Drug susceptibility and clinical analysis of Cryptococcus neoformans from patients with acquired immunodeficiency syndrome in Yunnan province

Abstract

Abstract: Objective To investigate the distribution,drug resistance and clinical treatment effect of Cryptococcus neoformans(C. neoformans) isolated from patients with acquired immunodeficiency syndrom(AIDS) in Yunnan province. Methods A total of 424 strains of C. neoformans isolated from AIDS patients in Yunnan Infectious Diseases Hospital from January 2010 to December 2020 were identified by VITEK Compact automatic microorganism analyzer,and the sensitivity of 5 antifungal drugs was detected by ATB FUNGUS 3.The clinical data were alalyzed. Results The highest proportion of 424 strains of C. neoformans was detected in cerebrospinal fluid, 62.50%(265/424).Blood was the second,accounting for 30.90%(131/424).The third was sputum,accounting for 2.83%(12/424).The MIC for azole(except fluconazole) to C. neoformans was ≤ 2 μg/mL, the MIC for amphotericin B of polyene was ≤ 4 μg/mL, and the MIC for fluconazole and 5-fluorocytosine was ≤ 64 μg/mL. The sensitivity rate to amphotericin B, fluconazole and 5-fluorocytosine was 95.28%(404/424), 80.66%(342/424) and 75.71%(321/424),respectively.The epidemiologic cutoff value of 5-fluorocytosine and fluconazole was 16 μg/mL, and the ECV of amphotericin B itraconazole and voriconazole was 0.5 μg/mL. Conclusion Cryptococcus neoformances is more sensitive to amphotericin B, while fluconazole and 5-flucytosine have gradually emerged as non-sensitive strains in the clinical medication process for so many years, and the MIC range of itraconazole and voriconazole is ≤ 2 μg/mL. The Results of drug sensitivity test of C. neoformans provide reference for clinicians to select drugs.Combined amphotericin B with 5-fluorocytosine was the first choice of treatment of C. neoformans. Cryptococcus, as an important pathogenic fungus in clinic, should be valued highly by laboratory and clinic.

Key words: acquired immunodeficiency syndrome, Cryptococcus neoformans, Cryptococcus gattii, drug susceptibility, clinical analysis

CLC Number:

R519.4

GAO Li, ZHAO Ziyi, FAN Hongli, ZHANG Guixian, LI Zhenglun. Drug susceptibility and clinical analysis of Cryptococcus neoformans from patients with acquired immunodeficiency syndrome in Yunnan province[J]. Chinese Journal of Mycology, 2022, 17(4): 283-288.

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