Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
Jiangxi Provincial Chest Hospital, Nanchang, China.
Front Cell Infect Microbiol. 2021 Nov 1;11:723251. doi: 10.3389/fcimb.2021.723251. eCollection 2021.
Cryptococcosis is caused by a fungi of the complex and is a severe concern for public health worldwide. species are globally distributed, and species are mostly found in America, Australia, and Sub-Saharan Africa. usually infects an immunocompromised population; however, the majority of cryptococcosis in China has been reported in patients without any recognizable immunosuppression, i.e., HIV infection. To date, very few studies investigated this disease in South Central China.
The present study recruited 230 clinically suspected cryptococcosis cases in the last 5 years at two hospitals in Jiangxi Province, South Central China. All isolated strains were subjected to multilocus sequence typing (MLST) and phylogenetic analysis. Serotype and mating type were assessed by PCR, antifungal susceptibility was assessed by the CLSI-M27-A3 protocol.
A total of 230 patients were identified as infected by , including 12 cases with coinfection. All seven MLST markers were successfully amplified and used to identify the ST genotype in 199 strains. strains were not detected. In contrast to previous studies, 59.3% of the patients had an immunocompromised status, and 61.9% of these patients were infected with HIV. All isolates manifested serotype A and mating type α. The ST5 genotype was common (89.5%) in the Jiangxi region, and three novel genotypes (ST656, ST657, and ST658 in six isolates) were detected in the present study. A total of 86 of the isolates (43.2%) were not sensitive to fluconazole at a MIC ≥ 8 μg/ml, most of the isolates were resistant to amphotericin B, and nearly all isolates were resistant to itraconazole and posaconazole. Resistances to 5-Flucytosine and voriconazole were very rare.
The results of the present study indicated that C. is the predominant species for cryptococcosis in Jiangxi Province, and a large proportion of the strains were not sensitive to fluconazole, which may be related to treatment failure and relapse. A high percentage of HIV-related C. infections was reported in Jiangxi, supporting a previous hypothesis that cryptococcosis is more frequent among the HIV-infected population in China. Continuous monitoring of species distribution and antifungal sensitivity is important for the investigation of this severe disease in the Jiangxi region.
cryptococcosis 是由真菌复合体引起的，是全球公共卫生的严重关注点。 种在全球范围内分布， 种主要分布在美洲、澳大利亚和撒哈拉以南非洲。 通常感染免疫功能低下的人群；然而，中国大多数 cryptococcosis 病例发生在没有任何可识别免疫抑制的患者中，即 HIV 感染。迄今为止，很少有研究调查中国中南部的这种疾病。
本研究在过去 5 年内在中国中南部江西省的两家医院共招募了 230 例临床疑似 cryptococcosis 病例。所有分离株均进行了多位点序列分型（MLST）和系统发育分析。通过 PCR 评估血清型和交配型，通过 CLSI-M27-A3 方案评估抗真菌药敏性。
共鉴定出 230 例患者感染了 ，其中 12 例合并 感染。成功扩增了所有 7 个 MLST 标记物，并用于鉴定 199 株中的 ST 基因型。 种未被检测到。与之前的研究不同，59.3%的患者存在免疫功能低下的情况，其中 61.9%的患者感染了 HIV。所有分离株均表现出血清型 A 和交配型 α。江西地区 ST5 基因型较为常见（89.5%），本研究共检测到 6 株分离株中的 3 个新基因型（6 株中的 ST656、ST657 和 ST658）。共有 86 株（43.2%）分离株对氟康唑 MIC≥8μg/ml 不敏感，大多数分离株对两性霉素 B 耐药，几乎所有分离株对伊曲康唑和泊沙康唑耐药。对 5-氟胞嘧啶和伏立康唑的耐药性非常罕见。
本研究结果表明，C. 在江西省是 cryptococcosis 的主要物种，很大比例的菌株对氟康唑不敏感，这可能与治疗失败和复发有关。江西 HIV 相关 C. 感染比例较高，支持 cryptococcosis 在中国 HIV 感染者中更为常见的先前假设。持续监测物种分布和抗真菌药敏性对于调查江西地区这种严重疾病非常重要。
