Mortality rates due to Cryptococcus neoformans var. grubii fungemia remain significant despite treatment with antifungal drugs. The predictive function of antifungal susceptibility and its correlation with treatment outcome remains controversial. A retrospective study was conducted from January 1, 2009, to December 31, 2016, on 85 patients with C. neoformans var. grubii fungemia confirmed by matrix-assisted laser desorption ionization–time-of-flight mass spectrometry. Antifungal drug susceptibility was determined using the YeastONE™ colorimetric broth microdilution method coupled with Vizion™ System following the Clinical and Laboratory Standards Institute guidelines. Six antifungal agents—amphotericin B, fluconazole, flucytosine, itraconazole, posaconazole, and voriconazole—were tested. The patients’ demographic data and clinical information were abstracted for further analyses. Antifungal regimens consisting of amphotericin B with or without fluconazole or flucytosine were administered for induction treatment of these patients, followed with intravenous or oral fluconazole for maintenance therapy. Clinical outcomes were defined by 14- and 30-day mortality rates. Risk factors associated with outcomes were fitted in a logistic regression model by univariate or multivariate method. Eighty-five patients with C. neoformans var. grubii fungemia were enrolled in the study. The Sequential Organ Failure Assessment Score, Glasgow Coma Scale, Charlson comorbidity score, and adequate duration of therapy for amphotericin B were predictors for mortality in univariate analysis. Antifungal susceptibility testing with YeastONE™ does not predict clinical outcomes of C. neoformans var. grubii fungemia. Greater disease severity, high comorbidities, poor consciousness level, and inappropriate treatment were associated with increased mortality in cryptococcemia cases.

中文翻译：

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使用 YeastONE™ 进行的抗真菌药敏试验不能预测新型隐球菌 var. 的临床结果。格鲁比真菌病

由新型隐球菌引起的死亡率。尽管用抗真菌药物治疗，格鲁比真菌血症仍然很严重。抗真菌药敏感性的预测功能及其与治疗结果的相关性仍存在争议。从 2009 年 1 月 1 日到 2016 年 12 月 31 日，对 85 名 C. neoformans var. 患者进行了一项回顾性研究。grubii 真菌血症通过基质辅助激光解吸电离-飞行时间质谱法证实。根据临床和实验室标准协会指南，使用 YeastONE™ 比色肉汤微量稀释法结合 Vizion™ 系统确定抗真菌药物敏感性。测试了六种抗真菌药物——两性霉素 B、氟康唑、氟胞嘧啶、伊曲康唑、泊沙康唑和伏立康唑。提取患者的人口统计数据和临床信息以供进一步分析。由两性霉素 B 组成的抗真菌方案联合或不联合氟康唑或氟胞嘧啶对这些患者进行诱导治疗，然后静脉内或口服氟康唑进行维持治疗。临床结果由 14 天和 30 天死亡率定义。通过单变量或多变量方法将与结果相关的风险因素拟合到逻辑回归模型中。85 名患有 C. neoformans var. 的患者。grubii 真菌血症被纳入研究。在单变量分析中，序贯器官衰竭评估评分、格拉斯哥昏迷评分、Charlson 合并症评分和足够的两性霉素 B 治疗持续时间是死亡率的预测因素。使用 YeastONE™ 进行的抗真菌药敏试验不能预测 C. neoformans var. 的临床结果。格鲁比真菌病。更大的疾病严重程度、高合并症、意识水平差和不适当的治疗与隐球菌血症病例的死亡率增加有关。