Infection and Drug Resistance (Jul 2023)
Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong
Abstract
Hazrat Bilal,1 Dongxing Zhang,2,3 Muhammad Shafiq,4 Muhammad Nadeem Khan,5 Canhua Chen,6 Sabir Khan,1 Qian Wang,1,7 Lin Cai,1 Muhammad Awais,8 Haibin Hu,9 Yuebin Zeng1,10 1Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, People’s Republic of China; 2Department of Dermatology, Meizhou Dongshan Hospital, Meizhou, Guangdong Province, 514023, People’s Republic of China; 3Department of Dermatology, Meizhou People’s Hospital, Meizhou, Guangdong Province, 514023, People’s Republic of China; 4Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, People’s Republic of China; 5Faculty of Biological Sciences, Department of Microbiology, Quaid-I-Azam University, Islamabad, 45320, Pakistan; 6Clinical Laboratory, Meizhou People’s Hospital, Meizhou, Guangdong Province, 514023, People’s Republic of China; 7Department of Medical-Surgical and Experimental Sciences University of Sassari Neurology Unit, Azienda Ospedaliera Universitaria (AOU), Sassari, Italy; 8Department of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China; 9The First Clinical Medical college, Guangdong Medical University, Zhanjiang, 523808, People’s Republic of China; 10Department of Dermatology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610021, People’s Republic of ChinaCorrespondence: Yuebin Zeng, Tel +8618607549813, Email [email protected]: Cryptococcosis is a fatal infection that can affect both immunocompetent and immunocompromised patients, and it is little understood in China’s various regions. This research aimed to look at the epidemiology, risk factors, and antifungal susceptibility pattern of Cryptococcus neoformans in eastern Guangdong, China.Methods: A six-year (2016– 2022) retrospective study was conducted at Meizhou People’s Hospital, China. Demographical, clinical, and laboratory data of cryptococcal patients were collected from hospital records and statistically analyzed using the chi-square and ANOVA tests.Results: Overall, 170 cryptococcal infections were recorded, of which meningitis accounted for 78 (45.88%), cryptococcemia for 50 (29.41%), and pneumonia for 42 (24.7%). The number of cases increased 8-fold during the study duration. The median age of patients was 58 years (Inter quartile range: 47– 66), and the high proportion of cases was from the male population (n = 121, 71.17%). The underlying diseases were identified only in 60 (35.29%) patients, of which 26 (15.29%) were severely immunocompromised, and 26 (15.29%) others were mildly immunocompromised. A statistically significant difference was reported for chronic renal failure, and anemia (p < 0.05) persisted in cases of three infection types. A high number of non-wild type (NWT) isolates were found against amphotericin B (n=13/145, 8.96%), followed by itraconazole (n=7/136, 5.15%) and voriconazole (n=4/158, 2.53%). Only six isolates (3.79%) were multidrug-resistant, four of which were from cryptococcemia patients. Compared to meningitis and pneumonia, cryptococcemia revealed a higher percentage of NWT isolates (p < 0.05).Conclusion: In high-risk populations, cryptococcal infections require ongoing monitoring and management.Keywords: cryptococcosis, Cryptococcus neoformans, epidemiology, risk factors, antifungal susceptibility
