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Nishikawa MM, Almeida-Paes R, Brito-Santos F, Nascimento CR, Fialho MM, Trilles L, Morales BP, da Silva SA, Santos W, Santos LO, Fortes ST, Cardarelli-Leite P, Lázera MDS. Comparative antifungal susceptibility analyses of Cryptococcus neoformans VNI and Cryptococcus gattii VGII from the Brazilian Amazon Region by the Etest, Vitek 2, and the Clinical and Laboratory Standards Institute broth microdilution methods. Med Mycol 2020; 57:864-873. [PMID: 30657975 DOI: 10.1093/mmy/myy150] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/09/2018] [Accepted: 12/11/2018] [Indexed: 12/11/2022] Open
Abstract
Early diagnosis, efficient clinical support, and proper antifungal therapy are essential to reduce death and sequels caused by cryptococcosis. The emergence of resistance to the antifungal drugs commonly used for cryptococcosis treatment is an important issue of concern. Thus, the in vitro antifungal susceptibility of clinical strains from northern Brazil, including C. neoformans VNI (n = 62) and C. gattii VGII (n = 37), to amphotericin B (AMB), 5-flucytosine, fluconazole, voriconazole, and itraconazole was evaluated using the Etest and Vitek 2 systems and the standardized broth microdilution (CLSI-BMD) methodology. According to the CLSI-BMD, the most active in vitro azole was voriconazole (C. neoformans VNI modal MIC of 0.06 μg/ml and C. gattii VGII modal MIC of 0.25 μg/ml), and fluconazole was the least active (modal MIC of 4 μg/ml for both fungi). Modal MICs for amphotericin B were 1 μg/ml for both fungi. In general, good essential agreement (EA) values were observed between the methods. However, AMB presented the lowest EA between CLSI-BMD and Etest for C. neoformans VNI and C. gattii VGII (1.6% and 2.56%, respectively, P < .05 for both). Considering the proposed Cryptococcus spp. epidemiological cutoff values, more than 97% of the studied isolates were categorized as wild-type for the azoles. However, the high frequency of C. neoformans VNI isolates in the population described here that displayed non-wild-type susceptibility to AMB is noteworthy. Epidemiological surveillance of the antifungal resistance of cryptococcal strains is relevant due to the potential burden and the high lethality of cryptococcal meningitis in the Amazon region.
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Affiliation(s)
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, INI/Fiocruz, Rio de Janeiro, RJ
| | - Fabio Brito-Santos
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, INI/Fiocruz, Rio de Janeiro, RJ
| | | | - Miguel Madi Fialho
- Fungal Section, National Institute of Quality Control in Health, INCQS/Fiocruz, Rio de Janeiro, RJ
| | - Luciana Trilles
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, INI/Fiocruz, Rio de Janeiro, RJ
| | | | - Sérgio Alves da Silva
- Quality Management board, National Institute for Quality Control in Health, INCQS/ Fiocruz, Rio de Janeiro, RJ
| | - Wallace Santos
- Department of Pharmacy, Federal University of Pará, Belém, PA
| | | | | | - Paola Cardarelli-Leite
- Molecular Biology Section, National Institute for Quality Control in Health, INCQS/ Fiocruz, Rio de Janeiro, RJ
| | - Márcia Dos Santos Lázera
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, INI/Fiocruz, Rio de Janeiro, RJ
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102
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Lee GHA, Arthur I, Merritt A, Leung M. Molecular types of Cryptococcus neoformans and Cryptococcus gattii in Western Australia and correlation with antifungal susceptibility. Med Mycol 2020; 57:1004-1010. [PMID: 30649538 DOI: 10.1093/mmy/myy161] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/13/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii species complexes have a worldwide distribution; however, there is geographical variation in the prevalence of different molecular types. Additionally, antifungal susceptibility differences between molecular types have been demonstrated. This study investigates the distribution of cryptococcal molecular types among human clinical isolates over a 10-year period from a Western Australian population. Molecular type was determined based on polymorphisms in the phospholipase gene locus identified through amplification and sequencing. Minimum inhibitory concentrations (MICs) were identified for fluconazole, 5-fluorocytosine, posaconazole, itraconazole, voriconazole, and amphotericin B. Most isolates were C. neoformans complex (42) of which over half were molecular type VNI (22) followed by VNII (20). Among the remaining C. gattii complex (13) the majority were VGI (11) with VGII (2) uncommonly found. All isolates demonstrated low MICs to antifungal agents including fluconazole. Geometric mean MIC values against 5-fluorocytosine for VNI (1.741 mg/l) were significantly higher than those for VGI (0.47 mg/l, P = .002). Similarly fluconazole geometric mean MICs against fluconazole for VNI (2.3 mg/l) were significantly higher than VNII (0.87 mg/l, P = .036). These data reveal the presence of four molecular types (VNI, VNII, VGI and VGII) within clinical Western Australian cryptococcal isolates and, while elevated antifungal MICs were not encountered, significant molecular type dependent differences in susceptibility were found.
