{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:13:33Z","timestamp":1784308413610,"version":"3.55.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004948","name":"Astellas Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004948","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Infection by Cryptococcus gattii can lead to pulmonary or central nervous system (CNS) disease, or both. Whether the sites of infection and disease severity are associated with C. gattii species and lineages or with certain underlying medical conditions, or both is unclear. We conducted a retrospective cohort study to identify factors associated with site of infection and mortality among C. gattii cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We extracted data on 258 C. gattii cases from Australia, Canada, and the United States reported from 1999 to 2011. We conducted unadjusted and multivariable logistic regression analyses to evaluate factors associated with site of infection and C. gattii mortality among hospitalized cases (N = 218).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Hospitalized C. gattii cases with CNS and other extrapulmonary disease were younger, more likely to reside in Australia, and be infected with variety gattii I (VGI) lineage but less likely to have comorbidities and die as compared to cases with pulmonary disease. The odds of having CNS and\/or other extrapulmonary disease were 9 times higher in cases with VGI infection (adjusted odds ratio [aOR] = 9.21, 95% confidence interval [CI] = 3.28\u201325.89). Age \u226570 years (aOR = 6.69, 95% CI = 2.44\u201318.30), chronic lung disease (aOR = 2.62, 95% CI = 1.05\u20136.51) and an immunocompromised status (aOR = 2.08, 95% CI = 1.05\u20136.51) were associated with higher odds of C. gattii mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among hospitalized cases, C. gattii species and lineage are associated with site of infection but not with the risk of death, whereas older age and comorbidities increase the risk of death.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae640","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T18:44:56Z","timestamp":1736275496000},"page":"1088-1094","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of <i>Cryptococcus gattii<\/i> Clinical Presentation and Outcome: An International Study"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7702-3575","authenticated-orcid":false,"given":"Eleni","family":"Galanis","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]},{"name":"British Columbia Centre for Disease Control , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"MacDougall","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Disease Control , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caren","family":"Rose","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]},{"name":"British Columbia Centre for Disease Control , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C A","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital , Westmead, New South Wales ,","place":["Australia"]},{"name":"Sydney Infectious Diseases Institute, Faculty of Medicine and Health, University of Sydney , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna N","family":"Oltean","sequence":"additional","affiliation":[{"name":"Washington Department of Health , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2231-5797","authenticated-orcid":false,"given":"Paul R","family":"Cieslak","sequence":"additional","affiliation":[{"name":"Oregon Department of Health , Portland, Oregon ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"DeBess","sequence":"additional","affiliation":[{"name":"Oregon Department of Health , Portland, Oregon ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Chong","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Disease Control , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania C","family":"Sorrell","sequence":"additional","affiliation":[{"name":"Sydney Infectious Diseases Institute, Faculty of Medicine and Health, University of Sydney , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9111-625X","authenticated-orcid":false,"given":"John W","family":"Baddley","sequence":"additional","affiliation":[{"name":"School of Medicine, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M N","family":"Hoang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]},{"name":"British Columbia Centre for Disease Control , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-9931","authenticated-orcid":false,"given":"Peter G","family":"Pappas","sequence":"additional","affiliation":[{"name":"Heersink School of Medicine, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-1966","authenticated-orcid":false,"given":"Peter","family":"Phillips","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]},{"name":"Division of Infectious Diseases, St. Paul's Hospital , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"2025060412013313200_ciae640-B1","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.2217\/fmb.13.123","article-title":"Cryptococcus gattii infections: contemporary aspects of epidemiology, clinical manifestations and management of infection","volume":"8","author":"McMullan","year":"2013","journal-title":"Fut Microbiol"},{"key":"2025060412013313200_ciae640-B2","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3390\/jof7040260","article-title":"Associations between Cryptococcus genotypes, phenotypes, and clinical parameters of human disease. A review","volume":"7","author":"Montoya","year":"2021","journal-title":"J