Microbiological, Epidemiological, and Clinical Characteristics and Outcomes of Patients with Cryptococcosis in Taiwan, 1997–2010

• DOI: 10.1371/journal.pone.0061921
• Publication Date: 2013-04-17T20:47:10Z
• Authors: Hsiang-Kuang Tseng; Chang-Pan Liu; Mao-Wang Ho; Po-Liang Lu; Hsiu-Jung Lo; Yu-Hui Lin; Wen-Long Cho; Yee-Chun Chen
• Keywords: Cryptococcus gattii

Background Among members of Cryptococcus neoformans- gattii species complex, C. neoformans is distributed worldwide whereas considered to be more prevalent in the subtropics and tropics including Taiwan. This nationwide study was undertaken determine distribution genotypes, clinical characteristics outcomes 219 patients with proven cryptococcosis at 20 hospitals representative all geographic areas Taiwan during 1997–2010. Methods Findings Of isolates analyzed, accounted for 210 (95.9%); nine were (4.1%). The predominant genotype VNI (206 isolates). other genotypes included VNII (4 isolates), VGI (3 isolates) VGII (6 Antifungal minimal inhibition concentrations higher than epidemiologic cutoff values (ECVs) found (7 amphotericin B). HIV infection most common underlying condition (54/219, 24.6%). HIV-negative patients, liver diseases (HBV carrier or cirrhosis) (30.2%) 15.4% did not have any condition. Meningoencephalitis presentation (58.9%), followed by pulmonary (19.6%) "others" (predominantly cryptococcemia) (18.7%). independent risk factors 10-week mortality, multivariate analysis, cirrhosis (P = 0.014) CSF cryptococcal antigen titer ≥512 0.020). All except one 54 HIV-infected infected (98.1%). 13 VNI, 12 (92.3%) isolated from patients. compared likely meningoencephalitis serum ≥1∶512. Patients younger, (100% vs. 57%), reside Central (56% 31%), crude mortality (44.4% 22.2%). Conclusions Taiwan, gatii, has a genotype. Isolates antifungal MIC ECVs rare.