新生隐球菌感染流行病学现状及耐药机制相关研究进展

A review of the epidemiology and drug resistance mechanism of Cryptococcus neoformans infection

新生隐球菌是一种广泛存在于环境中的酵母类真菌,主要侵犯中枢神经系统引起隐球菌性脑膜炎。HIV感染是导致隐球菌感染的主要危险因素之一,但近年来关于非HIV患者隐球菌感染的报道不断增加。体外药敏试验证实大部分新生隐球菌对棘白菌素类药物具有内在抗性。两性霉素B和氟康唑是用于隐球菌感染治疗的一线药物,而长期广泛用药引起新生隐球菌对氟康唑的耐药率逐年升高,患者临床治疗失败率居高不下。为进一步加深对新生隐球菌的认识,本文结合国内外流行病学报道及相关研究,从感染现状、生物学特征、诊治方法和耐药性等方面进行综述,以期为新生隐球菌性脑膜炎的临床诊治提供参考。

Cryptococcus neoformans is a kind of pathogenic yeast that distributes widely in environment, mainly invading the central nervous system and causing cryptococcal meningitis.HIV is one of the major risk factors for cryptococcosis, but reports of non-HIV patients of cryptococcosis have increased in recent years. In vitro antifungal resistance tests have confirmed that most C. neoformans had intrinsic resistance to echinocandins. Amphotericin B and fluconazole are the first-line drugs used to treat cryptococcosis, however, with the abusing use of antifungal drugs, the resistance of C. neoformans to fluconazole becomes higher year by year, and the prognosis of patients is poor. In order to providing references for the clinical diagnosis and treatment of cryptococcal meningitis, this review summarizes the current knowledge of C.neoformans concerning epidemiology, biological characteristics, diagnosis, treatment and drug resistance.