Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality.

Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Research Abstract Details 

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Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Abstract Text:

Nina Singh,Barbara D Alexander,Olivier Lortholary,Francoise Dromer,Krishan L Gupta,George T John,Ramon del Busto,Goran B Klintmalm,Jyoti Somani,G Marshall Lyon,Kenneth Pursell,Valentina Stosor,Patricia Munoz,Ajit P Limaye,Andre C Kalil,Timothy L Pruett,Julia Garcia-Diaz,Atul Humar,Sally Houston,Andrew A House,Dannah Wray,Susan Orloff,Lorraine A Dowdy,Robert A Fisher,Joseph Heitman,Marilyn M Wagener,Shahid Husain, ,

Variables influencing the risk of dissemination and outcome of Cryptococcus neoformans infection were assessed in 111 organ transplant recipients with cryptococcosis in a prospective, multicenter, international study. Sixty-one percent (68/111) of the patients had disseminated infection. The risk of disseminated cryptococcosis was significantly higher for liver transplant recipients (adjusted hazard ratio [HR], 6.65; P=.048). The overall mortality rate at 90 days was 14% (16/111). The mortality rate was higher in patients with abnormal mental status (P=.023), renal failure at baseline (P=.028), fungemia (P=.006), and disseminated infection (P=.035) and was lower in those receiving a calcineurin-inhibitor agent (P=.003). In a multivariable analysis, the receipt of a calcineurin-inhibitor agent was independently associated with a lower mortality (adjusted HR, 0.21; P=.008), and renal failure at baseline with a higher mortality rate (adjusted HR, 3.14; P=.037). Thus, outcome in transplant recipients with cryptococcosis appears to be influenced by the type of immunosuppressive agent employed. Additionally, discerning the basis for transplant type-specific differences in disease severity has implications relevant for yielding further insights into the pathogenesis of C. neoformans infection in transplant recipients.

Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Publishing Authors By Initials

N Singh,BD Alexander,O Lortholary,F Dromer,KL Gupta,GT John,R del Busto,GB Klintmalm,J Somani,GM Lyon,K Pursell,V Stosor,P Munoz,AP Limaye,AC Kalil,TL Pruett,J Garcia-Diaz,A Humar,S Houston,AA House,D Wray,S Orloff,LA Dowdy,RA Fisher,J Heitman,MM Wagener,S Husain, ,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: The Journal of infectious diseases

VOLUME: 195

Page Numbers: 756-64

Journal Abbreviation: J. Infect. Dis.

ISSN: 0022-1899

DAY: 23

MONTH: 01

YEAR: 2007

Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 413675

Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: pharmacology

Chemical & Substance for Abstract: Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. Information

Substance Name: Calcineurin

Registry Number: EC 3.1.3.-

Grant and Affiliation Information for Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality.

AFFILIATION: University of Pittsburgh Medical Center, Pittsburgh, PA 15240, USA. nis5@pitt.edu

Country: United States

AGENCY: United States NIAID

GRANT: R01 AI054719-01

ACRONYM: AI

MEDLINETA: J Infect Dis

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