Clinical Characteristics and Outcomes in Patients With Cryptococcaemia From a Large Population-Based Cohort
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View abstract on PubMed
Summary
This summary is machine-generated.Cryptococcus bloodstream infections (BSIs) are deadly, especially in non-HIV patients. Rising fluconazole resistance in Cryptococcus neoformans complex is a growing concern, necessitating ongoing surveillance.
Area Of Science
- Medical Mycology
- Infectious Diseases
- Epidemiology
Background
- Cryptococcus bloodstream infections (BSIs), or cryptococcaemia, are severe opportunistic infections with high mortality rates.
- These infections predominantly affect immunocompromised individuals or those with end-stage organ disease.
- Limited population-based studies exist on infection trends, host factors, geographic variations, antifungal resistance, and clinical outcomes.
Purpose Of The Study
- To examine trends and identify risk factors associated with mortality in cryptococcaemia over a 20-year period.
- To investigate the impact of host factors, geography, and antifungal resistance on clinical outcomes.
- To inform strategies for managing and preventing cryptococcal infections.
Main Methods
- Retrospective analysis of blood cultures positive for Cryptococcus species from January 1, 2000, to December 31, 2019.
- Collection and analysis of clinical, microbiological, and outcome data.
- Survival analyses to determine associations between characteristics and mortality.
Main Results
- 118 episodes of cryptococcaemia (115 patients) were identified; Cryptococcus neoformans complex caused 98% of infections.
- Overall 30-day mortality was 34%, significantly higher in non-HIV-associated cases (41.7%) compared to HIV-associated cases (12.5%).
- Increasing fluconazole minimum inhibitory concentration (MIC) values in C. neoformans complex correlated with increased mortality; 46% of isolates with MIC ≥ 8 mg/L were in the most recent 5-year period.
Conclusions
- Cryptococcus BSI is highly lethal, particularly in non-HIV infected individuals.
- Blood culture collection is crucial for diagnosing cryptococcal infections and guiding treatment.
- Continued surveillance of fluconazole susceptibility is essential due to emerging resistance patterns.
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