{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:50:58Z","timestamp":1791255058858,"version":"4.1.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Predictors of mortality in cryptococcal meningoencephalitis (CM) across HIV, solid organ transplant (SOT), and non-HIV, non-transplant (NHNT) populations remain incompletely defined. We compared clinical characteristics and 90-day mortality across host groups and evaluated factors associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with CM were identified in TriNetX (2003\u20132024) using ICD-10-CM codes or cerebrospinal fluid cryptococcal antigen or DNA evidence. Analyses were restricted to amphotericin B-treated patients to improve diagnostic specificity. Patients with available host-group information were categorized as HIV, SOT, or NHNT. Multivariable Cox regression evaluated 90-day mortality, adjusting for age, sex, ethnicity, Charlson Comorbidity Index, pre-index glucocorticoid exposure, and calendar year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 650 patients in the final analytic cohort, 26.0% had HIV, 22.2% were SOT recipients, and 51.8% were NHNT. Overall 90-day mortality was 19.5% (n=127), and was highest among NHNT patients (23.1%), followed by SOT recipients (19.4%) and patients with HIV (12.4%). Non-survivors were older and more frequently had neoplasms, hematologic malignancy, aplastic anemia, and liver disease. NHNT status was associated with higher mortality than HIV in unadjusted analysis (HR 1.98, 95% CI 1.22\u20133.20). In the multivariable model (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009608, 113 deaths), this association was attenuated (aHR 1.16, 95% CI 0.36\u20133.69), while advancing age remained independently associated with mortality (aHR 1.02\/year, 95% CI 1.01\u20131.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NHNT adults had the highest crude mortality, but this association was attenuated after adjustment. Advancing age remained independently associated with mortality, while the independent association between host group and mortality remained uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02997-3","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:19:55Z","timestamp":1791191995000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with 90-day mortality in adults with cryptococcal meningoencephalitis across HIV, solid organ transplant, and non-HIV, non-transplant populations"],"prefix":"10.1007","author":[{"suffix":"II","given":"Bayard A.","family":"Taylor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameera","family":"Jamshad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-8652","authenticated-orcid":false,"given":"Andr\u00e9s F.","family":"Henao-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlie","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3656-1144","authenticated-orcid":false,"given":"David B.","family":"Cluck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-0195","authenticated-orcid":false,"given":"Daniel B.","family":"Chastain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"12","key":"2997_CR1","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1016\/s1473-3099(22)00499-6","volume":"22","author":"R Rajasingham","year":"2022","unstructured":"Rajasingham R, Govender NP, Jordan A, Loyse A, Shroufi A, Denning DW, et al. The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis. Lancet Infect Dis. 2022;22(12):1748\u201355. https:\/\/doi.org\/10.1016\/s1473-3099(22)00499-6.","journal-title":"Lancet Infect Dis"},{"key":"2997_CR2","doi-asserted-by":"publisher","first-page":"204993612412449","DOI":"10.1177\/20499361241244967","volume":"11","author":"DB Chastain","year":"2024","unstructured":"Chastain DB, Zhang Q, Chen X, Young HN, Franco-Paredes C, Tuells J, et al. Epidemiological trends and clinical outcomes of cryptococcosis in a medically insured population in the United States: a claims-based analysis from 2017 to 2019. Ther Adv Infect Dis. 2024;11:20499361241244967. https:\/\/doi.org\/10.1177\/20499361241244967.","journal-title":"Ther Adv Infect Dis"},{"issue":"4","key":"2997_CR3","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1093\/cid\/cix867","volume":"66","author":"IA George","year":"2018","unstructured":"George IA, Spec A, Powderly WG, Santos CAQ. Comparative Epidemiology and Outcomes of Human Immunodeficiency virus (HIV), Non-HIV Non-transplant, and Solid Organ Transplant Associated Cryptococcosis: A Population-Based Study. Clin Infect Dis. 2018;66(4):608\u201311. https:\/\/doi.org\/10.1093\/cid\/cix867.","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2997_CR4","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1093\/cid\/cit794","volume":"58","author":"JN Jarvis","year":"2014","unstructured":"Jarvis JN, Bicanic T, Loyse A, Namarika D, Jackson A, Nussbaum JC, et al. Determinants of mortality in a combined cohort of 501 patients with HIV-associated Cryptococcal meningitis: implications for improving outcomes. Clin Infect Dis. 2014;58(5):736\u201345. https:\/\/doi.org\/10.1093\/cid\/cit794.