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Affiliation(s)
- Gar-Hing Andrew Lee
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Ian Arthur
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Adam Merritt
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
| | - Michael Leung
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Hospital Avenue, Nedlands, Western Australia, 6009
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103
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Hybridization Facilitates Adaptive Evolution in Two Major Fungal Pathogens. Genes (Basel) 2020; 11:genes11010101. [PMID: 31963231 PMCID: PMC7017293 DOI: 10.3390/genes11010101] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/02/2020] [Accepted: 01/14/2020] [Indexed: 01/13/2023] Open
Abstract
Hybridization is increasingly recognized as an important force impacting adaptation and evolution in many lineages of fungi. During hybridization, divergent genomes and alleles are brought together into the same cell, potentiating adaptation by increasing genomic plasticity. Here, we review hybridization in fungi by focusing on two fungal pathogens of animals. Hybridization is common between the basidiomycete yeast species Cryptococcus neoformans × Cryptococcus deneoformans, and hybrid genotypes are frequently found in both environmental and clinical settings. The two species show 10-15% nucleotide divergence at the genome level, and their hybrids are highly heterozygous. Though largely sterile and unable to mate, these hybrids can propagate asexually and generate diverse genotypes by nondisjunction, aberrant meiosis, mitotic recombination, and gene conversion. Under stress conditions, the rate of such genetic changes can increase, leading to rapid adaptation. Conversely, in hybrids formed between lineages of the chytridiomycete frog pathogen Batrachochytrium dendrobatidis (Bd), the parental genotypes are considerably less diverged (0.2% divergent). Bd hybrids are formed from crosses between lineages that rarely undergo sex. A common theme in both species is that hybrids show genome plasticity via aneuploidy or loss of heterozygosity and leverage these mechanisms as a rapid way to generate genotypic/phenotypic diversity. Some hybrids show greater fitness and survival in both virulence and virulence-associated phenotypes than parental lineages under certain conditions. These studies showcase how experimentation in model species such as Cryptococcus can be a powerful tool in elucidating the genotypic and phenotypic consequences of hybridization.
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104
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Prakash A, Sundar G, Sharma B, Hagen F, Meis JF, Chowdhary A. Genotypic diversity in clinical and environmental isolates of Cryptococcus neoformans from India using multilocus microsatellite and multilocus sequence typing. Mycoses 2020; 63:284-293. [PMID: 31820495 DOI: 10.1111/myc.13041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cryptococcus neoformans is the leading cause of cryptococcal meningitis in HIV/AIDS patients. As infections in humans are predominantly caused by the inhalation of basidiospores from environmental sources, therefore, analysing the population structure of both clinical and environmental populations of C neoformans can increase our understanding of the molecular epidemiology of cryptococcosis. OBJECTIVE To investigate the genotypic diversity and antifungal susceptibility profile of a large collection of C neoformans isolates (n = 523) from clinical and environmental sources in India between 2001 and 2014. MATERIALS AND METHODS Cryptococcus neoformans isolates were genotyped by AFLP, microsatellite typing (MLMT) and MLST. In vitro antifungal susceptibility for standard antifungals was undertaken using CLSI M27-A3. RESULTS All isolates were C neoformans, AFLP1/VNI and exhibited mating-type MATα. MLMT revealed that the majority of isolates belonged to microsatellite cluster (MC) MC3 (49%), followed by MC1 (35%), and the remaining isolates fell in 11 other MC types. Interestingly, two-thirds of clinical isolates were genotype MC3 and only 17% of them were MC1, whereas majority of environmental strains were MC1 (54%) followed by MC3 (16%). Overall, MLST assigned 5 sequence types (STs) among all isolates and ST93 was the most common (n = 76.7%), which was equally distributed in both HIV-positive and HIV-negative patients. Geometric mean MICs revealed that isolates in MC1 were significantly less (P < .05) susceptible to amphotericin B, 5-flucytosine, itraconazole, posaconazole and isavuconazole than isolates in MC3. CONCLUSIONS The study shows a good correlation between MLMT and MLST genotyping methods. Further, environmental isolates were genetically more diverse than clinical isolates.
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Affiliation(s)
- Anupam Prakash
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Gandhi Sundar
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Brijesh Sharma
- Department of Medicine, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Jacques F Meis
- Center of Expertise in Mycology, Radboud University Medical Centre/Canisius Wilhelmina Hospital and Excellence Center for Medical Mycology of the European Confederation of Medical Mycology (ECMM), Nijmegen, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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105
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First Autochthonous Case of Cryptococcal Meningitis in an Immunocompetent Host Due to Cryptococcus gattii VGIin Northern Italy. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-019-00208-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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106
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Cryptococcus gattii infection in an immunocompetent host in Greece. Med Mycol Case Rep 2019; 27:1-3. [PMID: 31867171 PMCID: PMC6906646 DOI: 10.1016/j.mmcr.2019.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/03/2019] [Accepted: 12/02/2019] [Indexed: 12/28/2022] Open
Abstract
We report a case of a 31-year-old otherwise healthy female with pulmonary cryptococcoma along with cryptococcal meningitis due to Cryptococcus gattii molecular type VGI, in Greece. Combined antifungal treatment and surgical excision of pulmonary cryptococcoma yielded a good response.
