Profile of patients with cryptococcosis in a regional hospital in the interior of São Paulo

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.7642

Keywords:

HIV; Death; Relative Risk; Cryptococcosis; Odds ratio.

Abstract

Infections caused by Cryptococus spp. are opportunistic, urban, and associated with immunosuppression. Mortality is estimated at 10% in developed countries and 43% in emerging countries. The objective was to evaluate the clinical-epidemiological aspects of cryptococcosis in the region of western São Paulo. This is a cross-sectional study, based on information from the medical records of patients in a hospital in the interior of São Paulo from 2006 to 2018. Descriptive analysis was applied through absolute (n) and relative (%) frequency; and statistics through the x2 and Fisher's Exact tests. Relative Risk (RR) and Odds Ratio (OD) for death were also calculated. Neurocriptococcosis was the primary clinical manifestation of 64.50%. The direct search for CSF was positive in 85.71% of the samples, the immunodiagnosis in 93.80% and the culture, gold standard for fungus, in 55.55% of the cases. The x2 test and Fisher's exact test showed no difference between sex, age group, clinical form of death. RR and OD were considered low. The association of the epidemiological aspects of cryptococcosis with its clinical signs allows the early diagnosis of the disease, reducing severe conditions. Besides, high-performance antiretroviral therapies have dramatically decreased the occurrence of deaths in patients with HIV.

Author Biography

Maikiane Aparecida Nascimento, Hospital Estadual de Doenças Tropicais Dr. Anuar Auad (HDT/GO) e Laboratório Estadual de Saúde Pública Dr. Giovanni Cysneiros (LACEN/GO), Goiânia, Goiás, Brasil.

Atualmente, residente do Programa de Residência Multiprofissional da Secretaria do Estado de Goiás, alocado no Hospital de Doenças Tropicais Dr. Anuar Auad, com atuação na área de infectologia e no Laboratório Estadual de Saúde Pública Dr. Giovanni Cysneiros (LACEN/GO). Possui graduação em Biomedicina (2018) pela universidade do Oeste Paulista (UNOESTE), anteriormente realizou graduação Sanduíche na Faculdade de Farmácia da Universidade do Porto - Portugal pelo programa Santander Universidades - Bolsas de mobilidade Ibero-Americanas. Linhas de pesquisa: Microbiologia, Micologia Clinica, doenças tropicais, infectologia.

References

Acheson, E. S., Galanis, E., Bartlett, K., Mak, S., & Klinkenberg, B. (2018). Searching for clues for eighteen years: Deciphering the ecological determinants of Cryptococcus gattii on Vancouver Island, British Columbia. Medical Mycology, 56(2), 129–144. doi:10.1093/mmy/myx037

Andrade-Silva, L. E., Ferreira-Paim, K., Ferreira, T. B., Vilas-Boas, A., Mora, D. J., Manzato, V. M., Fonseca, [..], & Silva-Vergara, M. L. (2018). Genotypic analysis of clinical and environmental Cryptococcus neoformans isolates from Brazil reveals the presence of VNB isolates and a correlation with biological factors. PloS one, 13(3), 82 p. doi:10.1371/journal.pone.0193237

Bastos A. L. (2017). Aspectos clínicos-epidemiológicos da criptococose no estado de Goiás. Dissertação de Mestrado em Ciências da Saúde, Universidade Federal de Goiás – UFG, Goiânia, Brasil.

Brazilian Society of Tropical Medicine. Guidelines in cryptococcosis-2008. (2008). Rev. Soc. Bras. Med. Trop, 41(5), 524-544. doi:10.1590/S0037-86822008000500022

Candiani, T. M. S., Pinto, J., Cardoso, C. A. A., Carvalho, I. R., Dias, A. C. M., Carneiro, M., & Goulart, E. A. (2007). Impact of highly active antiretroviral therapy (HAART) on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil. Cadernos de Saúde Pública, 23 (Suppl. 3), S414-S423. doi:10.1590/S0102-311X2007001500009

Colombo, G., Táparo, C. V., Araújo Júnior, E. C., Makatu, M. Y., Santos, F. S., & Marinho, M. (2015). Caracterização bioquímica e molecular de Cryptococcus spp. isolados de excretas ambientais de pombos (Columba livia domestica). Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 67(6), 1639-1645. doi:10.1590/1678-4162-7753

Hurtado, J. C., Castillo, P., Fernandes, F., Navarro, M., Lovane, L., [..], & Casas, I. (2019). Mortality due to Cryptococcus neoformans and Cryptococcus gattii in low-income settings: an autopsy study. Scientific reports, 9(1): 1-10. doi:10.1038/s41598-019-43941-w

Maziarz, E. K., & Perfect, J. R. (2016). Cryptococcosis. Infectious disease clinics of North America, 30(1), 179–206. doi:10.1016/j.idc.2015.10.006

Mourad, A., & Perfect, J. R. (2018). Present and Future Therapy of Cryptococcus. Infections. Journal of fungi, 4(3), 79. doi:10.3390/jof4030079

Nunes, A. A., Caliani, L. S., Nunes, M. S., Silva, A. S., & Mello, L. M. (2015). Análise do perfil de pacientes com HIV/Aids hospitalizados após introdução da terapia antirretroviral (HAART). Ciência & Saúde Coletiva, 20(10), 3191-3198. doi:10.1590/1413-812320152010.03062015

Skipper, C., Abassi, M., & Boulware, D. R. (2019). Diagnosis and Management of Central Nervous System Cryptococcal Infections in HIV-Infected Adults. Journal of fungi (Basel, Switzerland), 5(3), 65-76. doi:10.3390/jof5030065

Spadari, C. C, Wirth, F., Lopes, L. B, & Ishida, K. (2020). Novas abordagens para o tratamento de criptococose. Microorganismos, 8 (4), 613. doi:10.3390/microorganisms8040613

Secretaria de Saúde do Estado de Goiás - SUVISA. (2012). Micoses Sistêmicas. Retirado de: https://www.saude.go.gov.br/sesg/comissao-de-integracao-ensino-servico/337-suvisa/7428-micoses-sist.

WHO, World Health Organization. (2018). The diagnosis, prevention and management of cryptococcal disease in hiv-infected adults, adolescents and children. Retirado de: https://www.who.int/hiv/pub/guidelines/cryptococcal-disease/en/.

Zaragoza, O. (2019). Basic principles of the virulence of Cryptococcus. Virulence, 10(1), 490–501. doi:10.1080/21505594.2019.1614383

Published

30/08/2020

How to Cite

Nascimento, M. A., Santos, E. C. M. ., Carvalho, V. M. de, Borges, M. S. ., Ederli, J. P. B. ., Albuquerque, C. A. N. de ., Silva, S. F. S. ., Ederli, R. B. ., Soto, B. A. S. ., Portelinha Filho, A. M. ., & Moris, D. V. . (2020). Profile of patients with cryptococcosis in a regional hospital in the interior of São Paulo. Research, Society and Development, 9(9), e598997642. https://doi.org/10.33448/rsd-v9i9.7642

Issue

Section

Health Sciences