Fungi"},{"key":"2025060412013313200_ciae640-B3","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1128\/CMR.00126-13","article-title":"Cryptococcus gattii infections","volume":"27","author":"Chen","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"2025060412013313200_ciae640-B4","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/cid\/cir723","article-title":"Cryptococcus gattii in the United States: clinical aspects of infection with an emerging pathogen","volume":"53","author":"Harris","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2025060412013313200_ciae640-B5","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1093\/cid\/cis529","article-title":"Clinical manifestations of Cryptococcus gattii infection: determinants of neurological sequelae and death","volume":"55","author":"Chen","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2025060412013313200_ciae640-B6","doi-asserted-by":"crossref","first-page":"e88875","DOI":"10.1371\/journal.pone.0088875","article-title":"Treatment and outcomes among patients with Cryptococcus gattii infections in the United States Pacific Northwest","volume":"9","author":"Smith","year":"2014","journal-title":"PLoS One"},{"key":"2025060412013313200_ciae640-B7","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1093\/cid\/civ041","article-title":"Longitudinal clinical findings and outcome among patients with Cryptococcus gattii infection in British Columbia","volume":"60","author":"Phillips","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2025060412013313200_ciae640-B8","doi-asserted-by":"crossref","first-page":"e16936","DOI":"10.1371\/journal.pone.0016936","article-title":"Clonality and \u03b1-a recombination in the Australian Cryptococcus gattii VGII population\u2014an emerging outbreak in Australia","volume":"6","author":"Carriconde","year":"2011","journal-title":"PLoS One"},{"key":"2025060412013313200_ciae640-B9","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1128\/jcm.34.5.1253-1260.1996","article-title":"Concordance of clinical and environmental isolates of Cryptococcus neoformans var. gattii by random amplification of polymorphic DNA analysis and PCR fingerprinting","volume":"34","author":"Sorrell","year":"1996","journal-title":"J Clin Microbiol"},{"key":"2025060412013313200_ciae640-B10","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1093\/cid\/ciab268","article-title":"MSG07: an international cohort study comparing epidemiology and outcomes of patients with Cryptococcus neoformans or Cryptococcus gattii infections","volume":"73","author":"Baddley","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025060412013313200_ciae640-B11","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s10096-008-0529-z","article-title":"Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease","volume":"27","author":"Baddley","year":"2008","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2025060412013313200_ciae640-B12","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3201\/eid1702.101020","article-title":"Risk factors for Cryptococcus gattii infection, British Columbia, Canada","volume":"17","author":"MacDougall","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"2025060412013313200_ciae640-B13","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/mmy\/myy086","article-title":"Pulmonary cryptococcosis: a review of pathobiology and clinical aspects","volume":"57","author":"Setianingrum","year":"2019","journal-title":"Med Mycol"},{"key":"2025060412013313200_ciae640-B14","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1007\/s10875-022-01341-2","article-title":"Cryptococcus gattii infection as the major clinical manifestation in patients with autoantibodies against granulocyte\u2013macrophage colony-stimulating factor","volume":"42","author":"Wang","year":"2022","journal-title":"J Clin Immunol"},{"key":"2025060412013313200_ciae640-B15","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1086\/313757","article-title":"Practice guidelines for the management of cryptococcal disease","volume":"30","author":"Saag","year":"2000","journal-title":"Clin Infect Dis"},{"key":"2025060412013313200_ciae640-B16","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1086\/649858","article-title":"Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America","volume":"50","author":"Perfect","year":"2010","journal-title":"Clin Infect Dis"},{"issue":"8):","key":"2025060412013313200_ciae640-B17","doi-asserted-by":"crossref","first-page":"e495","DOI":"10.1016\/S1473-3099(23)00731-4","article-title":"Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM","volume":"24","author":"Chang","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2025060412013313200_ciae640-B18","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/cid\/cit341","article-title":"Antifungal therapy and management of complications of cryptococcosis due to Cryptococcus gattii","volume":"57","author":"Chen","year":"2013","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciae640\/61370630\/ciae640.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/5\/1088\/61370630\/ciae640.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/5\/1088\/61370630\/ciae640.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T16:01:41Z","timestamp":1749052901000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/80\/5\/1088\/7945113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,1,7]]},"published-print":{"date-parts":[[2025,6,4]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciae640","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5,15]]},"published":{"date-parts":[[2025,1,7]]}}}