Strain distribution and antifungal susceptibility of fungus isolates from acquired immune deficiency syndrome patients in Shanghai from 2010 to 2014

Abstract

Objective To investigate strain distribution and antifungal susceptibility of fungus isolates from acquired immune deficiency syndrome (AIDS) patients of Shanghai public health clinic center. Methods The funus isolates from clinical specimens of in-hospital AIDS patients in our hospital between January 2010 and December 2014 were retrospectively analyzed. Results Of the 3 155 hospitalized patients with human immunodeficiency virus (HIV)/AIDS, a total of 11 291 fungus culture specimens were collected, of which 1 786 (15.82%) were positive. Nine hundred and seventy-nine fungus strains were isolated, which were identified as 27 species or genus. The most common isolates were Candida albicans (503), Candida tropicalis (60), Candida glabrata (48), Candida krusei (41), Cryptococcus neoformans (179) and Penicillium marneffei (59). The majority positive samples were from respiratory tract (61.29%), followed by the feces (13.28%), cerebrospinal fluid (11.24%) and blood (11.13%). The positive isolation rate of sterile tissue specimens (mainly blood and cerebrospinal fluid) was 6.92%(558/8 052), and 96.24%(537/558) of the isolated fungi were Cryptococcus neoformans and Penicillium marneffei. The drug susceptibility rate of Candida to five antifungal drugs commonly used in clinical (amphotericin B, 5-fluorine cytosine, fluconazole, itraconazole, voriconazole) were 100.00%, 91.67%, 83.33%, 70.83% and 83.33%, respectively. The drug susceptibility rate of Cryptococcus neoformans to three antifungal drugs commonly used in clinical (amphotericin B, 5-fluorine cytosine, fluconazole) were 96.05%, 94.74% and 97.37%, respectively. Conclusions The predominant species of fungal pathogens in AIDS patient in our hospital include Candida, Cryptococcus neoformans and Penicillium marneffei. The pathogen distribution of blood and cerebrospinal fluid are different. Some of Candida and Cryptococcus neoformans are resistant to the commonly used antifungal drugs. Key words: Candida; Cryptococcus neoformans; Penicillium marneffei; Acquired immunodeficiency syndrome; Drug susceptibility