Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Abstract

Objective 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.

Cryptococcosis with pulmonary cavitation in an immunocompetent child: a case report and literature review

“…In mainland China, 15.7% of the cryptococcosis patients were AIDS or HIV-infected [ 26 ], while 60% of PC cases were diagnosed in immunocompetent non-HIV patients [ 27 ]. A recent study reported the most common types of Cryptococcus infections in Southern China were cryptococcal meningitis, cryptococcal fungemia, and PC, and only 12 out of the 170 patients had autoimmune disorders [ 28 ]. According to the local Health Department in the Ningbo city, there were 9 cases of adult with PC over the past year, all with normal immune function, and the present case was the only case of PC in child.…”