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1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience
BACKGROUND: Cryptococcus has a worldwide distribution, with C. neoformans and C. gattii being two of the most common species causing disease. Despite advances in therapy, disseminated infection often results in significant morbidity and mortality. METHODS: We conducted a single center retrospective...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776216/ http://dx.doi.org/10.1093/ofid/ofaa439.1350 |
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author | Kumar, Rebecca Nirmal Nam, Hannah Roberts, Scott C Penugonda, Sudhir Angarone, Michael Stosor, Valentina |
author_facet | Kumar, Rebecca Nirmal Nam, Hannah Roberts, Scott C Penugonda, Sudhir Angarone, Michael Stosor, Valentina |
author_sort | Kumar, Rebecca Nirmal |
collection | PubMed |
description | BACKGROUND: Cryptococcus has a worldwide distribution, with C. neoformans and C. gattii being two of the most common species causing disease. Despite advances in therapy, disseminated infection often results in significant morbidity and mortality. METHODS: We conducted a single center retrospective cohort study over a twenty-year period spanning from January 2000 through May 2020 to determine epidemiology and outcomes of non-HIV-associated cryptococcosis at Northwestern Memorial Hospital. Cases were identified by positive culture data or positive cryptococcal antigen in the serum or cerebrospinal fluid (CSF). Epidemiology of risk factors, morbidity, and mortality was evaluated. RESULTS: 81 cases were identified of which, 67 had Cryptococcus spp isolated from culture and the remaining patients diagnosed by cryptococcal antigen and/or histopathology. The cohort was primarily Caucasian (56.8%, n=46) and male gender (67.9%, n=55), with a median age of 59.5 (IQR: 52.75-66.25) years old. Common predisposing conditions were diabetes (37%, n=30), chronic kidney disease (34.6%, n=28), and liver disease (28.4%, n=23). Solid organ transplant recipients and use of immunosuppression accounted for, respectively, 32.1% (n=26) and 29.6% (n=24) of the cohort. Sites of infection include lung (65.4%. n=53), central nervous system (33.3%, n=27), blood (30.9%, n=25), peritoneum (6.2%, n=5), musculoskeletal (2.5%, n=2), and prostate (1.2%, n=1). Mean opening pressure on lumbar puncture was 25.3 mmHg (range: 9 -52 mmHg). In hospital mortality at time of diagnosis was 27.2% (n=22), and mortality at 12 months post diagnosis was 51.9% (n=42). CONCLUSION: At our center, those with cryptococcosis commonly had risk factors such as immunosuppression either secondary to solid organ transplant or otherwise. Morbidity and mortality remain high. DISCLOSURES: Sudhir Penugonda, MD, MPH, AbbVie, Inc. (Employee, Other Financial or Material Support, ownership and/or investment interests) Michael Angarone, DO, Abbvie (Other Financial or Material Support, Data Safety Monitoring Board)Allergan (Speaker’s Bureau) |
format | Online Article Text |
id | pubmed-7776216 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77762162021-01-07 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience Kumar, Rebecca Nirmal Nam, Hannah Roberts, Scott C Penugonda, Sudhir Angarone, Michael Stosor, Valentina Open Forum Infect Dis Poster Abstracts BACKGROUND: Cryptococcus has a worldwide distribution, with C. neoformans and C. gattii being two of the most common species causing disease. Despite advances in therapy, disseminated infection often results in significant morbidity and mortality. METHODS: We conducted a single center retrospective cohort study over a twenty-year period spanning from January 2000 through May 2020 to determine epidemiology and outcomes of non-HIV-associated cryptococcosis at Northwestern Memorial Hospital. Cases were identified by positive culture data or positive cryptococcal antigen in the serum or cerebrospinal fluid (CSF). Epidemiology of risk factors, morbidity, and mortality was evaluated. RESULTS: 81 cases were identified of which, 67 had Cryptococcus spp isolated from culture and the remaining patients diagnosed by cryptococcal antigen and/or histopathology. The cohort was primarily Caucasian (56.8%, n=46) and male gender (67.9%, n=55), with a median age of 59.5 (IQR: 52.75-66.25) years old. Common predisposing conditions were diabetes (37%, n=30), chronic kidney disease (34.6%, n=28), and liver disease (28.4%, n=23). Solid organ transplant recipients and use of immunosuppression accounted for, respectively, 32.1% (n=26) and 29.6% (n=24) of the cohort. Sites of infection include lung (65.4%. n=53), central nervous system (33.3%, n=27), blood (30.9%, n=25), peritoneum (6.2%, n=5), musculoskeletal (2.5%, n=2), and prostate (1.2%, n=1). Mean opening pressure on lumbar puncture was 25.3 mmHg (range: 9 -52 mmHg). In hospital mortality at time of diagnosis was 27.2% (n=22), and mortality at 12 months post diagnosis was 51.9% (n=42). CONCLUSION: At our center, those with cryptococcosis commonly had risk factors such as immunosuppression either secondary to solid organ transplant or otherwise. Morbidity and mortality remain high. DISCLOSURES: Sudhir Penugonda, MD, MPH, AbbVie, Inc. (Employee, Other Financial or Material Support, ownership and/or investment interests) Michael Angarone, DO, Abbvie (Other Financial or Material Support, Data Safety Monitoring Board)Allergan (Speaker’s Bureau) Oxford University Press 2020-12-31 /pmc/articles/PMC7776216/ http://dx.doi.org/10.1093/ofid/ofaa439.1350 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Kumar, Rebecca Nirmal Nam, Hannah Roberts, Scott C Penugonda, Sudhir Angarone, Michael Stosor, Valentina 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title | 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title_full | 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title_fullStr | 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title_full_unstemmed | 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title_short | 1164. Epidemiology of Cryptococcal Infections in Non-HIV Patients: A 20-year Single Center Experience |
title_sort | 1164. epidemiology of cryptococcal infections in non-hiv patients: a 20-year single center experience |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776216/ http://dx.doi.org/10.1093/ofid/ofaa439.1350 |
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