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107
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Abstract
We discovered a new lineage of the globally important fungal pathogen Cryptococcus gattii on the basis of analysis of six isolates collected from three locations spanning the Central Miombo Woodlands of Zambia, Africa. All isolates were from environments (middens and tree holes) that are associated with a small mammal, the African hyrax. Phylogenetic and population genetic analyses confirmed that these isolates form a distinct, deeply divergent lineage, which we name VGV. VGV comprises two subclades (A and B) that are capable of causing mild lung infection with negligible neurotropism in mice. Comparing the VGV genome to previously identified lineages of C. gattii revealed a unique suite of genes together with gene loss and inversion events. However, standard URA5 restriction fragment length polymorphism (RFLP) analysis could not distinguish between VGV and VGIV isolates. We therefore developed a new URA5 RFLP method that can reliably identify the newly described lineage. Our work highlights how sampling understudied ecological regions alongside genomic and functional characterization can broaden our understanding of the evolution and ecology of major global pathogens.IMPORTANCE Cryptococcus gattii is an environmental pathogen that causes severe systemic infection in immunocompetent individuals more often than in immunocompromised humans. Over the past 2 decades, researchers have shown that C. gattii falls within four genetically distinct major lineages. By combining field work from an understudied ecological region (the Central Miombo Woodlands of Zambia, Africa), genome sequencing and assemblies, phylogenetic and population genetic analyses, and phenotypic characterization (morphology, histopathological, drug-sensitivity, survival experiments), we discovered a hitherto unknown lineage, which we name VGV (variety gattii five). The discovery of a new lineage from an understudied ecological region has far-reaching implications for the study and understanding of fungal pathogens and diseases they cause.
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108
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Kassi FK, Drakulovski P, Bellet V, Roger F, Chabrol A, Krasteva D, Doumbia A, Landman R, Kakou A, Reynes J, Delaporte E, Menan HEI, Bertout S. Cryptococcus genetic diversity and mixed infections in Ivorian HIV patients: A follow up study. PLoS Negl Trop Dis 2019; 13:e0007812. [PMID: 31738768 PMCID: PMC6886875 DOI: 10.1371/journal.pntd.0007812] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 12/02/2019] [Accepted: 09/26/2019] [Indexed: 01/07/2023] Open
Abstract
Genetic diversity analyses were performed by sero-genotyping and multi-locus sequence typing on 252 cryptococcal isolates from 13 HIV-positive Ivorian patients followed-up for cryptococcal meningitis. Antifungal susceptibility analyses were performed according to the CLSI M27A3 method. The majority (67.8%) of the isolates belonged to the Cryptococcus neoformans (serotype A) species complex, with 93% being VNI and 7% being VNII. Cryptococcus deuterogattii VGII (serotype B) represented 16.7% of the strains, while C. neoformans/C. deneoformans VNIII (serotype AD) hybrids accounted for 15.1% of the strains. One strain (0.4%) was not identifiable. Nine different sequence types (STs 5, 6, 23, 40, 93, 207, 311, and a new ST; 555) were identified in the C. neoformans population, while the C. deuterogattii population comprised the single ST 173. The distribution of the strains showed that, while the majority of patients (9/13) harboured a single sequence type, 4 patients showed mixed infections. These patients experienced up to 4 shifts in strain content either at the species and/or ST level during their follow-up. This evolution of diversity over time led to the co-existence of up to 3 different Cryptococcus species and 4 different ST within the same individual during the course of infection. Susceptibility testing showed that all strains were susceptible to amphotericin B while 3.6% of them had a none-wild type phenotype to 5-flucytosine. Concerning fluconazole, 2.9% of C.neoformans serotype A strains and 2.4% of C. deuterogattii had also respectively a none-wild type phenotype to this molecule. All C. neoformans x C. deneoformans serotype AD hybrids had however a wild type phenotype to fluconazole. The present study showed that mixed infections exist and could be of particular importance for care outcomes. Indeed, (i) the different Cryptococcus species are known to exhibit different virulence and different susceptibility patterns to antifungal drugs and (ii) the strains genetic diversity within the samples may influence the susceptibility to antifungal treatment.
