Clinical characteristics and drug sensitivity analysis of 138 patients with non-HIV cryptococcal meningitis
Objective To analyze the clinical characteristics and drug susceptibility in vitro of non-HIV patients with cryptococcal meningitis.Methods The clinical data of 138 patients with cryptococcal meningitis who were treated in the hospital from 2018 to 2021 were retrospectively analyzed,the clinical manifestations,underlying conditions,and results of laboratory examinations were observed.Results The positive rate of ink staining test and CrAg test was 73.9％and 100％in 138 patients with non-HIV cryptococcal meningitis.Forty-two patients had immunosuppressive diseases,49 patients had other underlying diseases,and 47 patients had no history of underlying diseases.Cerebrospinal fluid biochemical examination of patients with headaches,fevers,vomiting,limb weakness,consciousness disorders,and other symptoms showed a decrease in glucose and chloride and an increase in cerebrospinal fluid protein content.The MIC ranges of 138 cryptococcus strains against 5-flucytosine,amphotericin B,fluconazole,itraconazole and voriconazole were ≤4～≥16 μg/mL、≤0.5～1 μg/mL、1～16 μg/mL、≤0.125～0.5 μg/mL、≤0.06～0.5 μg/mL.The sensitivity of 5-flucytosine,fluconazole and itraconazole was 95.60％,94.93％and 65.22％,respectively.The sensitivities of both amphotericin B and voriconazole were 100％.Conclusion Patients with cryptococcal meningitis often have underlying diseases(including immunosuppressive diseases).The positive rate of CrAg test was significantly higher than that of ink staining test,and the strains isolated from patients with non-HIV cryptococcal meningitis had different sensitivity to different antifungal drugs,which provided references for clinical medication.
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