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Cryptococcal Antigen Testing in an Integrated Medical System: Eastern Wisconsin.

Marianne Klumph^1,2, Brian Hoeynck³, Dennis J Baumgardner^1,2,4

¹Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI.

Journal of Patient-Centered Research and Reviews

|February 1, 2020

Summary

Cryptococcosis, a fungal infection, was found in 1.9% of patients tested in Wisconsin. Immunocompromised individuals, males, and nonwhite patients were disproportionately affected, not geographic location.

Keywords:

AIDS-related opportunistic infections Cryptococcus antigens cryptococcosis fungal mycoses

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Area of Science:

Medical Mycology
Infectious Diseases
Epidemiology

Background:

Cryptococcosis is an endemic fungal infection linked to immunocompromised hosts.
Data on cryptococcosis frequency and distribution in Wisconsin is limited.

Purpose of the Study:

To explore the geodemographic and clinical features of patients tested for cryptococcal antigen (CrAg) in eastern Wisconsin.
To identify risk factors associated with positive CrAg test results.

Main Methods:

Retrospective analysis of 1465 CrAg tests from 1211 unique patients within a large healthcare system.
Evaluation of patient demographics (sex, race, age) and geographic data (zip codes, proximity to waterways/green space).

Main Results:

1.9% (23/1211) of patients had at least one positive CrAg result.
Positive cases were disproportionately male (82.6%) and nonwhite (3.8% vs. 1.2% of white patients tested; P<0.01).
Immunocompromised status was strongly associated with positive CrAg (21/23 cases).

Conclusions:

Male sex, nonwhite race/ethnicity, and immunocompromised status are statistically associated with positive CrAg.
Geographic factors like zip code or proximity to waterways did not show a significant association with positive CrAg results in this study.
Findings highlight specific demographic groups at higher risk for cryptococcosis in Wisconsin.