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Affiliation(s)
- Fulgence Kondo Kassi
- Université Félix Houphouet-Boigny, Unité des Sciences Pharmaceutiques et Biologiques, Abidjan, Côte d’Ivoire
| | - Pascal Drakulovski
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Virginie Bellet
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Frédéric Roger
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Amélie Chabrol
- Service de Maladies Infectieuses et Tropicales, CH Sud Francilien, Corbeil, France
| | - Donika Krasteva
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Adama Doumbia
- Université Félix Houphouet-Boigny, Unité des Sciences Pharmaceutiques et Biologiques, Abidjan, Côte d’Ivoire
| | - Roland Landman
- Institut de Médecine et Epidémiologie Appliquée (IMEA), Fondation Léon M’Ba, Paris, France
| | - Aka Kakou
- Service des Maladies Infectieuses et Tropicales, CHU Treichville, Abidjan, Côte d’Ivoire
| | - Jacques Reynes
- CHU Gui de Chauliac, Service des Maladies Infectieuses et Tropicales, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Eric Delaporte
- TransVIHMI/INSERM1175, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | - Hervé Eby Ignace Menan
- Diagnostic and Research Center on AIDS and Other Infectious Diseases (CeDReS), Abidjan, Côte d'Ivoire
| | - Sébastien Bertout
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
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109
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Trovato L, Oliveri S, Esposto MC, Prigitano A, Romanò L, Cogliati M. Cryptococcus neoformans and Cryptococcus gattii Species Complex Isolates on the Slopes of Mount Etna, SICILY, Italy. Front Microbiol 2019; 10:2390. [PMID: 31681242 PMCID: PMC6813189 DOI: 10.3389/fmicb.2019.02390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/02/2019] [Indexed: 12/23/2022] Open
Abstract
This study investigated the presence of Cryptococcus neoformans and Cryptococcus gattii species complex isolates on olive trees growing in the Eastern part of Sicily (Italy) characterized by the presence of the volcano Etna and the ability of these fungal pathogens to sexually reproduce on medium containing volcanic soil. Samples from 124 olive trees were collected from 14 different sites around Mount Etna. Eighteen trees (14.5%) resulted colonized by C. neoformans VNI-αA isolates, one (0.8%) by VNIV-αD isolates, and two (1.6%) by C. gattii VGI-αB isolates. The ability of environmental and reference strains belonging to VNI, VNIV, and VGI molecular types to sexually reproduce on a medium containing volcanic soil was also tested. VNI and VNIV strains were able to produce filaments and basiodiospores more vigorously than on the control medium, whereas VGI strains were not fertile. In conclusion, the present study identified which C. neoformans and C. gattii species complex genotypes are circulating in Eastern Sicily and confirmed the ecological role of olive trees as environmental reservoir of these pathogens. It also showed that Cryptococcus is able to colonize and sexually reproduce in inhospitable environments such as the slopes of a volcano.
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Affiliation(s)
- Laura Trovato
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Salvatore Oliveri
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maria Carmela Esposto
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Anna Prigitano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Luisa Romanò
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Cogliati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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110
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Pllana-Hajdari D, Cogliati M, Čičmak L, Pleško S, Mlinarić-Missoni E, Mareković I. First Isolation, Antifungal Susceptibility, and Molecular Characterization of Cryptococcus neoformans from the Environment in Croatia. J Fungi (Basel) 2019; 5:jof5040099. [PMID: 31614885 PMCID: PMC6958495 DOI: 10.3390/jof5040099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study was to investigate the presence of Cryptococcus neoformans species complex isolates from environmental sources in Croatia and to determine their molecular types and antifungal susceptibility. Swab samples of tree hollows and bird excreta in the soil beneath trees were collected. Samples included 472 (92.73%) samples obtained from tree hollows and 37 (7.27%) samples from bird excreta. Four C. neoformans species complex isolates were recovered from tree hollow swabs along the Mediterranean coast, while there were no isolates recovered from bird excreta or from the continental area. Three isolates were identified as molecular types VNI and one as VNIV. All tested antifungals showed high in vitro activity against the four isolates. This is the first report proving the presence of C. neoformans species complex in the environment of Croatia. The results of the study suggest a major risk of exposure for inhabitants living along the Croatian coast and that both VNI and VNIV molecular types can be expected in clinical cases of cryptococcosis. Susceptibility to antifungals confirmed that no resistance should be expected in patients with cryptococcosis at the present time.
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Affiliation(s)
- Donjeta Pllana-Hajdari
- Department of Molecular Microbiology, National Institute of Public Health, Prishtina 10 000, Kosovo.
| | - Massimo Cogliati
- Laboratorio di Micologia Medica, Dipartimento Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano 20133, Italy.
| | - Ljiljana Čičmak
- Department for Parasitology and Mycology, Croatian Institute for Public Health, Zagreb 10 000, Croatia.
| | - Sanja Pleško
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb 10 000, Croatia.
| | - Emilija Mlinarić-Missoni
- Department for Parasitology and Mycology, Croatian Institute for Public Health, Zagreb 10 000, Croatia.
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb 10 000, Croatia.
