Epidemiology of cryptococcal meningitis in the US: 1997-2009.

Epidemiology of cryptococcal meningitis in the US: 1997-2009.
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DOI:
10.1371/journal.pone.0056269
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发表时间:
2013
期刊:
影响因子:
3.7
通讯作者:
Williamson PR
Williamson PR
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Pyrgos V;Seitz AE;Steiner CA;Prevots DR;Williamson PR

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隐球菌性脑膜炎(CM)在全球范围内造成了严重的发病率和死亡率;然而,最近的国家趋势尚未得到描述。使用1997年至2009年美国医疗保健和研究质量局(AHRQ)州住院患者数据库(SID)数据集,估计了18个州的CM相关住院的发病率和趋势。我们确定了30,840例编码为CM的住院治疗,其中21.6%为未感染HIV的患者。CM住院死亡率显著(女性为12.4%,男性为10.8%),研究期间共有3,440例死亡。在未感染HIV的CM住院人群中,编码频率增加的CM合并症包括脑积水和急性/慢性肾衰竭以及可能的易感性,包括移植、T和B细胞联合缺陷、库欣综合征、肝病和低丙种球蛋白血症。CM患者的中位住院费用显著高于HIV未感染患者(16,803.01 vs. 15,708.07; p<0.0001)。隐球菌性脑膜炎在美国仍然是一种发病率和死亡率很高的疾病,没有艾滋病毒感染的人的相对负担正在增加。
Cryptococcal meningitis (CM) causes significant morbidity and mortality globally; however, recent national trends have not been described. Incidence and trends for CM-associated hospitalizations in 18 states were estimated using the Agency for Healthcare and Research Quality (AHRQ) State Inpatient Databases (SID) datasets for 1997 through 2009. We identified 30,840 hospitalizations coded for CM, of which 21.6% were among HIV-uninfected patients. CM in-hospital mortality was significant (12.4% for women and 10.8% for men) with a total of 3,440 deaths over the study period. Co-morbidities of CM coded at increased frequency in HIV-uninfected CM hospitalized populations included hydrocephalus and acute/chronic renal failure as well as possible predispositions including transplantation, combined T and B cell defects, Cushing’s syndrome, liver disease and hypogammaglobulinemia. Median hospitalization costs were significant for CM and higher for HIV-uninfected patients (16,803.01 vs. 15,708.07; p<0.0001). Cryptococcal meningitis remains a disease with significant morbidity and mortality in the U.S. and the relative burden among persons without HIV infection is increasing.
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