Journal Article

Epidemiology and Host- and Variety-Dependent Characteristics of Infection Due to <i>Cryptococcus neoformans</i> in Australia and New Zealand

Sharon Chen, Tania Sorrell, Graeme Nimmo, Bryan Speed, Bart Currie, David Ellis, Deborah Marriott, Tania Pfeiffer, Dinah Parr and Karen Byth

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 2, pages 499-508
Published in print August 2000 | ISSN: 1058-4838
Published online August 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313992
Epidemiology and Host- and Variety-Dependent Characteristics of Infection Due to Cryptococcus neoformans in Australia and New Zealand

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A prospective population-based study was conducted in Australia and New Zealand during 1994–1997 to elucidate the epidemiology of cryptococcosis due to Cryptococcus neoformans var. neoformans (CNVN) and C. neoformans var. gattii (CNVG) and to relate clinical manifestations to host immune status and cryptococcal variety. The mean annual incidence per 106 population was 6.6 in Australia and 2.2 in New Zealand. Of 312 episodes, CNVN caused 265 (85%; 98% of the episodes in immunocompromised hosts) and CNVG caused 47 (15%; 44% of the episodes in immunocompetent hosts). The incidence of AIDS-associated cases in Australia declined annually (P < .001). Aborigines in rural or semirural locations (P < .001) and immunocompetent males (P < .001) were at increased risk of CNVG infection. Cryptococcomas in lung or brain were more common in immunocompetent hosts (P ≤ .03) in whom there was an association only between lung cryptococcomas and CNVG. An AIDS-associated genetic profile of CNVN serotype A was confirmed by random amplification of polymorphic DNA analysis. Resistance to antifungal drugs was uncommon. The epidemiology of CNVN infection has changed substantially. Clinical manifestations of disease are influenced more strongly by host immune status than by cryptococcal variety.

Journal Article.  7084 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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