{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:09:35Z","timestamp":1790712575788,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002377"],"award-info":[{"award-number":["UL1TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are no established clinical breakpoints for antifungal agents against <jats:italic>Cryptococcus<\/jats:italic> species; however, epidemiological cut\u2010off values can help distinguish wild\u2010type (WT) isolates without any acquired resistance from non\u2010WT strains, which may harbour resistance mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>We describe the trends of antifungal MICs and percentages of WT <jats:italic>C. neoformans<\/jats:italic> species complex (CNSC) isolates processed in our reference laboratory from November 2011 to June 2021. There were only nine isolates in 2011, thus, we included them in the year 2012 for data analysis. Clinical data is also described when available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 632 CNSC, the majority collected from blood (<jats:italic>n<\/jats:italic>\u2009=\u2009301), cerebrospinal fluid (<jats:italic>n<\/jats:italic>\u2009=\u2009230), and respiratory (<jats:italic>n<\/jats:italic>\u2009=\u200971) sources. The overall percentage of WT isolates for amphotericin B (AMB), 5\u2010flucytosine, and fluconazole was 77%, 98%, and 91%, respectively. We noticed a statistically significant change in the percentage of AMB WT isolates over the years, with 98% of isolates being WT in 2012 compared to 79% in 2021 (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). A similar change was not observed for other antifungal agents. Clinical data was available for 36 patients, primarily non\u2010HIV immunocompromised patients with disseminated cryptococcosis. There were no statistically significant differences in the clinical characteristics and outcomes between patients with WT (58.3%) versus non\u2010WT (41.7%) isolates, but we noticed higher mortality in patients infected with an AMB non\u2010WT CNSC isolate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed an increase in the percentage of AMB non\u2010WT CNSC isolates in the past decade. The clinical implications of this finding warrant further evaluation in larger studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13691","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T14:37:11Z","timestamp":1704206231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Temporal trends in antifungal susceptibility of <i>Cryptococcus neoformans<\/i> isolates from a reference laboratory in the United States, 2011\u20132021"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3090-9261","authenticated-orcid":false,"given":"Eloy E.","family":"Ordaya","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar 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