Disseminated Cryptococcus neoformans var. grubii infections in intensive care units

Y. M. Chuang, S. C. Ku, S. J. Liaw, S. C. Wu, Y. C. Ho, C. J. Yu, P. R. Hsueh

Research output: Contribution to journalArticle

Abstract

A retrospective study of clinical characteristics, outcome and prognostic factors of patients with cryptococcosis was undertaken in intensive care units (ICUs) of a medical centre for the period 2000-2005. Twenty-six patients with Cryptococcus neoformans var. grubii infection were identified (16 males, median age 58 years). The most frequent underlying diseases were liver cirrhosis (385%), diabetes mellitus (269%) and HIV infection (192%). The most frequently identified sites of infection were blood (615%), cerebrospinal fluid (385%) and airways (346%). The mean Acute Physiologic and Chronic Health Evaluation II score at ICU admission was 2246. The ICU mortality rate in these patients was 731% (19/26) and there were a further two mortalities recorded after discharge from ICU, reaching a total mortality rate of 808% (21/26). Patients with ICU survival >2 weeks had lower rates of HIV infection (P=0004), less use of inotropic agents during ICU stay (P<0001) and lower white blood cell counts (P=001). After adjusting for clinical variables in the multivariate Cox regression model, diabetes and cryptococcal infection after ICU admission were independent predictors of good long-term prognosis (P=0015) and HIV infectious status was associated with poor outcome (P=0012).

Original languageEnglish (US)
Pages (from-to)1036-1043
Number of pages8
JournalEpidemiology and infection
Volume138
Issue number7
DOIs
StatePublished - Jul 1 2010

Keywords

  • Cryptococcus neoformans var. grubii
  • Diabetes mellitus
  • HIV infection
  • Intensive care units
  • Liver cirrhosis
  • Prognosis

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases

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  • Cite this

    Chuang, Y. M., Ku, S. C., Liaw, S. J., Wu, S. C., Ho, Y. C., Yu, C. J., & Hsueh, P. R. (2010). Disseminated Cryptococcus neoformans var. grubii infections in intensive care units. Epidemiology and infection, 138(7), 1036-1043. https://doi.org/10.1017/S0950268809990926