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MSG07: An International Cohort Study Comparing Epidemiology and Outcomes of Patients with Cryptococcus neoformans or Cryptococcus gattii infections
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3 27 2021
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Source: Clin Infect Dis. 73(7):1133-1141
Details:
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Alternative Title:Clin Infect Dis
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Personal Author:
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Description:Background
Cryptococcosis due to Cryptococcus neoformans and Cryptococcus gattii varies with geographic region, populations affected, disease manifestations and severity of infection, which impact treatment.
Methods
We developed a retrospective cohort of patients diagnosed with culture-proven cryptococcosis during 1995–2013 from five centers in North America and Australia. We compared underlying diseases, clinical manifestations, treatment and outcomes in patients with C. gattii or C. neoformans infection.
Results
A total of 709 patients (452 C. neoformans; 257 C. gattii) were identified. Mean age was 50.2 years; 61.4% were male; and 52.3% were Caucasian. Time to diagnosis was prolonged in C. gattii patients compared with C. neoformans (mean 52.2 vs 36.0 days; p<0.003) and there was a higher proportion of C. gattii patients without underlying disease (40.5% vs 10.2%; p<0.0001). Overall, 59% had central nervous system (CNS) infection, with lung (42.5%) and blood (24.5%) being common sites. Pulmonary infection was more common in patients with C. gattii than those with C. neoformans (60.7% vs 32.1%; p<0.0001). CNS or blood infections were more common in C. neoformans-infected patients (p≤0.0001 for both). Treatment of CNS disease with induction therapy of amphotericin B and flucytosine occurred in 76.4% of patients. Crude 12-month mortality was higher in patients with C neoformans (28.4% vs 20.2%; Odds Ratio 1.56; 95% CI 1.08, 2.26).
Conclusions
This study emphasizes differences in species-specific epidemiology and outcomes of patients with cryptococcosis, including underlying diseases, site of infection and mortality. Species identification in patients with cryptococcosis is necessary to discern epidemiologic patterns, guide treatment regimens and predict clinical progression and outcomes.
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Source:
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Pubmed ID:33772538
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Pubmed Central ID:PMC8473583
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Funding:
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Volume:73
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Issue:7
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[PDF-135.36 KB]
