Abstract
Abstract We investigated an unusual cluster of 6 patients with Cryptococcus neoformans infection at a community hospital in Arkansas during April–December 2013, to determine source of infection. Four patients had bloodstream infection and 2 had respiratory infection; 3 infections occurred within a 10-day period. Five patients had been admitted to the intensive care unit (ICU) with diagnoses other than cryptococcosis; none had HIV infection, and 1 patient had a history of organ transplantation. We then conducted a retrospective cohort study of all patients admitted to the ICU during April–December 2013 to determine risk factors for cryptococcosis. Four patients with C. neoformans infection had received a short course of steroids; this short-term use was associated with increased risk for cryptococcosis (rate ratio 19.1; 95% CI 2.1–170.0; p<0.01). Although long-term use of steroids is a known risk factor for cryptococcosis, the relationship between short-term steroid use and disease warrants further study
Highlights
Case-Patient Descriptions We identified 6 cases of C. neoformans infection at hospital A during 2013: 4 case-patients had bloodstream infection (BSI), and 2 case-patients had respiratory specimens that yielded C. neoformans
One of the patients with a BSI had C. neoformans isolated from cerebrospinal fluid (CSF) and urine specimens
Receipt of short-term steroids in the intensive care unit (ICU) was significantly associated with cryptococcosis in this cohort
Summary
Review of microbiology laboratory records at hospital A identified a median of 2 patients (range 0–8) per year with positive C. neoformans cultures during 1992–2012; most were from respiratory samples. 4 blood cultures yielded C. neoformans during this time: 1 in 2004, 2 in 2007 (February and August), and 1 in 2008 (Figure). 4 BSIs occurred during 2013, with 3 occurring within 10 days of each other. Laboratory staff and ICPs at 4 surrounding hospitals had reported no increase in the Figure. Culture-confirmed Cryptococcus isolates at hospital A, Arkansas, USA, 1992–2013. Emerging Infectious Diseases www.cdc.gov/eid Vol 21, No 10, October 2015
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
