关键词： Blastomyces dermatitidis Blastomyces gilchristii Canada Coccidioides immitis Coccidioides posadasii Histoplasma capsulatum Ontario blastomycosis climate change coccidioidomycosis dimorphic fungi fungi geographic distribution histoplasmosis

Mesh ： Adolescent Adult Aged Aged, 80 and over Blastomycosis / epidemiology history microbiology Coccidioidomycosis / epidemiology history microbiology Female Geography, Medical Histoplasmosis / epidemiology history microbiology History, 20th Century History, 21st Century Humans Incidence Male Middle Aged Ontario / epidemiology Prevalence Public Health Surveillance Young Adult

来  源：   DOI：10.3201/eid2407.172063   PDF(Sci-hub)   PDF(Pubmed)

Abstract：
Endemic mycoses represent a growing public health challenge in North America. We describe the epidemiology of 1,392 microbiology laboratory-confirmed cases of blastomycosis, histoplasmosis, and coccidioidomycosis in Ontario during 1990-2015. Blastomycosis was the most common infection (1,092 cases; incidence of 0.41 cases/100,000 population), followed by histoplasmosis (211 cases) and coccidioidomycosis (89 cases). Incidence of blastomycosis increased from 1995 to 2001 and has remained elevated, especially in the northwest region, incorporating several localized hotspots where disease incidence (10.9 cases/100,000 population) is 12.6 times greater than in any other region of the province. This retrospective study substantially increases the number of known endemic fungal infections reported in Canada, confirms Ontario as an important region of endemicity for blastomycosis and histoplasmosis, and provides an epidemiologic baseline for future disease surveillance. Clinicians should include blastomycosis and histoplasmosis in the differential diagnosis of antibiotic-refractory pneumonia in patients traveling to or residing in Ontario.
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