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111
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Lin KH, Lin YP, Chung WH. Two-step method for isolating Cryptococcus species complex from environmental material using a new selective medium. ENVIRONMENTAL MICROBIOLOGY REPORTS 2019; 11:651-658. [PMID: 31215749 DOI: 10.1111/1758-2229.12775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 06/09/2023]
Abstract
Cryptococcosis is an opportunistic infection caused by the Cryptococcus species complex. An outbreak of cryptococcosis caused by Cryptococcus gattii (AFLP6/VGII) in North America has indicated the need for studies of this organism and its environmental niche. Difficulties in isolating the Cryptococcus spp. because of the overgrowth of filamentous fungi onto culture media and its low fungal population size under natural conditions limit studies of these pathogenic yeasts. We designed a selective medium that inhibits the growth of environmental filamentous fungi but does not inhibit that of Cryptococcus cells. After enrichment in acidified YPD media and inoculation onto selective media, Cryptococcus cells in brown-coloured colonies were isolated from environmental materials. This two-step method is useful for isolating environmental members of the Cryptococcus species complex, which is essential for further studies involving diversity and the microbe-environment relationship of this yeast.
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Affiliation(s)
- Kuo-Hsi Lin
- National Chung Hsing University, Taichung, Taiwan
- Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Yi-Pei Lin
- Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Wen-Hsin Chung
- National Chung Hsing University, Taichung, Taiwan
- Innovation and Development Center of Sustainable Agriculture (IDCSA), Taichung, Taiwan
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112
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Schmertmann LJ, Wardman A, Setyo L, Kan A, Meyer W, Malik R, Krockenberger MB. Identification of the environmental source of infection for a domestic ferret with cryptococcosis. J Vet Diagn Invest 2019; 31:828-835. [PMID: 31551015 DOI: 10.1177/1040638719876968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cryptococcosis, caused by the Cryptococcus gattii and C. neoformans species complexes, is an environmentally acquired mycosis affecting a broad range of host species. Among 9 communally housed ferrets, a 5-y-old castrated male ferret domiciled in an outdoor enclosure in Sydney, Australia was diagnosed with sinonasal cryptococcosis. Clinical signs resolved during 18 mo of itraconazole therapy, but the ferret was eventually euthanized because of splenic hemangiosarcoma. At postmortem, microscopic foci of persistent cryptococcosis were detected. The diagnosis raised concerns that the owners and other ferrets were exposed to a common environmental source of infection, thus prompting an investigation. Soil samples, swabs of a hollow eucalypt log (used for behavioral enrichment), and nasal swabs from 8 asymptomatic ferrets were collected. Nasal exudate (obtained at diagnosis) and tissues (collected at postmortem) were available from the clinical case. Bird seed agar culture resulted in a heavy growth of Cryptococcus spp. from one environmental site (the log), one nasal swab, and nasal exudate and tissues from the clinical case. All other samples were culture-negative. Sub-cultured isolates from the log were a mixture of C. gattii molecular type VGI and C. neoformans molecular type VNI. Ferret isolates were a similar mixture of C. gattii VGI (all disease isolates) and C. neoformans VNI (nasal-colonizing isolate). Multilocus sequence typing further revealed the ferret isolates as identical to environmental isolates collected from the log, confirming the log as the source of clinical disease and nasal colonization. The log was removed to prevent further exposure to a high environmental load of Cryptococcus spp.
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Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alison Wardman
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Laura Setyo
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alex Kan
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Wieland Meyer
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Richard Malik
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Mark B Krockenberger
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
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113
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Setianingrum F, Rautemaa-Richardson R, Denning DW. Pulmonary cryptococcosis: A review of pathobiology and clinical aspects. Med Mycol 2019; 57:133-150. [PMID: 30329097 DOI: 10.1093/mmy/myy086] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/05/2018] [Indexed: 01/13/2023] Open
Abstract
Pulmonary cryptococcosis is an important opportunistic invasive mycosis in immunocompromised patients, but it is also increasingly seen in immunocompetent patients. The main human pathogens are Cryptococcus neoformans and C. gattii, which have a worldwide distribution. In contrast to cryptococcal meningitis, pulmonary cryptococcosis is still underdiagnosed because of limitations in diagnostic tools. It can mimic lung cancer, pulmonary tuberculosis, bacterial pneumonia, and other pulmonary mycoses both clinically and radiologically. Pulmonary nodules are the most common radiological feature, but these are not specific to pulmonary cryptococcosis. The sensitivity of culture of respiratory samples for Cryptococcus is poor and a positive result may also reflect colonisation. Cryptococcal antigen (CrAg) with lateral flow device is a fast and sensitive test and widely used on serum and cerebrospinal fluid, but sera from patients with pulmonary cryptococcosis are rarely positive in the absence of disseminated disease. Detection of CrAg from respiratory specimens might assist the diagnosis of pulmonary cryptococcosis but there are very few data. Molecular detection techniques such as multiplex reverse transcription polymerase chain reaction (RT-PCR) could also provide better sensitivity but these still require validation for respiratory specimens. The first line of treatment for pulmonary cryptococcosis is fluconazole, or amphotericin B and flucytosine for those with central nervous system involvement. Pulmonary cryptococcosis worsens the prognosis of cryptococcal meningitis. In this review, we summarize the biological aspects of Cryptococcus and provide an update on the diagnosis and management of pulmonary cryptococcosis.
