Current Epidemiology and Clinical Features of Cryptococcus Infection in Patients Without Human Immunodeficiency Virus: A Multicenter Study in 46 Hospitals in Australia and New Zealand.
Background Patients without human immunodeficiency virus (HIV) are increasingly recognized as being at risk for cryptococcosis. Knowledge of characteristics of cryptococcosis in these patients remains incomplete. Methods We conducted a retrospective study of cryptococcosis in 46 Australian and New Z...
| Publicado en: | Clinical Infectious Diseases Vol. 77; no. 7; pp. 976 - 987 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Oct2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172824612&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172824612 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10584838 46X jtl: Clinical Infectious Diseases issn: 10584838 maglogo: N pubinfo: dt: Oct2023 vid: 77 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 172824612 172824612 172824612 10.1093/cid/ciad321 172824612 ppf: 976 ppct: 11 formats: tig: atl: Current Epidemiology and Clinical Features of Cryptococcus Infection in Patients Without Human Immunodeficiency Virus: A Multicenter Study in 46 Hospitals in Australia and New Zealand. aug: au: Coussement, Julien Heath, Christopher H Roberts, Matthew B Lane, Rebekah J Spelman, Tim Smibert, Olivia C Longhitano, Anthony Morrissey, Orla Nield, Blake Tripathy, Monica Davis, Joshua S Kennedy, Karina J Lynar, Sarah A Crawford, Lucy C Crawford, Simeon J Smith, Benjamin J Gador-Whyte, Andrew P Haywood, Rose Mahony, Andrew A Howard, Julia C affil: Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne, Victoria , Australia sug: subj: Cryptococcosis Diagnosis Cryptococcosis Epidemiology Disease Attributes Hospitals Australia Hospitals New Zealand Cryptococcosis Risk Factors Human Immunodeficiency Virus Multicenter Studies Australia New Zealand Retrospective Design Cryptococcus Immunocompromised Host Organ Transplantation Neoplasms Antigens, Fungal Blood Fungemia Cause of Death Human Male Female Middle Age Aged Data Analysis Software Descriptive Statistics Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background Patients without human immunodeficiency virus (HIV) are increasingly recognized as being at risk for cryptococcosis. Knowledge of characteristics of cryptococcosis in these patients remains incomplete. Methods We conducted a retrospective study of cryptococcosis in 46 Australian and New Zealand hospitals to compare its frequency in patients with and without HIV and describe its characteristics in patients without HIV. Patients with cryptococcosis between January 2015 and December 2019 were included. Results Of 475 patients with cryptococcosis, 90% were without HIV (426 of 475) with marked predominance in both Cryptococcus neoformans (88.7%) and Cryptococcus gattii cases (94.3%). Most patients without HIV (60.8%) had a known immunocompromising condition: cancer (n = 91), organ transplantation (n = 81), or other immunocompromising condition (n = 97). Cryptococcosis presented as incidental imaging findings in 16.4% of patients (70 of 426). The serum cryptococcal antigen test was positive in 85.1% of tested patients (319 of 375); high titers independently predicted risk of central nervous system involvement. Lumbar puncture was performed in 167 patients to screen for asymptomatic meningitis, with a positivity rate of 13.2% where meningitis could have been predicted by a high serum cryptococcal antigen titer and/or fungemia in 95% of evaluable cases. One-year all-cause mortality was 20.9% in patients without HIV and 21.7% in patients with HIV (P =.89). Conclusions Ninety percent of cryptococcosis cases occurred in patients without HIV (89% and 94% for C. neoformans and C. gattii , respectively). Emerging patient risk groups were evident. A high level of awareness is warranted to diagnose cryptococcosis in patients without HIV. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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