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Mycoses. 2018 Oct 19. doi: 10.1111/myc.12863. [Epub ahead of print]

Genotypic diversity and antifungal susceptibility of Cryptococcus neoformans isolates from paediatric patients in China.

Hong N1,2, Chen M1,2, Xu N3, Al-Hatmi AMS4,5,6, Zhang C1,2, Pan WH1,2, Hagen F4, Boekhout T1,2,7,8, Xu J9, Zou XB10, Liao WQ1,2.

Author information

1
Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
2
Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
3
Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
4
Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.
5
Centre of Expertise in Mycology, Radboud University Medical Centre/Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
6
Ministry of Health, Directorate General of Health Services, Ibri, Oman.
7
Department of Yeast and Basidiomycete Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.
8
Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.
9
Department of Biology, McMaster University, Hamilton, Ontario, Canada.
10
Department of Dermatology, First Affiliated Hospital of PLA General Hospital, Beijing, China.

Abstract

Cryptococcosis is a life-threatening mycosis primarily occurring in adult patients particularly those with immunosuppression such as HIV infection/AIDS. The number of reported cases of paediatric cryptococcosis has increased in the last decade around the world, including China. However, current information on the characteristics of cryptococcosis in children, particularly the genotypic diversity and antifungal susceptibility of the isolates, is limited. In the present study, a total of 25 paediatric isolates of Cryptococcus neoformans were genotyped using the ISHAM-MLST scheme. In vitro susceptibility to antifungal agents of the 22 isolates was tested using the CLSI M27-A3 method. Our analyses revealed that the genotypic diversity of C. neoformans isolates from Chinese paediatric patients was low, with ST 5 (80%) and ST 31 (12%) being the two major sequence types. Reduced susceptibility to fluconazole (FLU), 5-flucytosine (5-FC) and itraconazole (ITR) was observed among C. neoformans isolates from Chinese paediatric patients, particularly among the ST5 isolates, which was similar to observations made on C. neoformans isolates from Chinese adult patients. In addition, the majority of isolates (3/4, 75%) obtained from deceased patients showed decreased antifungal susceptibility, which indicates that further monitoring of antifungal susceptibility of Cryptococcus isolates is warranted in management of paediatric cryptococcosis.

KEYWORDS:

Cryptococcus neoformans ; China; antifungal susceptibility; genotype; paediatric

PMID:
30341799
DOI:
10.1111/myc.12863

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