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Affiliation(s)
- Findra Setianingrum
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Parasitology Department, Universitas Indonesia, Jakarta, Indonesia
| | - Riina Rautemaa-Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Mycology Reference Centre Manchester, ECMM Centre of Excellence in Clinical and Laboratory Mycology and Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Department of Infectious Diseases, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
| | - David W Denning
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Department of Infectious Diseases, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
- National Aspergillosis Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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114
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Schmertmann LJ, Irinyi L, Malik R, Powell JR, Meyer W, Krockenberger MB. The mycobiome of Australian tree hollows in relation to the Cryptococcus gattii and C. neoformans species complexes. Ecol Evol 2019; 9:9684-9700. [PMID: 31534685 PMCID: PMC6745847 DOI: 10.1002/ece3.5498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/26/2022] Open
Abstract
Cryptococcosis is a fungal infection caused by members of the Cryptococcus gattii and C. neoformans species complexes. The C. gattii species complex has a strong environmental association with eucalypt hollows (particularly Eucalyptus camaldulensis), which may present a source of infection. It remains unclear whether a specific mycobiome is required to support its environmental survival and growth. Conventional detection of environmental Cryptococcus spp. involves culture on differential media, such as Guizotia abyssinica seed agar. Next-generation sequencing (NGS)-based culture-independent identification aids in contextualising these species in the environmental mycobiome. Samples from 23 Australian tree hollows were subjected to both culture- and amplicon-based metagenomic analysis to characterize the mycobiome and assess relationships between Cryptococcus spp. and other fungal taxa. The most abundant genera detected were Coniochaeta, Aspergillus, and Penicillium, all being commonly isolated from decaying wood. There was no correlation between the presence of Cryptococcus spp. in a tree hollow and the presence of any other fungal genus. Some differences in the abundance of numerous taxa were noted in a differential heat tree comparing samples with or without Cryptococcus-NGS reads. The study expanded the known environmental niche of the C. gattii and C. neoformans species complexes in Australia with detections from a further five tree species. Discrepancies between the detection of Cryptococcus spp. using culture or NGS suggest that neither is superior per se and that, rather, these methodologies are complementary. The inherent biases of amplicon-based metagenomics require cautious interpretation of data through consideration of its biological relevance.
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Affiliation(s)
- Laura J. Schmertmann
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Richard Malik
- Centre for Veterinary Education, Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
| | - Jeff R. Powell
- Hawkesbury Institute for the EnvironmentWestern Sydney UniversityPenrithNSWAustralia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Mark B. Krockenberger
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
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115
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Hurst S, Lysen C, Cooksey G, Vugia DJ, Litvintseva AP, Lockhart SR. Molecular typing of clinical and environmental isolates of Cryptococcus gattii species complex from southern California, United States. Mycoses 2019; 62:1029-1034. [PMID: 31376185 DOI: 10.1111/myc.12980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Two species complexes (SC) cause the majority of human Cryptococcus infections: Cryptococcus neoformans SC and Cryptococcus gattii SC. Infection is typically thought to be acquired following environmental exposure. In an urban setting, parks and other public spaces are a likely source of contact with C. gattii SC. OBJECTIVES The goals of this study were to describe the genetic diversity of C. gattii SC in the California environment, to determine the extent of environmental exposure in publicly accessed areas and to correlate the genotypes of environmental C. gattii SC isolates with those from patients in southern California. METHODS Specimens from trees and soil from 13 parks and public areas of seven California counties were examined for C. gattii SC isolates. Isolates were sequence typed and compared to sequence types from human clinical isolates from the same area. RESULTS Multilocus sequence typing identified C. gattii sensu stricto (VGI molecular type) as well as Cryptococcus bacillisporus (VGIII molecular type). Several C. bacillisporus but none of the C. gattii sensu stricto isolates shared sequence types with human clinical isolates from southern California. CONCLUSIONS C. gattii SC colonies exist in some California public parks. The presence of identical STs in environmental and human isolates of C. bacillisporus is suggestive of an arboreal origin of human infections. Two new tree species were documented as hosts for C. gattii SC in California, adding to the four species previously identified.
