PDF(Pubmed)
Abstract：
Cryptococcosis causes a high burden of disease worldwide. This systematic review summarizes the literature on Cryptococcus neoformans and C. gattii infections to inform the World Health Organization\'s first Fungal Priority Pathogen List. PubMed and Web of Science were used to identify studies reporting on annual incidence, mortality, morbidity, antifungal resistance, preventability, and distribution/emergence in the past 10 years. Mortality rates due to C. neoformans were 41%-61%. Complications included acute renal impairment, raised intracranial pressure needing shunts, and blindness. There was moderate evidence of reduced susceptibility (MIC range 16-32 mg/l) of C. neoformans to fluconazole, itraconazole, ketoconazole, voriconazole, and amphotericin B. Cryptococcus gattii infections comprised 11%-33% of all cases of invasive cryptococcosis globally. The mortality rates were 10%-23% for central nervous system (CNS) and pulmonary infections, and ∼43% for bloodstream infections. Complications described included neurological sequelae (17%-27% in C. gattii infections) and immune reconstitution inflammatory syndrome. MICs were generally low for amphotericin B (MICs: 0.25-0.5 mg/l), 5-flucytosine (MIC range: 0.5-2 mg/l), itraconazole, posaconazole, and voriconazole (MIC range: 0.06-0.5 mg/l). There is a need for increased surveillance of disease phenotype and outcome, long-term disability, and drug susceptibility to inform robust estimates of disease burden.
摘要：
隐球菌病在世界范围内造成很高的疾病负担。本系统综述总结了有关新生隐球菌和C.gattii感染的文献，以告知世界卫生组织的第一个真菌优先病原体清单。PubMed和WebofScience被用来确定报告年发病率的研究，死亡率,发病率，抗真菌耐药性，可预防性,以及过去10年的分布/出现。新型梭菌死亡率为41%-61%。并发症包括急性肾功能损害，颅内压升高需要分流，和失明。有中度证据表明新衣原体对氟康唑的敏感性降低（MIC范围16-32mg/l），伊曲康唑,酮康唑,伏立康唑,两性霉素B.隐球菌感染占全球所有侵袭性隐球菌病病例的11%-33%.中枢神经系统（CNS）和肺部感染的死亡率为10％-23％，和43%的血流感染。所描述的并发症包括神经后遗症(在C.gattii感染中17%-27%)和免疫重建炎性综合征。两性霉素B的MIC通常较低（MIC：0.25-0.5mg/l），5-氟胞嘧啶（MIC范围：0.5-2毫克/升），伊曲康唑,泊沙康唑,和伏立康唑（MIC范围：0.06-0.5mg/l）。需要加强对疾病表型和结果的监测，长期残疾,和药物敏感性为疾病负担提供可靠的估计。
