关键词: 新生隐球菌感染, 药物敏感性, 临床资料, 隐球菌肺炎

Abstract: Objective To investigate the infection type, treatment regimen, prognosis and drug susceptibility of Cryptococcus neoformans infection (CNI) in Chongqing area. Methods The clinical data of patients with CNI and the susceptibility of Cryptococcus neoformans isolates to 6 antifungal agents in our hospital in recent 5 years were analyzed retrospectively. Results A total of 47 cases with CNI were enrolled. Cryptococcal meningitis (72.3%) was the main type of Cryptococcus neoformans infection in our hospital, 78.7% of the patients were male, and most of the patients were non-HIV infection. In addition, 17.1% of the patients were diagnosed with cryptococcal pneumonia. Cryptococcal capsular polysaccharide antigen in serum and/or cerebrospinal fluid was assayed for 37 patients, and the positive rate was 100%. All strains were wild-type to itraconazole and voriconazole, more than 90% of strains were wild-type to 5-flucytosine and posaconazole, and 85.1% of strains were wild-type to fluconazole, but only 53.2% of strains were wild-type to amphotericin B. Good prognosis after antifungal treatment achieved in 78.0% patients. But only 16.7% of the untreated patients had a good prognosis. Conclusion Timely detection of cryptococcal capsular polysaccharide antigen can improve the diagnostic accuracy and positive rate of Cryptococcus neoformans infection. Drug susceptibility testing is also necessary after Cryptococcus neoformans was isolated. According to the Results of drug susceptibility testing, early combination therapy plays an important role in improving the prognosis of patients.

Key words: Cryptococcus neoformans infection, drug susceptibilities, clinical data, cryptococcal pneumonia