Criptococosis meníngea en pacientes con diabetes y sida

Messina, Fernando; Negroni, Ricardo; Maiolo, Elena; Arechavala, Alicia; Villafañe, María F.; Santiso, Gabriela; Bianchi, Marco; Walker, Laura; Corti, Marcelo

doi:10.1016/j.eimc.2013.11.001

Cited by 11 publications

(9 citation statements)

References 15 publications

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“…1 An Argentinian study found a marked increase in mortality in cryptococcal meningitis patients with AIDS and diabetes compared with those with AIDS without diabetes (85.7% versus 21.4%). 21 Matched cohort studies have identified a 20% increase in the risk of any infection among patients with diabetes. 22 This risk is modulated by increasing HbA1c levels.…”

Section: Discussionmentioning

confidence: 99%

Increased mortality associated with uncontrolled diabetes mellitus in patients with pulmonary cryptococcosis: a single US cohort study

Archuleta

Gharamti

Sillau

et al. 2021

Therapeutic Advances in Infection

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Background: Diabetes mellitus is an established risk factor for bacterial infections, but its role in cryptococcosis is unclear. The study aimed to determine whether uncontrolled diabetes (HbA1c >7%) was an independent risk factor for mortality in cryptococcosis. Methods: A retrospective case–control study partially matched by age and gender was performed in patients tested for Cryptococcus infection at the University of Colorado Hospital from 2000 to 2019. A multivariable logistic regression model was used to identify mortality predictors. Cox proportional hazard model was used for survival analysis. Results: We identified 96 cases of cryptococcosis and 125 controls. Among cases, cryptococcal meningitis (49.0%) and pneumonia (36.5%) constituted most infections. Cases with pulmonary cryptococcosis with uncontrolled diabetes had a higher mortality at 10 weeks (50% versus 7%, p = 0.006) and 1 year (66.7% versus 13.8%, p = 0.005) compared to pulmonary cases with controlled or no diabetes. Unadjusted Cox proportional hazard model found an increased rate of death for uncontrolled diabetes at 10 weeks [hazard ratio 8.4, confidence interval (CI): 1.4–50.8, p = 0.02] and 1 year (hazard ratio 7.0, CI: 1.7–28.4, p = 0.007) among pulmonary cryptococcosis cases. Multivariable analysis showed a significantly increased odds of 10 weeks [odds ratio (OR) = 4.3, CI: 1.1–16.5, p = 0.035] and 1 year (OR = 5.0, CI: 1.4–18.3, p = 0.014) mortality for uncontrolled diabetes among pulmonary cryptococcosis cases. After adjustment for gender, age, and case/control, for every 1% increase in HbA1c levels, the odds of pulmonary cryptococcosis mortality at 1 year increased by 11% (OR = 1.6, CI 95%: 1.1–2.3, p = 0.006). Conclusion: Uncontrolled diabetes is associated with worse outcomes in pulmonary cryptococcosis, including a 4-fold and 6-fold increased odds of death at 10 weeks and 1 year, respectively. Glucose control interventions should be explored to improve clinical outcomes in patients with pulmonary cryptococcosis.

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Section: Discussionmentioning

confidence: 99%

Increased mortality associated with uncontrolled diabetes mellitus in patients with pulmonary cryptococcosis: a single US cohort study

Archuleta

Gharamti

Sillau

et al. 2021

Therapeutic Advances in Infection

View full text Add to dashboard Cite

show abstract

“…These numbers correlate with the number of people living with diabetes based on age in the U.S. (1). An Argentinian study found a marked increase in mortality in Cryptococcal meningitis patients with AIDS and diabetes compared to those with AIDS without diabetes (85.7% vs 21.4%) (22). Matched cohort studies have identified a 20% increase in the risk of any infection among patients with diabetes (23).…”

Section: Discussionmentioning

confidence: 99%

Increased mortality associated with uncontrolled diabetes mellitus in patients with Pulmonary Cryptococcosis — a single U.S. cohort study