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Affiliation(s)
- Steven Hurst
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Colleen Lysen
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gail Cooksey
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Duc J Vugia
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | | | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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116
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Selb R, Fuchs V, Graf B, Hamprecht A, Hogardt M, Sedlacek L, Schwarz R, Idelevich EA, Becker SL, Held J, Küpper-Tetzel CP, McCormick-Smith I, Heckmann D, Gerkrath J, Han CO, Wilmes D, Rickerts V. Molecular typing and in vitro resistance of Cryptococcus neoformans clinical isolates obtained in Germany between 2011 and 2017. Int J Med Microbiol 2019; 309:151336. [PMID: 31444102 DOI: 10.1016/j.ijmm.2019.151336] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/05/2019] [Accepted: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
Cryptococcosis is a fungal infection of the central nervous system predominantly caused by Cryptococcus neoformans in immunocompromised patients. In several countries worldwide, up to 50% of isolates show in vitro resistance to clinically used antifungals including fluconazole. No prospective data on susceptibility to antifungal drugs are available for Germany. In this study, we characterised all C. neoformans isolates collected from individual patients' samples at the German reference laboratory for cryptococcosis 2011 and 2017 (n = 133) by multi-locus sequence typing and phenotypic drug susceptibility testing. We identified serotype A/genotype VNI isolates belonging to clonal complexes previously described from Europe, Africa, Asia and South America as the most prevalent agents of cryptococcosis in Germany. Overall, we observed minimal inhibitory concentrations (MICs) above the epidemiological cut-offs (ECVs) in 1.6% of isolates regarding fluconazole and 2.3% of isolates regarding 5-flucytosine. Here, two C. neoformans var. grubii isolates displayed decreased drug susceptibility to fluconazole, one of them additionally to 5-flucytosine. We also found 5-flucytosine MICs above the ECV for two C. neoformans var. neoformans isolates. We identified a novel mutation in the ERG11 gene which might be associated with the elevated fluconazole MIC in one of the isolates. The clinical importance of the detected in vitro resistance is documented by patient histories showing relapsed infection or primary fatal disease. Of note, sertraline demonstrated antifungal activity comparable to previous reports. Systematic collection of susceptibility data in combination with molecular typing of C. neoformans is important to comprehensively assess the spread of isolates and to understand their drug resistance patterns.
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Affiliation(s)
- Regina Selb
- European Public Health Microbiology Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Vidmante Fuchs
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Barbara Graf
- Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Axel Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany
| | - Michael Hogardt
- Institute of Medical Microbiology and Infection Control, Goethe University Hospital, Frankfurt/Main, Germany
| | - Ludwig Sedlacek
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Roman Schwarz
- MVZ Dr. Stein and colleagues, Moenchengladbach, Germany
| | - Evgeny A Idelevich
- Institute of Medical Microbiology, University Hospital Muenster, Muenster, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Jürgen Held
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Claus P Küpper-Tetzel
- Medical Department II, Infectious Diseases Unit, Goethe-University Hospital Frankfurt, Frankfurt, Germany
| | - Ilka McCormick-Smith
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Daniela Heckmann
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Jasmin Gerkrath
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Chang-Ok Han
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Dunja Wilmes
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany
| | - Volker Rickerts
- Department of Infectious Diseases, Unit for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Berlin, Germany.
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117
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Marcelino VR, Irinyi L, Eden JS, Meyer W, Holmes EC, Sorrell TC. Metatranscriptomics as a tool to identify fungal species and subspecies in mixed communities - a proof of concept under laboratory conditions. IMA Fungus 2019; 10:12. [PMID: 32355612 PMCID: PMC7184889 DOI: 10.1186/s43008-019-0012-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/21/2022] Open
Abstract
High-throughput sequencing (HTS) enables the generation of large amounts of genome sequence data at a reasonable cost. Organisms in mixed microbial communities can now be sequenced and identified in a culture-independent way, usually using amplicon sequencing of a DNA barcode. Bulk RNA-seq (metatranscriptomics) has several advantages over DNA-based amplicon sequencing: it is less susceptible to amplification biases, it captures only living organisms, and it enables a larger set of genes to be used for taxonomic identification. Using a model mock community comprising 17 fungal isolates, we evaluated whether metatranscriptomics can accurately identify fungal species and subspecies in mixed communities. Overall, 72.9% of the RNA transcripts were classified, from which the vast majority (99.5%) were correctly identified at the species level. Of the 15 species sequenced, 13 were retrieved and identified correctly. We also detected strain-level variation within the Cryptococcus species complexes: 99.3% of transcripts assigned to Cryptococcus were classified as one of the four strains used in the mock community. Laboratory contaminants and/or misclassifications were diverse, but represented only 0.44% of the transcripts. Hence, these results show that it is possible to obtain accurate species- and strain-level fungal identification from metatranscriptome data as long as taxa identified at low abundance are discarded to avoid false-positives derived from contamination or misclassifications. This study highlights both the advantages and current challenges in the application of metatranscriptomics in clinical mycology and ecological studies.
