI), viral URI, cough, or bronchitis;
- Pneumonia, bacterial pneumonia, community-acquired pneumonia, aspiration pneumonia, rule-out pneumonia, evaluate pneumonia, or bibasilar pneumonia;
- Chronic obstructive pulmonary disease (COPD) exacerbation, asthma exacerbation, status asthmaticus, or asthmatic bronchitis;
- Acute respiratory distress syndrome (ARDS), fever, nasal congestion, chest congestion, sore throat, chills, body aches/myalgias, fatigue, respiratory distress, shortness of breath, difficulty in breathing, dyspnea, sepsis, cystic fibrosis exacerbation, respiratory medical other, congestive heart failure, idiopathic pulmonary fibrosis, altered mental status and new onset, exacerbation, or change of two or more of the following symptoms with at least one respiratory symptom beginning less than 10 days;
- o
- Respiratory symptoms: cough, shortness of breath, nasal congestion, chest congestion, or sore throat;
- o
- Constitutional symptoms: fever/feverishness, chills, body aches/myalgias, or fatigue.
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
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Characteristics | All n (%) | Positive Fungal Testing n (%) | Negative Fungal Testing n (%) | OR (CI) | p |
---|---|---|---|---|---|
Total | 224 | 49 | 175 | ||
Median age (IQR) | 68 (11) | 68 (9) | 68 (12) | - | - |
Sex (male) | 214 (96) | 47 (96) | 167 (95) | 0.88 (0.18–4.23) | 0.883 |
Race white | 128 (57) | 26 (53) | 102 (58) | 0.80 (0.42–1.52) | 0.514 |
Race black | 92 (41) | 23 (47) | 69 (39) | 1.35 (0.71–2.57) | 0.346 |
Race unknown | 4 (2) | 0 (0) | 4 (3) | 1.23 (0.65–2.33) | 0.514 |
Ethnicity hispanic | 13 (6) | 4 (8) | 9 (5) | 1.63 (0.48–5.56) | 0.428 |
Constitutional symptoms | |||||
Fatigue | 191 (85) | 37 (76) | 154 (88) | 0.42 (0.19–0.93) | 0.033 * |
Loss of appetite | 127 (57) | 25 (51) | 102 (59) | 0.73 (0.38–1.38) | 0.343 |
Chills | 112 (50) | 22 (45) | 90 (51) | 0.76 (0.41–1.45) | 0.420 |
Myalgias | 97 (43) | 22 (45) | 75 (43) | 1.08 (0.57–2.05) | 0.799 |
Headache | 92 (41) | 14 (29) | 78 (45) | 0.49 (0.25–0.98) | 0.047 * |
Fever | 83 (41) | 16 (38) | 67 (42) | 0.85 (0.42–1.71) | 0.658 |
Confusion | 69 (31) | 12 (24) | 57 (33) | 0.66 (0.32–1.37) | 0.271 |
Earache | 20 (9) | 2 (4) | 18 (10) | 0.36 (0.08–1.64) | 0.191 |
Conjunctivitis | 17 (8) | 4 (8) | 13 (7) | 1.10 (0.34–3.56) | 0.864 |
Skin rash | 11 (5) | 4 (8) | 7 (4) | 2.12 (0.59–7.56) | 0.247 |
Respiratory symptoms | |||||
Cough | 212 (95) | 48 (98) | 164 (94) | 2.92 (0.36–23.44) | 0.312 |
Productive cough | 137 (83) | 32 (67) | 137 (84) | 0.39 (0.19–0.81) | 0.012 * |
Dyspnea | 208 (93) | 45 (92) | 163 (93) | 0.83 (0.25–2.69) | 0.754 |
Wheezing | 160 (71) | 31 (63) | 129 (74) | 0.61 (0.31–1.20) | 0.155 |
Nasal congestion | 123 (59) | 27 (55) | 105 (60) | 0.80 (0.42–1.52) | 0.510 |
Respiratory rate | 107 (48) | 27 (55) | 80 (45) | 1.44 (0.76–2.72) | 0.260 |
Chest retractions | 95 (42) | 18 (37) | 77 (44) | 0.73 (0.38–1.41) | 0.364 |
