Epidemiology and Clinical Characteristics of Cryptococcal Meningitis in China (1981-2013): A Review of the Literature

Li, Zhu; Liu, Yongquan; Cao, Hong; Huang, Shenghe; Long, Min

doi:10.21767/2471-8203.100022

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Our clinical observations have been replicated in China, where >70% of CM cases from apparently immunocompetent individuals were infected with C. neoformans 10,11 . Again these organisms were latterly identified as genotype ST5 12,13 .…”

Section: Introductionsupporting

confidence: 58%

Assessing the virulence ofCryptococcus neoformanscausing meningitis in HIV infected and uninfected patients in Vietnam

Lam

Toffaletti

Tenor

et al. 2017

Preprint

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Section: Introductionsupporting

confidence: 58%

Assessing the virulence ofCryptococcus neoformanscausing meningitis in HIV infected and uninfected patients in Vietnam

Lam

Toffaletti

Tenor

et al. 2017

Preprint

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“…Our clinical observations have been replicated in China, where >70% of CM cases from apparently immunocompetent individuals were infected with C. neoformans . 10 , 11 Again, these organisms were later identified as genotype ST5. 12 , 13 Comparably, ST5 accounted for >80% of HIV-uninfected CM patients in South Korea, although some patients from this location had potentially immunosuppressive conditions.…”

Section: Introductionmentioning

confidence: 99%

Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam

et al. 2020

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We previously observed a substantial burden of cryptococcal meningitis in Vietnam atypically arising in individuals who are uninfected with human immunodeficiency virus (HIV). This disease was associated with a single genotype of Cryptococcus neoformans (sequence type [ST]5), which was significantly less common in HIV-infected individuals. Aiming to compare the phenotypic characteristics of ST5 and non-ST5 C. neoformans, we selected 30 representative Vietnamese isolates and compared their in vitro pathogenic potential and in vivo virulence. ST5 and non-ST5 organisms exhibited comparable characteristics with respect to in vitro virulence markers including melanin production, replication at 37°C, and growth in cerebrospinal fluid. However, the ST5 isolates had significantly increased variability in cellular and capsular sizing compared with non-ST5 organisms (P < .001). Counterintuitively, mice infected with ST5 isolates had significantly longer survival with lower fungal burdens at day 7 than non-ST5 isolates. Notably, ST5 isolates induced significantly greater initial inflammatory responses than non-ST5 strains, measured by TNF-α concentrations (P < .001). Despite being generally less virulent in the mouse model, we hypothesize that the significant within strain variation seen in ST5 isolates in the tested phenotypes may represent an evolutionary advantage enabling adaptation to novel niches including apparently immunocompetent human hosts.

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“…We derived data for patients with AIDS from those who had a 5-year decline in CD4 counts to <200 cells/mL in the total population of HIV patients. We estimated the annual incidence of CM at 8% in patients with AIDS (CD4 count <200 cells/mL) (33) and estimated the overall CM annual incidence based on the assumption that the proportion of HIV-positive patients with CM was 21% (34). In children, 23 cases of CM were diagnosed over a 5-year period (2007-2012) in Shijiazhuang, giving an annual incidence of 0.43/100,000 (35).…”

Section: Hiv-related Infection Burden Estimationmentioning

confidence: 99%

Risk-Based Estimate of Human Fungal Disease Burden, China

Zhou¹,

Jiang²,

Li³

et al. 2020

Emerg. Infect. Dis.

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F ungal diseases constitute a growing problem worldwide, causing a large, but poorly quantified, impact on public health (1). The incidence of fungal infections varies according to geographic region, socioeconomic conditions, and the number of persons with underlying conditions. China is one of the largest countries in the world (largest population and third largest land area). It has almost every type of weather niche, from the Pacific coast in the south to the snowy mountains in the Qinghai-Tibet Plateau, and even tropical rain forest. Many endemic fungal infections are present in China, along with globally distributed fungal pathogens. Although China has become the world's second largest economy, it is still a developing country, with millions of impoverished citizens who are susceptible to fungal infections. Fungal keratitis, one of the major causes of avoidable blindness, has been relatively neglected (2). Moreover, old pathogens such as Histoplasma and Talaromyces marneffei (talaromycosis) have expanded (3,4); new hosts contributing to new therapies for malignant and autoimmune disease have increased (5,6); and new patterns, including aspergillosis in pulmonary tuberculosis (PTB) and chronic obstructive pulmonary disease (COPD), are emerging (7,8). In addition, the lack of effective drugs, shortages of well-trained medical care personnel, and unaffordable antifungal drugs result in severe outcomes. Therefore, an estimation of fungal disease burden is needed for China to increase public health awareness and facilitate effective interventions. As in most other countries, fungal infections are not reportable in China, and the incidence and prevalence are difficult to calculate because of the lack of population-based surveillance data and few high quality epidemiology studies. The Chinese National Fungal Diseases Surveillance System (http://www. chifungi.cn) was established on May 18, 2019, but no data have been released yet. Even with this dearth of data, we have attempted to estimate the burden of fungal disease in China. Materials and Methods Study Procedures We conducted a literature review for published epidemiology papers that discussed fungal infections in China. If no epidemiological data existed for a particular fungal disease, we estimated the burden based on fungal infection incidence or prevalence and the specific populations at risk (Figure 1; Appendix Table 1, https://wwwnc.cdc.gov/EID/article/26/9/20-0016-App1.pdf).

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Epidemiology and Clinical Characteristics of Cryptococcal Meningitis in China (1981-2013): A Review of the Literature

Cited by 8 publications

References 19 publications

Assessing the virulence ofCryptococcus neoformanscausing meningitis in HIV infected and uninfected patients in Vietnam

Assessing the virulence ofCryptococcus neoformanscausing meningitis in HIV infected and uninfected patients in Vietnam

Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam

Risk-Based Estimate of Human Fungal Disease Burden, China

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