{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T03:44:22Z","timestamp":1775879062191,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012247","name":"Program of Shanghai Academic Research Leader","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>Cryptococcosis is an opportunistic and potentially lethal infection caused by <jats:italic>Cryptococcus neoformans<\/jats:italic> and <jats:italic>Cryptococcus gattii<\/jats:italic> complex, which affects both immunocompromised and immunocompetent people, and it has become a major public health concern worldwide. In this study, we characterized the molecular epidemiology and antifungal susceptibility of 133 <jats:italic>C. neoformans<\/jats:italic> isolates from East China Invasive Fungal Infection Group (ECIFIG), 2017\u20132020. Isolates were identified to species level by matrix-assisted laser desorption ionization-time of flight mass spectrometry and confirmed by <jats:italic>IGS1<\/jats:italic> sequencing. Whole-genome sequencing (WGS) was conducted on three multidrug-resistant isolates. Among the 133 strains, 61 (45.86%) were isolated from HIV-positive patients and 72 (54.16%) were isolated from HIV-negative patients. In total, <jats:italic>C. neoformans<\/jats:italic> var. <jats:italic>grubii<\/jats:italic> accounted for 97.74% (130\/133), while <jats:italic>C. neoformans<\/jats:italic> var. <jats:italic>neoformans<\/jats:italic> was rare (2.06%, 3\/133). The strains were further classified into nine sequence types (STs) dominated by ST5 (90.23%, 120\/133) with low genetic diversity. No association was observed between STs and HIV status. All strains were wild type to voriconazole, while high antifungal minimal inhibitory concentrations (MICs) above the epidemiological cutoff values (ECVs) were observed in <jats:italic>C. neoformans<\/jats:italic> strains, and more than half of isolates were non-wild-type to amphotericin B (89.15%, 109\/133). Eight isolates were resistant to fluconazole, and eight isolates were non-wild type to 5-fluorocytosine. Furthermore, WGS has verified the novel mutations of <jats:italic>FUR1<\/jats:italic> in 5-fluorocytosine-resistant strains. In one isolate, aneuploidy of chromosome 1 with G484S mutation of <jats:italic>ERG11<\/jats:italic> was observed, inducing high-level resistance (MIC: 32 \u03bcg\/ml) to fluconazole. In general, our data showed that there was no significant difference between HIV-positive and HIV-negative patients on STs, and we elucidate the resistant mechanisms of <jats:italic>C. neoformans<\/jats:italic> from different perspectives. It is important for clinical therapy and drug usage in the future.<\/jats:p>","DOI":"10.3389\/fmicb.2022.942940","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T07:58:59Z","timestamp":1657007939000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Molecular Epidemiology and Antifungal Resistance of Cryptococcus neoformans From Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Patients in Eastern China"],"prefix":"10.3389","volume":"13","author":[{"given":"Ziyi","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chendi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Ip","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoqin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryon","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingbing","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjuan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-014-0100-8","article-title":"YMAP: a pipeline for visualization of copy number variation and loss of heterozygosity in eukaryotic pathogens.","volume":"6","author":"Abbey","year":"2014","journal-title":"Genome Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/myc.12171","article-title":"Molecular epidemiology and antifungal susceptibility of Serbian Cryptococcus neoformans isolates.","volume":"57","author":"Arsic Arsenijevic","year":"2014","journal-title":"Mycoses"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-10092-5","article-title":"Three phylogenetic groups have driven the recent population expansion of Cryptococcus neoformans.","volume":"10","author":"Ashton","year":"2019","journal-title":"Nat. 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