Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
Med Mycol. 2010 Nov;48(7):942-8. doi: 10.3109/13693781003690067.
We studied the serotypes, mating-types, AFLP genotypes, and antifungal susceptibility of 58 Cryptococcus neoformans strains causing 56 episodes of cryptococcosis in 55 patients over an 18-year period in a single institution. The underlying conditions of the patients were classified as HIV infection (n = 48) or non-HIV-related immunodeficiency (n = 7). Serotype A (n = 34; 58.9%) predominated, but serotype AD was involved in 23.2% of episodes. Most of the episodes were caused by mating-type α (n = 41; 73.2%) or α/a strains (n = 12; 21.5%). The most common genotype was AFLP1 (n = 26; 44.8%), followed by AFLP3 (n = 21; 36.2%), and AFLP2 (n = 11; 19.0%). In two different patients, we showed the coexistence of different serotypes and/or genotypes in the same episode (AFLP1 and 3). The new triazoles voriconazole, posaconazole and isavuconazole showed high and similar antifungal activity (MICs ≤ 0.125 μg/ml). Fluconazole also had good antifungal activity, but two strains from patients with HIV-infections had an MIC of 16 μg/ml (3.4%). However, these two isolates remained very susceptible to the new triazoles (MICs ≤ 0.062 μg/ml). The remaining strains always showed MICs ≤ 8 μg/ml.
我们研究了 58 株新型隐球菌分离株的血清型、交配型、AFLP 基因型和抗真菌药敏性，这些菌株引起了 55 名患者在 18 年期间的 56 次隐球菌病发作。患者的基础疾病分为 HIV 感染（n=48）或非 HIV 相关免疫缺陷（n=7）。A 型血清型（n=34；58.9%）占优势，但 AD 型血清型也涉及 23.2%的病例。大多数病例由交配型α（n=41；73.2%）或α/a 菌株（n=12；21.5%）引起。最常见的基因型是 AFLP1（n=26；44.8%），其次是 AFLP3（n=21；36.2%）和 AFLP2（n=11；19.0%）。在两个不同的患者中，我们在同一发作中显示了不同血清型和/或基因型的共存（AFLP1 和 3）。新型三唑类药物伏立康唑、泊沙康唑和伊曲康唑显示出高且相似的抗真菌活性（MICs≤0.125μg/ml）。氟康唑也具有良好的抗真菌活性，但来自 HIV 感染患者的 2 株菌株的 MIC 为 16μg/ml（3.4%）。然而，这两个分离株对新型三唑类药物仍非常敏感（MICs≤0.062μg/ml）。其余菌株的 MICs 始终≤8μg/ml。