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"2997_CR5","doi-asserted-by":"publisher","first-page":"e13658","DOI":"10.1111\/myc.13658","volume":"67","author":"H Namie","year":"2024","unstructured":"Namie H, Takazono T, Hidaka Y, Morimoto S, Ito Y, Nakada N, et al. The prognostic factors for cryptococcal meningitis in non-human immunodeficiency virus patients: An observational study using nationwide database. Mycoses. 2024;67(1):e13658. https:\/\/doi.org\/10.1111\/myc.13658.","journal-title":"Mycoses"},{"issue":"2","key":"2997_CR6","doi-asserted-by":"publisher","first-page":"ooad035","DOI":"10.1093\/jamiaopen\/ooad035","volume":"6","author":"MB Palchuk","year":"2023","unstructured":"Palchuk MB, London JW, Perez-Rey D, Drebert ZJ, Winer-Jones JP, Thompson CN, et al. A global federated real-world data and analytics platform for research. JAMIA Open. 2023;6(2):ooad035. https:\/\/doi.org\/10.1093\/jamiaopen\/ooad035.","journal-title":"JAMIA Open"},{"key":"2997_CR7","unstructured":"TriNetX. . Accessed 2 Mar 2026. https:\/\/trinetx.com\/real-world-resources\/case-studies-publications\/trinetx-publication-guidelines\/"},{"issue":"4","key":"2997_CR8","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.jclinepi.2006.07.011","volume":"60","author":"S Schneeweiss","year":"2007","unstructured":"Schneeweiss S, Robicsek A, Scranton R, Zuckerman D, Solomon DH. Veteran\u2019s affairs hospital discharge databases coded serious bacterial infections accurately. J Clin Epidemiol. 2007;60(4):397\u2013409. https:\/\/doi.org\/10.1016\/j.jclinepi.2006.07.011.","journal-title":"J Clin Epidemiol"},{"key":"2997_CR9","unstructured":"WHO. Anatomical Therapeutic Chemical (ATC) Classification. (2026). https:\/\/www.who.int\/tools\/atc-ddd-toolkit\/atc-classification. Accessed 2 Mar 2026."},{"issue":"2","key":"2997_CR10","doi-asserted-by":"publisher","first-page":"ofad658","DOI":"10.1093\/ofid\/ofad658","volume":"11","author":"O Paccoud","year":"2024","unstructured":"Paccoud O, Desnos-Ollivier M, Cassaing S, Boukris-Sitbon K, Alanio A, Bellanger AP, et al. Cryptococcus neoformans Infections Differ Among Human Immunodeficiency Virus (HIV)-Seropositive and HIV-Seronegative Individuals: Results From a Nationwide Surveillance Program in France. Open Forum Infect Dis. 2024;11(2):ofad658. https:\/\/doi.org\/10.1093\/ofid\/ofad658.","journal-title":"Open Forum Infect Dis"},{"issue":"9","key":"2997_CR11","doi-asserted-by":"publisher","first-page":"e0013521","DOI":"10.1371\/journal.pntd.0013521","volume":"19","author":"X Xu","year":"2025","unstructured":"Xu X, Su X, Li W, Xu L, Li D, Dai K, et al. Clinical features and mortality risk factors in non-HIV elderly patients with cryptococcal meningitis: A retrospective cohort study from 2013 to 2022. PLoS Negl Trop Dis. 2025;19(9):e0013521. https:\/\/doi.org\/10.1371\/journal.pntd.0013521.","journal-title":"PLoS Negl Trop Dis"},{"key":"2997_CR12","doi-asserted-by":"publisher","first-page":"1410090","DOI":"10.3389\/fimmu.2024.1410090","volume":"15","author":"L Soraci","year":"2024","unstructured":"Soraci L, Beccacece A, Princiotto M, Villalta Savedra E, Gambuzza ME, Aguennouz M, et al. The emerging links between immunosenescence in innate immune system and neurocryptococcosis. Front Immunol. 2024;15:1410090. https:\/\/doi.org\/10.3389\/fimmu.2024.1410090.","journal-title":"Front Immunol"},{"issue":"7","key":"2997_CR13","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/j.cmi.2024.03.031","volume":"30","author":"O Paccoud","year":"2024","unstructured":"Paccoud O, Desnos-Ollivier M, Persat F, Demar M, Boukris-Sitbon K, Bellanger AP, et al. Features of cryptococcosis among 652 HIV-seronegative individuals in France: a cross-sectional observational study (2005\u20132020). Clin Microbiol Infect. 2024;30(7):937\u201344. https:\/\/doi.org\/10.1016\/j.cmi.2024.03.031.","journal-title":"Clin Microbiol Infect"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02997-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02997-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02997-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:02:34Z","timestamp":1791252154000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02997-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":13,"alternative-id":["2997"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02997-3","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"26 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A.F.H.-M. reports serving on advisory boards for ViiV and Valneva. D.B. Cluck has served as a consultant for Astellas. All other authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study involved the secondary analysis of existing, de-identified data and did not include any intervention or interaction with human subjects. Therefore, patient consent was not required.","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study utilized de-identified data and involved no direct patient interaction, therefore consent for publication was not required.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}