Variation in clinical phenotype of human infection among genetic groups of Blastomyces dermatitidis

Journal of Infectious Diseases
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Abstract

Background.Blastomyces dermatitidis, the etiologic agent of blastomycosis, has 2 genetic groups and shows varied clinical presentation, ranging from silent infections to fulminant respiratory disease and dissemination. The objective of this study was to determine whether clinical phenotype and outcomes vary based on the infecting organism's genetic group.

Methods. We used microsatellites to genotype 227 clinical isolates of B. dermatitidis from Wisconsin patients. For each isolate, corresponding clinical disease characteristics and patient demographic information were abstracted from electronic health records and Wisconsin Division of Health reportable disease forms and questionnaires.

Results. In univariate analysis, group 1 isolates were more likely to be associated with pulmonary-only infections (P < .0001) and constitutional symptoms such as fever (P < .0001). In contrast, group 2 isolates were more likely to be associated with disseminated disease (P < .0001), older patient age (P < .0001), and comorbidities (P = .0019). In multivariate analysis, disease onset to diagnosis of >1 month (P < .0001), older age at diagnosis (P < .0001), and current smoking status (P = .0001) remained predictors for group 2 infections.

Conclusions. This study identified previously unknown associations between clinical phenotype of human infection and genetic groups of B. dermatitidis and provides a framework for further investigations of the genetic basis for virulence in B. dermatitidis.

Additional publication details

Publication type Article
Publication Subtype Journal Article
Title Variation in clinical phenotype of human infection among genetic groups of Blastomyces dermatitidis
Series title Journal of Infectious Diseases
DOI 10.1093/infdis/jis756
Volume 207
Issue 5
Year Published 2013
Language English
Publisher Oxford Academic
Contributing office(s) Coop Res Unit Leetown
Description 9 p.
First page 814
Last page 822