{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:57:02Z","timestamp":1788969422722,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T00:00:00Z","timestamp":1484179200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Washington University Institute of Clinical and Translational Sciences","award":["UL1 TR000448"],"award-info":[{"award-number":["UL1 TR000448"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R24 HS19455"],"award-info":[{"award-number":["R24 HS19455"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["KM1CA156708"],"award-info":[{"award-number":["KM1CA156708"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cryptococcosis is the third most common invasive fungal infection in solid organ transplant (SOT) recipients. There are no nationally representative data describing the incidence, risk factors, and outcomes of cryptococcosis after SOT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assembled a large cohort of adult SOT recipients using Classification of Diseases, Ninth Revision, Clinical Modification billing data from Healthcare Cost and Utilization Project State Inpatient Databases of Florida (2006\u20132012), New York (2006\u20132011), and California (2004\u20132010). Demographics, comorbidities, death, and cryptococcal infections coded during hospitalization were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 42634 adults with SOT were identified during the study period. Cryptococcal disease was identified in 0.37% (n = 158), 44% of which had meningitis (n = 69). Median time to diagnosis of cryptococcosis was 464 days (range, 4\u20132393). The median time to onset of cryptococcosis was earlier for lung (191 days; range, 7.5\u20131816), heart (195 days; range, 4\u20131061), and liver (200 days; range, 4\u20131581) compared with kidney transplant recipients (616 days; range, 12\u20132393; P &amp;lt; .001, log rank test). Very early-onset disease (&amp;lt;30 days after transplantation) more frequently occurred in liver and lung transplant recipients. Lung transplant recipients had the highest risk of cryptococcosis (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.21\u20133.60). Cryptococcosis was associated with death (HR, 2.29; 95% CI, 1.68\u20133.11), after adjusting for age, type of SOT, and other comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cryptococcosis is rare after SOT, but it is associated with significantly increased risk of death. Lung transplant recipients are at highest risk for cryptococcosis among SOTs. Nonkidney transplants have earlier onset of cryptococcosis and higher risk of death compared with kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofx004","type":"journal-article","created":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T20:25:24Z","timestamp":1484252724000},"source":"Crossref","is-referenced-by-count":68,"title":["Epidemiology of Cryptococcosis and Cryptococcal Meningitis in a Large Retrospective Cohort of Patients After Solid Organ Transplantation"],"prefix":"10.1093","volume":"4","author":[{"given":"Ige A.","family":"George","sequence":"first","affiliation":[{"name":"Divisions of Infectious Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A. Q.","family":"Santos","sequence":"additional","affiliation":[{"name":"Divisions of Infectious Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret A.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Divisions of Infectious Diseases and"},{"name":"Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Powderly","sequence":"additional","affiliation":[{"name":"Divisions of Infectious Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,1,12]]},"reference":[{"key":"2020081005070173900_CIT0001","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1086\/651262","article-title":"Invasive fungal infections among organ transplant recipients: results of the transplant-associated infection surveillance network (TRANSNET)","volume":"50","author":"Pappas","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2020081005070173900_CIT0002","doi-asserted-by":"crossref","first-page":"e60431","DOI":"10.1371\/journal.pone.0060431","article-title":"Predictors of mortality and differences in clinical features among patients with Cryptococcosis according to immune status","volume":"8","author":"Brizendine","year":"2013","journal-title":"PLoS One"},{"key":"2020081005070173900_CIT0003","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1086\/598936","article-title":"Cryptococcosis in solid-organ, hematopoietic stem cell, and tissue transplant recipients: evidence-based evolving trends","volume":"48","author":"Sun","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2020081005070173900_CIT0004","first-page":"61","article-title":"Cryptococcal infections in non-HIV-infected patients","volume":"124","author":"Pappas","year":"2013","journal-title":"Trans Am Clin Climatol Assoc"},{"key":"2020081005070173900_CIT0005","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s40265-013-0037-z","article-title":"Cryptococcal infections: changing epidemiology and implications for therapy","volume":"73","author":"La Hoz","year":"2013","journal-title":"Drugs"},{"key":"2020081005070173900_CIT0006","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1399-3062.2010.00492.x","article-title":"Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients","volume":"12","author":"Neofytos","year":"2010","journal-title":"Transpl Infect Dis"},{"key":"2020081005070173900_CIT0007","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1034\/j.1399-3062.2002.t01-1-02005.x","article-title":"Cryptococcal meningitis: an analysis among 5521 consecutive organ transplant recipients","volume":"4","author":"Wu","year":"2002","journal-title":"Transpl Infect Dis"},{"key":"2020081005070173900_CIT0008","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med Care"},{"key":"2020081005070173900_CIT0009","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/biomet\/69.1.239","article-title":"Partial residuals for the proportional hazards regression model on JSTOR","volume":"69","author":"Schoenfeld","year":"1982","journal-title":"Biometrika"},{"key":"2020081005070173900_CIT0010","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-2555-1","volume-title":"Survival Analysis: A Self-Learning Text","author":"Kleinbaum","year":"1996"},{"key":"2020081005070173900_CIT0011","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1086\/511438","article-title":"Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality","volume":"195","author":"Singh","year":"2007","journal-title":"J Infect Dis"},{"key":"2020081005070173900_CIT0012","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/j.1399-3062.2009.00424.x","article-title":"Central nervous system involvement in cryptococcal infection in individuals after solid organ transplantation or with AIDS","volume":"11","author":"Davis","year":"2009","journal-title":"Transpl Infect Dis"},{"key":"2020081005070173900_CIT0013","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"},{"key":"2020081005070173900_CIT0014","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1086\/592690","article-title":"Cryptococcosis in solid organ transplant recipients: current state of the science","volume":"47","author":"Singh","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2020081005070173900_CIT0015","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1086\/656584","article-title":"Unrecognized pretransplant and donor-derived cryptococcal disease in organ transplant recipients","volume":"51","author":"Sun","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2020081005070173900_CIT0016","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3201\/eid0703.017302","article-title":"Cryptococcus neoformans infection in organ transplant recipients: variables influencing clinical characteristics and outcome","volume":"7","author":"Husain","year":"2001","journal-title":"Emerg Infect Dis"},{"key":"2020081005070173900_CIT0017","doi-asserted-by":"crossref","first-page":"e56269","DOI":"10.1371\/journal.pone.0056269","article-title":"Epidemiology of cryptococcal meningitis in the US: 1997\u20132009","volume":"8","author":"Pyrgos","year":"2013","journal-title":"PLoS One"},{"key":"2020081005070173900_CIT0018","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1093\/aje\/kwq285","article-title":"Utility of international classification of diseases, ninth revision, clinical modification codes for communicable disease surveillance","volume":"172","author":"Sickbert-Bennett","year":"2010","journal-title":"Am J Epidemiol"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/4\/1\/ofx004\/33622212\/ofx004.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/4\/1\/ofx004\/33622212\/ofx004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T05:07:26Z","timestamp":1597036046000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofx004\/2895933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofx004","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017]]},"published":{"date-parts":[[2017,1,1]]},"article-number":"ofx004"}}