{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:35:11Z","timestamp":1782995711251,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Cryptococcus<\/jats:italic>\n                      bloodstream infections (BSIs) or cryptococcaemia are severe opportunistic infections with high mortality, predominantly affecting immunocompromised individuals or those with end\u2010stage organ disease. Population\u2010based studies examining infection trends and associations between host factors, geography, antifungal resistance, and clinical outcomes are few.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Blood cultures with growth of\n                      <jats:italic>Cryptococcus<\/jats:italic>\n                      species were retrospectively identified over a 20\u2010year period (January 1, 2000\u2013December 31, 2019) from a state\u2010wide database. Clinical, microbiological and outcome information was also obtained. Survival analyses were used to establish associations between clinical or microbiological characteristics and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 118 cryptococcaemia episodes (115 patients) were identified, with\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                      <\/jats:styled-content>\n                      complex causing 98 episodes (83.1%). HIV\u2010associated infections represented 28 episodes (23.7%), with non\u2010HIV episodes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200990) more likely to be associated with comorbidities including solid organ transplantation, malignancy, chronic kidney disease, and rheumatological conditions. Overall, 30\u2010day all\u2010cause mortality was 34%, with higher mortality in non\u2010HIV\u2010associated cases (41.7% vs. 12.5%, HR 0.29; 95% CI 0.09\u20130.94). Of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>C. neoformans<\/jats:italic>\n                      <\/jats:styled-content>\n                      complex isolates with a fluconazole MIC  8\u2009mg\/L, 6 (46%) were observed in the most recent 5\u2010year period. Thirty\u2010day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.85) and 1\u2010year (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.35) mortality increased in a stepwise fashion with increasing fluconazole MIC values in\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>C. neoformans<\/jats:italic>\n                      <\/jats:styled-content>\n                      complex infection. Fifty\u2010three episodes (49.1%) documented isolated cryptococcaemia. Patients with additional sites of infection, including CNS involvement, experienced longer hospital stays. Those living in a regional or remote area (HR 1.33; 95% CI 0.68\u20132.61) or with older age (HR 1.02; 95% CI 1.00\u20131.04) experienced higher rates of death, although these findings were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Cryptococcus<\/jats:italic>\n                      BSI is a highly lethal condition, particularly among non\u2010HIV infected individuals. We highlight the prognostic importance of blood culture collection in patients with suspected cryptococcal infection. Identifying contemporary risk factors for mortality is critical to understanding what drives poor outcomes. There is a need for continued surveillance of fluconazole susceptibility among\n                      <jats:italic>Cryptococcus<\/jats:italic>\n                      species.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70091","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T06:10:05Z","timestamp":1751955005000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Characteristics and Outcomes in Patients With Cryptococcaemia From a Large Population\u2010Based Cohort"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7262-7529","authenticated-orcid":false,"given":"Adam G.","family":"Stewart","sequence":"first","affiliation":[{"name":"Transplant and Immunocompromised Host Infectious Diseases, Infectious Diseases Division Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Centre for Clinical Research, Faculty of Medicine The University of Queensland, Royal Brisbane and Women's Hospital Campus  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin B.","family":"Laupland","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Services Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Queensland University of Technology  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Services Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Queensland University of Technology  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Gassiep","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Mater Hospital  Brisbane Queensland Australia"},{"name":"Pathology Queensland Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Koo","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Infectious Diseases Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah P.","family":"Hammond","sequence":"additional","affiliation":[{"name":"Transplant and Immunocompromised Host Infectious Diseases, Infectious Diseases Division Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Dana\u2010Farber Cancer Institute, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medical Oncology Massachusetts General Hospital Cancer Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C.\u2010A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Sydney Infectious Diseases Institute The University of Sydney  Sydney Australia"},{"name":"Department of Infectious Diseases Westmead Hospital  Sydney Australia"},{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services New South Wales Health Pathology, Westmead Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A.","family":"Slavin","sequence":"additional","affiliation":[{"name":"National Centre for Infections in Cancer Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198303000-00003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad321"},{"issue":"4","key":"e_1_2_10_4_1","article-title":"Infections due to Rare Cryptococcus Species. A Literature Review","volume":"7","author":"Morales\u2010L\u00f3pez S. E.","year":"2021","journal-title":"Journal of Fungi (Basel, Switzerland)"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myz089"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae630"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13261"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1023-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/femsle\/fnab040"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-020-00375-6"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/653207"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_10_14_1","unstructured":"Australian Statistical Geography Standard (ASGS)(2021) https:\/\/www.abs.gov.au\/statistics\/standards\/australian\u2010statistical\u2010geography\u2010standard\u2010asgs\u2010edition\u20103\/jul2021\u2010jun2026."},{"key":"e_1_2_10_15_1","unstructured":"Bureau of Meteorology: Australian Government http:\/\/www.bom.gov.au\/."},{"key":"e_1_2_10_16_1","unstructured":"\u201cM59 Epidemiological Cutoff Values for Antifungal Susceptibility Testing \u201d (2020)."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/13693780902953886"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/95.8.511"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13091358"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-023-00814-1"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myad125"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.6.1544-1548.2000"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-361"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12847"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw076"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2023.12.009"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1544"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-017-3142-1"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008137"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70091","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.70091","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:35:14Z","timestamp":1772958914000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.70091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":28,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/myc.70091"],"URL":"https:\/\/doi.org\/10.1111\/myc.70091","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70091"}}