Diabetes Mellitus Type 2 as a Risk Factor and Outcome Modifier for Cryptococcosis in HIV Negative, Non-transplant Patients, a Propensity Score Match Analysis
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Title: | Diabetes Mellitus Type 2 as a Risk Factor and Outcome Modifier for Cryptococcosis in HIV Negative, Non-transplant Patients, a Propensity Score Match Analysis |
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Authors: | Kung, Vanessa M. | Ferraz, Carolina | Kennis, Matthew | Franco-Paredes, Carlos | Tuells, José | Vargas Barahona, Lilian | Shapiro, Leland | Thompson III, George R. | Chastain, Daniel B. | Henao-Martinez, Andres F. |
Research Group/s: | Salud Comunitaria (SALUD) |
Center, Department or Service: | Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia |
Keywords: | Cryptococcosis | Cryptococcus neoformans | Cryptococcus gattii | Type 2 diabetes mellitus | HIV-negative patients | Non-transplant patients |
Issue Date: | 31-Oct-2023 |
Publisher: | Springer Nature |
Citation: | Current Microbiology. 2023, 80:396. https://doi.org/10.1007/s00284-023-03512-9 |
Abstract: | Cryptococcosis is an opportunistic fungal infection of worldwide distribution with significant associated morbidity and mortality. HIV, organ transplantation, malignancy, cirrhosis, sarcoidosis, and immunosuppressive medications are established risk factors for cryptococcosis. Type 2 diabetes mellitus (DM2) has been hypothesized as a risk factor and an outcome modifier for cryptococcosis. We aimed to compare outcomes among HIV-negative, non-transplant (NHNT) patients with and without DM2. We queried a global research network to identify NHNT patients (n = 3280). We performed a propensity score-matched (PSM) analysis comparing clinical outcomes among cryptococcosis patients by DM status. We also characterize adults with cryptococcosis and DM2 as the only risk factor. After PSM, NHNT patients with DM2 were more likely to develop cognitive dysfunction [9% vs. 6%, OR 1.6; 95% CI (1.1–2.3); P = 0.01] but had similar mortality, hospitalization, ICU, and stroke risk after acquiring cryptococcosis when compared to NHNT patients without DM2. Pulmonary cryptococcosis was the most common site of infection. Among 44 cryptococcosis patients with DM2 as the only identifiable risk factor for disease, the annual incidence of cryptococcosis was 0.001%, with a prevalence of 0.002%. DM2 is associated with increased cognitive dysfunction risk in NHNT patients with cryptococcosis. It is rare for DM2 to be the only identified risk factor for developing cryptococcosis. Kidney disease, hyperglycemia, and immune dysfunction can increase the risk of cryptococcosis in patients with DM2. |
URI: | http://hdl.handle.net/10045/138186 |
ISSN: | 0343-8651 (Print) | 1432-0991 (Online) |
DOI: | 10.1007/s00284-023-03512-9 |
Language: | eng |
Type: | info:eu-repo/semantics/article |
Rights: | © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023 |
Peer Review: | si |
Publisher version: | https://doi.org/10.1007/s00284-023-03512-9 |
Appears in Collections: | INV - SALUD - Artículos de Revistas |
Files in This Item:
File | Description | Size | Format | |
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Kung_etal_2023_CurrMicrobiol_final.pdf | Versión final (acceso restringido) | 631,75 kB | Adobe PDF | Open Preview |
Kung_etal_2023_CurrMicrobiol_preprint.pdf | Preprint (acceso abierto) | 503,77 kB | Adobe PDF | Open Preview |
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