Chest pain | 89 (40) | 16 (33) | 73 (42) | 0.66 (0.34–1.29) | 0.231 |
Sore of throat | 77 (35) | 17 (35) | 60 (34) | 1.00 (0.51–1.96) | 0.978 |
Gastrointestinal symptoms | |||||
Diarrhea | 64 (29) | 20 (41) | 44 (25) | 2.03 (1.04–3.95) | 0.036 * |
Abdominal pain | 51 (23) | 14 (29) | 37 (21) | 1.48 (0.72–3.03) | 0.284 |
Vomiting | 23 (10) | 8 (16) | 15 (9) | 2.06 (0.82–5.21) | 0.123 |
Underlying conditions | |||||
Heart disease | 176 (79) | 38 (80) | 138 (79) | 1.04 (0.47–2.28) | 0.911 |
Genetic disorder | 118 (53) | 26 (53) | 92 (53) | 1.01 (0.54–1.92) | 0.952 |
Neurologic disease | 110 (49) | 25 (51) | 85 (49) | 1.10 (0.58–2.07) | 0.762 |
Diabetes | 102 (46) | 21 (43) | 81 (46) | 0.87 (0.45–1.64) | 0.670 |
Emphysema | 98 (44) | 16 (33) | 82 (47) | 0.54 (0.28–1.07) | 0.079 |
Oxygen support | 84 (38) | 20 (41) | 64 (37) | 1.18 (0.62–2.26) | 0.607 |
Tobacco smoker | 71 (32) | 21 (43) | 50 (29) | 1.87 (0.97–3.60) | 0.060 |
Cancer | 61 (27) | 16 (33) | 45 (26) | 1.40 (0.70–2.78) | 0.336 |
Kidney disease | 51 (23) | 15 (31) | 36 (31) | 1.70 (0.84–3.46) | 0.141 |
Immunodeficiency | 38 (17) | 9 (18) | 29 (17) | 1.13 (0.49–2.58) | 0.767 |
Liver disease | 25 (11) | 6 (12) | 19 (11) | 1.14 (0.43–3.04) | 0.785 |
Asthma | 17 (8) | 4 (8) | 13 (7) | 1.10 (0.34–3.56) | 0.864 |
Transplant | 5 (2) | 3 (6) | 2 (1) | 5.64 (0.91–34.76) | 0.062 |
Treatments | |||||
Antibiotics | 172 (77) | 38 (78) | 134 (77) | 1.05 (0.49–2.25) | 0.886 |
Antivirals | 18 (8) | 5 (10) | 13 (7) | 1.41 (0.48–4.18) | 0.529 |
Hospital encounters and outcomes | |||||
ICU admission | 34 (15) | 7 (14) | 27 (15) | 0.91 (0.37–2.24) | 0.844 |
Intubated | 11 (5) | 2 (4) | 9 (5) | 0.78 (0.16–3.75) | 0.762 |
Outcome (survived) | 218 (97) | 49 (100) | 169 (97) | - | - |
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Caceres, D.H.; Rodriguez-Barradas, M.C.; Whitaker, M.; Jackson, B.R.; Kim, L.; Surie, D.; Cikesh, B.; Lindsley, M.D.; McCotter, O.Z.; Berkow, E.L.; et al. Fungal Pathogens as Causes of Acute Respiratory Illness in Hospitalized Veterans: Frequency of Fungal Positive Test Results Using Rapid Immunodiagnostic Assays. J. Fungi 2023, 9, 456. https://doi.org/10.3390/jof9040456
Caceres DH, Rodriguez-Barradas MC, Whitaker M, Jackson BR, Kim L, Surie D, Cikesh B, Lindsley MD, McCotter OZ, Berkow EL, et al. Fungal Pathogens as Causes of Acute Respiratory Illness in Hospitalized Veterans: Frequency of Fungal Positive Test Results Using Rapid Immunodiagnostic Assays. Journal of Fungi. 2023; 9(4):456. https://doi.org/10.3390/jof9040456
Chicago/Turabian StyleCaceres, Diego H., Maria C. Rodriguez-Barradas, Michael Whitaker, Brendan R. Jackson, Lindsay Kim, Diya Surie, Bryanna Cikesh, Mark D. Lindsley, Orion Z. McCotter, Elizabeth L. Berkow, and et al. 2023. "Fungal Pathogens as Causes of Acute Respiratory Illness in Hospitalized Veterans: Frequency of Fungal Positive Test Results Using Rapid Immunodiagnostic Assays" Journal of Fungi 9, no. 4: 456. https://doi.org/10.3390/jof9040456