Zono Bive Bive, Sacheli Rosalie, Kasumba Dacquin Muhandwa, Situakibanza Hippolyte Nani-Tuma, Mavanga Alphonse, Anyshayi Justin Mwambi, Etondo Mamie, Muwonga Jérémie, Moutschen Michel, Mvumbi Georges Lelo, Hayette Marie-Pierre
Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Clinical Microbiology Laboratory, National Reference Center for Mycosis, Center for Interdisciplinary Research on Medicines (CIRM), University of Liege, Liege, Belgium.
Sci Rep. 2024 Dec 2;14(1):29959. doi: 10.1038/s41598-024-80772-w.
We evaluated the prevalence of serum and meningeal cryptococcosis in asymptomatic outpatients with advanced HIV disease (CD4 < 200 cells/mm3) in a cross-sectional screening context in Kinshasa clinics (DRC). Lumbar puncture (LP) was performed in patients with positive serum cryptococcal antigen (CrAg) test, and Cryptococcus spp. isolated from cerebrospinal fluid (CSF) were identified by MALDI-TOF-MS, and characterized using serotyping-PCR, ITS-sequencing and multilocus sequence typing (MLST). The genetic profiles obtained were then compared with those of isolates previously described in symptomatic patients in the same clinics. Forty-seven patients with advanced HIV disease out of 262 included were positive for serum CrAg (18%, 95% CI: 14.2-24.3). The prevalence of asymptomatic cryptococcal meningitis (CM) was then measured at 50% among patients with positive serum CrAg test who consented to LP (19/38). Only four CSF samples were culture positive and all were characterized as Cryptococcus neoformans, molecular type VNI and belonging to two different sequence types (ST): ST93 (3/4) and ST63 (1/4). While ST93 is also the main genomic profile described in advanced HIV disease patients with symptomatic CM in Kinshasa clinics, ST63 has not yet been identified in DRC before. It is likely that future studies involving a large number of strains will be necessary before any definitive conclusions can be drawn on the involved strains in asymptomatic patients.
在金沙萨诊所（刚果民主共和国）的一项横断面筛查中，我们评估了晚期HIV疾病（CD4＜200个细胞/mm³）无症状门诊患者血清和脑膜隐球菌病的患病率。对血清隐球菌抗原（CrAg）检测呈阳性的患者进行腰椎穿刺（LP），从脑脊液（CSF）中分离出的隐球菌属通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF-MS）进行鉴定，并使用血清分型-PCR、内转录间隔区测序（ITS测序）和多位点序列分型（MLST）进行特征分析。然后将获得的基因图谱与之前在同一诊所症状性患者中描述的分离株的图谱进行比较。在纳入的262名晚期HIV疾病患者中，47名（18%，95%置信区间：14.2 - 24.3）血清CrAg呈阳性。在同意进行LP的血清CrAg检测呈阳性的患者中，无症状隐球菌性脑膜炎（CM）的患病率经测量为50%（19/38）。只有4份脑脊液样本培养阳性，所有样本均被鉴定为新生隐球菌，分子型为VNI，属于两种不同的序列类型（ST）：ST93（3/4）和ST63（1/4）。虽然ST93也是金沙萨诊所晚期HIV疾病有症状CM患者中描述的主要基因组图谱，但ST63此前在刚果民主共和国尚未被鉴定出来。在对无症状患者中涉及的菌株得出任何明确结论之前，可能需要进行涉及大量菌株的未来研究。
