Molecular epidemiology and antifungal susceptibilities ofCryptococcusspecies isolates from HIV and non-HIV patients in Southwest China

To investigated the molecular epidemiology and in vitro antifungal susceptibility ofCryptococcusisolates from West China Hospital from HIV and non-HIV patients between 2009 and 2015. A total of 132C. neoformansandC. gattiiwere subjected to antifungal susceptibility testing byE-test method. Among the 132 isolates, 42C. neoformansandC. gattiiwere analyzed by mating type andURA5-RFLP. A total of 113C. neoformansandC. gattiiwere 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% ofC. neoformansisolates for amphotericin B, 5-flucytosine, fluconazole, and voriconazole. However, 72.3% (94/130) ofC. neoformansisolates were non-wild-type (non-WT) to itraconazole byE-test method. In the sixth study year, the geometric mean, MIC(50)and MIC(90)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 thatCryptococcusin southwest China showed a low degree of genetic diversity. The increased MIC values of fluconazole are noted.Cryptococcusisolates from HIV and non-HIV patients have shown no differences in susceptibility to five antifungal agents.