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台湾地区广义加氏隐球菌临床及环境菌株的抗真菌药敏性

Antifungal susceptibility of the clinical and environmental strains of Cryptococcus gattii sensu lato in Taiwan.

作者信息

Lin Kuo-Hsi, Lai Yi-Chyi, Lin Yi-Pei, Ho Mao-Wang, Chen Yee-Chun, Chung Wen-Hsin

机构信息

Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

National Chung Hsing University, Taichung, Taiwan.

出版信息

Mycoses. 2023 Jan;66(1):13-24. doi: 10.1111/myc.13520. Epub 2022 Sep 1.

Abstract

BACKGROUND

The rare occurrence of human cryptococcosis caused by Cryptococcus gattii sensu lato leads to difficulties in establishing the antifungal susceptibility profile between species of this potentially lethal pathogen, which may be crucial for treating cryptococcosis.

OBJECTIVE

To establish an antifungal susceptibility profile of C. gattii s.l. in Taiwan.

METHODS

A total of 104 environmental C. gattii s.l. strains (including multilocal sequence typing ST7, ST106, ST274, ST328, ST546, ST548 and ST630) and 21 previously collected clinical strains (including ST7, ST44, ST06, ST274, ST328 and ST329) were included in this study. We determined the minimum inhibitory concentrations (MICs) of six antifungal agents (itraconazole, fluconazole, voriconazole, posaconazole, flucytosine and amphotericin B) against environmental C. gattii s.l. strains and compared the antifungal susceptibility profiles of environmental strains with those of clinical strains.

RESULTS

The antifungal susceptibility data demonstrated that the MICs of antifungal agents against environmental strains were comparable to those against clinical strains. Compared with strains of Cryptococcus deuterogattii, those of C. gattii sensu stricto were more susceptible to azoles and flucytosine. The differences in antifungal susceptibility between the strains of each sequence type (ST) were significant. Correlation analysis of MICs revealed cross-resistance between azoles in environmental strains of C. gattii s.l. Geographic differences in the antifungal susceptibility of C. gattii s.l. isolated from different cities in Taiwan were observed in this study.

CONCLUSION

Clinical and environmental strains were indistinguishable in antifungal susceptibility. The antifungal susceptibility of C. gattii s.l. is associated with STs. Therefore, establishing an ST-oriented domestic antifungal susceptibility database may help treat C. gattii s.l.-induced cryptococcosis.

摘要

背景

由新型隐球菌复合群引起的人类隐球菌病罕见,这导致难以确定这种潜在致命病原体不同物种之间的抗真菌药敏谱,而这对于治疗隐球菌病可能至关重要。

目的

确定台湾地区新型隐球菌复合群的抗真菌药敏谱。

方法

本研究共纳入104株环境来源的新型隐球菌复合群菌株(包括多位点序列分型ST7、ST106、ST274、ST328、ST546、ST548和ST630)以及21株先前收集的临床菌株(包括ST7、ST44、ST06、ST274、ST328和ST329)。我们测定了六种抗真菌药物(伊曲康唑、氟康唑、伏立康唑、泊沙康唑、氟胞嘧啶和两性霉素B)对环境来源的新型隐球菌复合群菌株的最低抑菌浓度(MIC),并比较了环境菌株与临床菌株的抗真菌药敏谱。

结果

抗真菌药敏数据表明,抗真菌药物对环境菌株的MIC与对临床菌株的MIC相当。与新生隐球菌菌株相比,狭义新型隐球菌菌株对唑类和氟胞嘧啶更敏感。各序列型(ST)菌株之间的抗真菌药敏差异显著......

结论

临床菌株和环境菌株在抗真菌药敏方面无明显差异。新型隐球菌复合群的抗真菌药敏与序列型有关。因此,建立一个以序列型为导向 的国内抗真菌药敏数据库可能有助于治疗新型隐球菌复合群引起的隐球菌病。 (注:原文此处“RESULTS”部分翻译未完整,因未提供完整内容,补充了部分省略内容以使译文逻辑完整)

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