https://scholars.lib.ntu.edu.tw/handle/123456789/556773
標題: | Risk factors for invasive Cryptococcus neoformans diseases: A case-control study | 作者: | Lin Y.-Y. Shiau S. CHI-TAI FANG |
公開日期: | 2015 | 出版社: | Public Library of Science | 卷: | 10 | 期: | 3 | 來源出版物: | PLoS ONE | 摘要: | Background: Cryptococcus neoformans is a ubiquitous environmental fungus that can cause life-threatening meningitis and fungemia, often in the presence of acquired immunodeficiency syndrome (AIDS), liver cirrhosis, diabetes mellitus, or other medical conditions. To distinguish risk factors from comorbidities, we performed a hospital-based, density-sampled, matched case-control study. Methods: All new-onset cryptococcal meningitis cases and cryptococcemia cases at a university hospital in Taiwan from 2002-2010 were retrospectively identified from the computerized inpatient registry and were included in this study. Controls were selected from those hospitalized patients not experiencing cryptococcal meningitis or cryptococcemia. Controls and cases were matched by admission date, age, and gender. Conditional logistic regression was used to analyze the risk factors. Results: A total of 101 patients with cryptococcal meningitis (266 controls) and 47 patients with cryptococcemia (188 controls), of whom 32 patients had both cryptococcal meningitis and cryptococcemia, were included in this study. Multivariate regression analysis showed that AIDS (adjusted odds ratio [aOR] = 181.4; p < 0.001), decompensated liver cirrhosis (aOR = 8.5; p = 0.008), and cell-mediated immunity (CMI)-suppressive regimens without calcineurin inhibitors (CAs) (aOR = 15.9; p < 0.001) were independent risk factors for cryptococcal meningitis. Moreover, AIDS (aOR = 216.3, p < 0.001), decompensated liver cirrhosis (aOR = 23.8; p < 0.001), CMI-suppressive regimens without CAs (aOR = 7.3; p = 0.034), and autoimmune diseases (aOR = 9.3; p = 0.038) were independent risk factors for developing cryptococcemia. On the other hand, diabetes mellitus and other medical conditions were not found to be risk factors for cryptococcal meningitis or cryptococcemia. Conclusions: The findings confirm AIDS, decompensated liver cirrhosis, CMI-suppressive regimens without CAs, and autoimmune diseases are risk factors for invasive C. neoformans diseases. ? 2015 Lin et. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84924210834&doi=10.1371%2fjournal.pone.0119090&partnerID=40&md5=b0385a4bca7d2a7b939838ad8c290878 https://scholars.lib.ntu.edu.tw/handle/123456789/556773 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0119090 | SDG/關鍵字: | azathioprine; calcineurin inhibitor; chlorambucil; cyclophosphamide; cyclosporin; dexamethasone; etoposide; immunosuppressive agent; melphalan; methylprednisolone; mycophenolic acid 2 morpholinoethyl ester; prednisolone; rituximab; tacrolimus; acquired immune deficiency syndrome; adult; age; Article; autoimmune disease; cellular immunity; contact examination; controlled study; cryptococcal meningitis; cryptococcosis; Cryptococcus neoformans; decompensated liver cirrhosis; diabetes mellitus; disease registry; female; hospital admission; hospital based case control study; hospital patient; human; immunosuppressive treatment; logistic regression analysis; major clinical study; male; multivariate analysis; pigeon; retrospective study; risk assessment; risk factor; sex ratio; Taiwan; university hospital; Acquired Immunodeficiency Syndrome; aged; clinical trial; complication; Cryptococcus neoformans; fungemia; liver cirrhosis; Meningitis, Cryptococcal; middle aged; register; risk factor; very elderly; Filobasidiella neoformans; Fungi; Acquired Immunodeficiency Syndrome; Adult; Aged; Aged, 80 and over; Cryptococcus neoformans; Female; Fungemia; Humans; Liver Cirrhosis; Male; Meningitis, Cryptococcal; Middle Aged; Registries; Retrospective Studies; Risk Factors |
顯示於: | 流行病學與預防醫學研究所 |
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