Clinical and microbiological characteristics of cryptococcosis at an university hospital in China from 2013 to 2017.
BACKGROUND
This study aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis from 2013 to 2017 in a major teaching hospital in China.


METHODS
Trends in antifungal drug susceptibility of 217 consecutive non-repetitive cryptococcal isolates collected from patients of an university hospital in China were analyzed between 2013 and 2017. Of those, 98 isolates were conserved for identification by internal transcribed spacer (ITS) sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Multilocus sequence typing (MLST) was used to designate molecular types. Clinical characteristics of the 98 patients with cryptococcosis during the period of 2013-2017 were retrospectively evaluated.


RESULTS
There was a trend for gradual increase in the MIC range of fluconazole was from 2013 to 2017. The conserved 98 clinical cryptococcal isolates included 97 C. neoformans and one C. gattii, and 90 (91.8%) isolates belonged to ST5 genotype VNI. Out of the 98 patients with cryptococcosis, 28 (28.6%) were HIV-infected and 32 (32.7%) had no underlying diseases. HIV-infected patients had higher mortality than HIV-uninfected patients (28.6% vs 14.3%, p=0.147).


CONCLUSIONS
Most of the patients with cryptococcosis were not HIV-infected in this study, while patients with HIV had a higher mortality. Reduced susceptibility to fluconazole was observed among C. neoformans isolates, most of them belonged to ST5 genotype VNI having an impact on the effective dose of fluconazole.
['Fang|Lan-Fang|LF|', 'Zhang|Piao-Piao|PP|', 'Wang|Jie|J|', 'Yang|Qing|Q|', 'Qu|Ting-Ting|TT|']
D000328:Adult D000935:Antifungal Agents D002681:China D003430:Cross-Sectional Studies D003453:Cryptococcosis D056285:Cryptococcus gattii D003455:Cryptococcus neoformans D005260:Female D005838:Genotype D006785:Hospitals, University D006801:Humans D008297:Male D008826:Microbial Sensitivity Tests D008875:Middle Aged D058885:Multilocus Sequence Typing D012189:Retrospective Studies D018709:Statistics, Nonparametric D013997:Time Factors
Cryptococcosis Multilocus sequence typing (MLST) Antifungal susceptibility Cryptococcus neoformans Human immunodeficiency virus (HIV)