https://scholars.lib.ntu.edu.tw/handle/123456789/480109
標題: | Disseminated Cryptococcus neoformans var. grubii infections in intensive care units | 作者: | Chuang Y.-M. SHIH-CHI KU SHWU-JEN LIAW SHANG-GIN WU Ho Y.C. CHONG-JEN YU PO-REN HSUEH |
公開日期: | 2010 | 卷: | 138 | 期: | 7 | 起(迄)頁: | 1036-1043 | 來源出版物: | Epidemiology and Infection | 摘要: | 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). Copyright ? 2009 Cambridge University Press. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/480109 | ISSN: | 0950-2688 | DOI: | 10.1017/S0950268809990926 | SDG/關鍵字: | amphotericin B; amphotericin B lipid complex; antifungal agent; fluconazole; immunosuppressive agent; inotropic agent; adult; aged; airway; article; bloodstream infection; cerebrospinal fluid; clinical article; clinical evaluation; controlled study; cryptococcosis; Cryptococcus neoformans; diabetes mellitus; female; hospital admission; hospital discharge; human; Human immunodeficiency virus; Human immunodeficiency virus infection; intensive care unit; length of stay; leukocyte count; liver cirrhosis; long term care; male; mortality; outcome assessment; prognosis; retrospective study; risk factor; survival rate; treatment outcome; Ascites; Cross Infection; Cryptococcosis; Cryptococcus neoformans; Diabetes Complications; Female; Heart Diseases; HIV Infections; Humans; Hypertension; Intensive Care Units; Kidney Diseases; Liver Cirrhosis; Lung Diseases; Male; Middle Aged; Organ Transplantation; Retrospective Studies; Rheumatic Diseases |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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