Molecular epidemiology and antifungal susceptibilities of Cryptococcus species isolates from HIV and non-HIV patients in
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ORIGINAL ARTICLE
Molecular epidemiology and antifungal susceptibilities of Cryptococcus species isolates from HIV and non-HIV patients in Southwest China Si-Ying Wu 1 & Mei Kang 1 & Ya Liu 1 & Zhi-Xing Chen 1 & Yu-Ling Xiao 1 & Chao He 1 & Ying Ma 1 Received: 18 April 2020 / Accepted: 24 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract To investigated the molecular epidemiology and in vitro antifungal susceptibility of Cryptococcus isolates from West China Hospital from HIV and non-HIV patients between 2009 and 2015. A total of 132 C. neoformans and C. gattii were subjected to antifungal susceptibility testing by E-test method. Among the 132 isolates, 42 C. neoformans and C. gattii were analyzed by mating type and URA5-RFLP. A total of 113 C. neoformans and C. gattii were subjected to multi-locus sequence typing (MLST). MLST results revealed that ST5 was the major molecular type. The wild-type (WT) phenotype was seen in 91.5–100% of C. neoformans isolates for amphotericin B, 5-flucytosine, fluconazole, and voriconazole. However, 72.3% (94/130) of C. neoformans isolates were non-wild-type (non-WT) to itraconazole by E-test method. In the sixth study year, the geometric mean, MIC50 and MIC90 of fluconazole were the highest (P < 0.001). Among 132 patients. 52 were coinfected with HIV and 80 were HIV-negative. Isolates from HIV and non-HIV patients showed no differences in susceptibility to amphotericin B (P = 0.544), 5-flucytosine (P = 0.063), fluconazole (P = 0.570), voriconazole (P = 0.542), and itraconazole (P = 0.787). Our study showed that Cryptococcus in southwest China showed a low degree of genetic diversity. The increased MIC values of fluconazole are noted. Cryptococcus isolates from HIV and non-HIV patients have shown no differences in susceptibility to five antifungal agents. Keywords Cryptococcus . Molecular epidemiology . Antifungal susceptibilities . HIV . Southwest China
Introduction Cryptococcal meningitis is one of the most common invasive fungal diseases and was responsible for 15% of AIDS-related deaths [1]. The dominant species of Cryptococcus that cause human disease are Cryptococcus neoformans and Cryptococcus gattii. C. neoformans has a global distribution and generally affects immunocompromised individuals, while C. gattii mainly infects immunocompetent hosts and was thought to be geographically restricted to tropical and subtropical regions [2]. But through the years C. gattii emerged in the
* Mei Kang [email protected] 1
Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
temperate area, suggesting an ecological shift of this species [3, 4]. In order to analyze the molecular epidemiology of C. neoformans and C. gattii, several molecular techniques have been developed, including polymerase chain reaction (PCR) fingerprint, amplified fragment length polymorphism (AFLP), PCR-restriction fragment length polymorphism (RFLP), random amplification of polymorphic DNA (RAPD), multilocus mic
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