Archuleta

Gharamti

Sillau

et al. 2021

Preprint

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BackgroundDiabetes mellitus is an established risk factor for bacterial infections, but its role in Cryptococcosis is unclear. The study aimed to determine whether uncontrolled diabetes (HbA1c >7%) was an independent risk factor for mortality in cryptococcosis.MethodsA retrospective case-control study partially matched by age and gender was performed in patients tested for Cryptococcus infection at the University of Colorado Hospital from 2000-2019. A multivariable logistic regression model was used to identify mortality predictors. Cox proportional hazard model was used for survival analysis.ResultsWe identified 96 cases of Cryptococcosis and 125 controls. Among cases, cryptococcal meningitis (49.0%) and pneumonia (36.5%) constituted most infections. Cases with pulmonary cryptococcosis had a higher mortality at 10 weeks (50% vs 7%, p=0.006) and one year (66.7% vs 13.8%, p=0.005). Unadjusted Cox proportional hazard model found an increased rate of death for uncontrolled diabetes at 10-weeks (hazard ratio 8.4, CI: 1.4-50.8, p=0.02), and 1-year (hazard ratio 7.0, CI: 1.7-28.4, p=0.007) among pulmonary cryptococcosis cases. Multivariable analysis showed a significantly increased odds of 10-weeks (OR=4.3, CI: 1.1-16.5, p=0.035) and one-year (OR=5.9, CI: 2.2-15.8, p=0.014) mortality for uncontrolled diabetes among pulmonary cryptococcosis cases. After adjustment for gender, age, and case/control, for every 1% increase in HbA1c levels, the odds of pulmonary cryptococcosis mortality at one-year increased by 11% (OR = 1.6, CI 95%: 1.1-2.3, p= 0.006).ConclusionUncontrolled diabetes is associated with worse outcomes in pulmonary cryptococcosis, including a 4-fold and 6-fold increased odds of death at 10-weeks and 1-year, respectively. Glucose control interventions should be explored to improve clinical outcomes in patients with pulmonary cryptococcosis.

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“…El reporte de Cryptococcus neoformans en Lima es de importancia epidemiológica, debido a su relevancia para la salud pública, reconocida como la principal causa de meningitis micótica en el mundo (Firacative et al, 2018); relacionada a infecciones por el virus del VIH, donde se identifica su rol oportunista (Messina et al, 2014). Figura 1.…”

Section: Discussionunclassified

Cryptococcus neoformans en heces de palomas mensajeras y de Castilla (Columba livia) en Lima, Perú

Timmermann

Morales-Cauti

Villacaqui

2020

Rev. investig. vet. Perú

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El objetivo del presente estudio fue determinar la prevalencia de Cryptococcus neoformans en heces de palomas domésticas (Columba livia) en lugares públicos de la ciudad de Lima, Perú, en 2015-2016. Se recolectaron muestras de heces secas en palomares de palomas mensajeras criadas en cautiverio y en ambientes públicos de palomas de Castilla. Las muestras fueron procesadas y sembradas en agar Sabouraud dextrosa, e incubadas a 37 °C hasta por 10 días. Las colonias fueron identificadas a través de la evaluación macroscópica, visualización de cápsula con tinta china, prueba de ureasa, asimilación de azúcares, reducción rápida de nitrato, prueba de fenoloxidasa y crecimiento en agar CGB. Se determinó una frecuencia de 5.16% (16/310) de muestras positivas a C. neoformans en heces de ambos tipos de palomas evaluadas. En las heces de palomas de Castilla fue de 8.89% (16/180), en tanto que no hubo muestras positivas en las palomas mensajeras. En la simulación estocástica Beta Pert (@Risk 5.5®) se determinó una prevalencia mínima y máxima para el estudio de 4.59 y 5.61%, respectivamente. Se concluye que Cryptococcus neoformans se encuentra presente en heces de palomas Castilla en la ciudad de Lima, Perú.

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Criptococosis meníngea en pacientes con diabetes y sida

Cited by 11 publications

References 15 publications

Increased mortality associated with uncontrolled diabetes mellitus in patients with pulmonary cryptococcosis: a single US cohort study

Increased mortality associated with uncontrolled diabetes mellitus in patients with pulmonary cryptococcosis: a single US cohort study

Increased mortality associated with uncontrolled diabetes mellitus in patients with Pulmonary Cryptococcosis — a single U.S. cohort study

Cryptococcus neoformans en heces de palomas mensajeras y de Castilla (Columba livia) en Lima, Perú

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