背景:加利福尼亚州的大规模野火,美国,大小和频率都在增加,对健康有重大影响。野火烟雾取代微生物并引起临床上重要的真菌感染的能力知之甚少。我们旨在确定暴露于野火烟雾是否与系统性真菌感染住院风险增加有关。
方法:在这种基于人群的情况下,回顾性研究,我们使用了加州22家医院的医院管理数据,美国,分析野火烟雾暴露与曲霉病和球孢子菌病每月住院之间的关系。我们纳入了在研究期间属于Vizient临床数据库或资源管理器成员的医院,并排除了在研究期间未向Vizient完整报告的医院。在医院县使用卫星成像的烟雾羽流估算了烟雾暴露。烟雾暴露后1个月和3个月,计算所有感染类型的发生率比。
结果:在2014年10月1日至2018年5月31日之间,研究样本中每家医院的年入院人数中位数为1638。未收集个体患者的人口统计学。我们没有观察到烟雾暴露与曲霉病住院率之间的关联。然而,在任何烟雾暴露后的一个月内,球孢子菌病的住院率增加了20%(95%CI5-38).在过去一个月内,每天都有烟雾暴露,入院人数增加了2%(0-4),在调整温度和时间趋势后。入院前3个月的烟雾暴露数据也获得了类似的结果。
结论:在暴露于野火烟雾后的几个月内,加州医院发现球孢子菌病感染增加。鉴于加州野火的预计增加及其在土壤真菌特有地区的扩张,野火烟雾携带微生物并引起人类疾病的能力值得进一步研究。
背景:无。
Large-scale wildfires in California, USA, are increasing in both size and frequency, with substantial health consequences. The capacity for wildfire smoke to displace microbes and cause clinically significant fungal infections is poorly understood. We aimed to determine whether exposure to wildfire smoke was associated with an increased risk of hospital admissions for systemic fungal infections.
In this population-based, retrospective
study, we used hospital administrative data from 22 hospitals in California, USA, to analyse the association between wildfire smoke exposure and monthly hospital admissions for aspergillosis and
coccidioidomycosis. We included hospitals that were members of the Vizient Clinical Data Base or Resource Manager during the study and excluded those that did not have complete reporting into Vizient during the
study period. Smoke exposure was estimated using satellite-imaged smoke plumes in the hospital county. Incident rate ratios were calculated for all infection types 1 month and 3 months after smoke exposure.
Between Oct 1, 2014, and May 31, 2018, there were a median of 1638 annual admissions per hospital in the study sample. Individual patient demographics were not collected. We did not observe an association between smoke exposure and rate of hospital admission for aspergillosis. However, hospital admission for
coccidioidomycosis increased by 20% (95% CI 5-38) in the month following any smoke exposure. Hospital admission increased by 2% (0-4) for every day that there had been smoke exposure in the previous month, after adjustment for temperature and temporal trend. Similar results were obtained with smoke exposure data from the 3 months before admission.
In the months following wildfire smoke exposure, California hospitals saw increased
coccidioidomycosis infections. Given the projected increase in California wildfires and their expansion in endemic territories of soil-dwelling fungi, the ability for wildfire smoke to carry microbes and cause human disease warrants further research.
None.