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Affiliation(s)
- Vanesa R Marcelino
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW 2145 Australia.,4School of Life & Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
| | - Laszlo Irinyi
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW 2145 Australia
| | - John-Sebastian Eden
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW 2145 Australia
| | - Wieland Meyer
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW 2145 Australia.,3Westmead Hospital (Research and Education Network), Westmead, NSW 2145 Australia
| | - Edward C Holmes
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,4School of Life & Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
| | - Tania C Sorrell
- 1Marie Bashir Institute for Infectious Diseases and Biosecurity and Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, The University of Sydney, Sydney, NSW 2006 Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW 2145 Australia
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118
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Schmertmann LJ, Bodley K, Meyer W, Malik R, Krockenberger MB. Multi-locus sequence typing as a tool to investigate environmental sources of infection for cryptococcosis in captive birds. Med Mycol 2019; 57:653-657. [PMID: 30329084 DOI: 10.1093/mmy/myy098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/27/2018] [Accepted: 10/05/2018] [Indexed: 11/12/2022] Open
Abstract
A systematic investigation into environmental sources of infection was conducted at an Australian zoological park after cryptococcosis, caused by Cryptococcus gattii VGI, was diagnosed in a red-tailed black cockatoo (Calyptorhynchus banksii) residing in a large aviary with a diverse range of other avian species. A single tree with an extensive hollow was identified as the likely source of infection based on heavy culture of C. gattii VGI, multi-locus sequence typing and phylogenetic analysis of environmental and disease-related isolates. This led to the careful removal of the tree to reduce the risk of future cases of cryptococcosis in this aviary.
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Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, The University of Sydney - Westmead Clinical School, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Kate Bodley
- Zoos Victoria, Parkville, Victoria, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, The University of Sydney - Westmead Clinical School, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark B Krockenberger
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
- Veterinary Pathology Diagnostic Services, B14, The University of Sydney, Sydney, New South Wales, Australia 2006
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119
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Thanh LT, Phan TH, Rattanavong S, Nguyen TM, Duong AV, Dacon C, Hoang TN, Nguyen LPH, Tran CTH, Davong V, Nguyen CVV, Thwaites GE, Boni MF, Dance D, Ashton PM, Day JN. Multilocus sequence typing of Cryptococcus neoformans var. grubii from Laos in a regional and global context. Med Mycol 2019; 57:557-565. [PMID: 30339200 PMCID: PMC6581559 DOI: 10.1093/mmy/myy105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 12/21/2022] Open
Abstract
Cryptococcosis causes approximately 180 000 deaths each year in patients with human immunodeficiency virus (HIV). Patients with other forms of immunosuppression are also at risk, and disease is increasingly recognized in apparently immunocompetent individuals. Cryptococcus neoformans var. grubii, responsible for the majority of cases, is distributed globally. We used the consensus ISHAM Multilocus sequence typing (MLST) scheme to define the population structure of clinical C. neoformans var. grubii isolates from Laos (n = 81), which we placed into the global context using published MLST data from other countries (total N = 1047), including a reanalysis of 136 Vietnamese isolates previously reported. We observed a phylogeographical relationship in which the Laotian population was similar to its neighbor Thailand, being dominated (83%) by Sequence Types (ST) 4 and 6. This phylogeographical structure changed moving eastwards, with Vietnam's population consisting of an admixture of isolates dominated by the ST4/ST6 (35%) and ST5 (48%) lineages. The ST5 lineage is the predominant ST reported from China and East Asia, where it accounts for >90% of isolates. Analysis of genetic distance (Fst) between different populations of C. neoformans var. grubii supports this intermediate structure of the Vietnamese population. The pathogen and host diversity reported from Vietnam provide the strongest epidemiological evidence of the association between ST5 and HIV-uninfected patients. Regional anthropological genetic distances suggest diversity in the C. neoformans var. grubii population across Southeast Asia is driven by ecological rather than human host factors. Where the ST5 lineage is present, disease in HIV-uninfected patients is to be expected.
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Affiliation(s)
| | | | - Sayaphet Rattanavong
- Laos-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Lao People's Democratic Republic
| | | | | | - Cherrelle Dacon
- Sir William Dunn School of Pathology, University of Oxford, UK
| | | | - Lan Phu Huong Nguyen
- Oxford University Clinical Research Unit, Vietnam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Viengmon Davong
- Laos-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Lao People's Democratic Republic
| | | | - Guy E Thwaites
- Oxford University Clinical Research Unit, Vietnam
- Nuffield Department of Medicine, Oxford University, UK
| | - Maciej F Boni
- Nuffield Department of Medicine, Oxford University, UK
- Department of Biology, Pennsylvania State University, USA
| | - David Dance
- Laos-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Lao People's Democratic Republic
- Nuffield Department of Medicine, Oxford University, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Jeremy N Day
- Oxford University Clinical Research Unit, Vietnam
- Nuffield Department of Medicine, Oxford University, UK
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Abstract
Cryptococcus gattii molecular type VGII is one of the etiologic agents of cryptococcosis, a systemic mycosis affecting a wide range of host species. Koalas (Phascolarctos cinereus) exhibit a comparatively high prevalence of cryptococcosis (clinical and subclinical) and nasal colonization, particularly in captivity. In Australia, disease associated with C. gattii VGII is typically confined to Western Australia and the Northern Territory (with sporadic cases reported in eastern Australia), occupying an enigmatic ecologic niche. A cluster of cryptococcosis in captive koalas in eastern Australia (five confirmed cases, a further two suspected), caused predominantly by C. gattii VGII, was investigated by surveying for subclinical disease, culturing koala nasal swabs and environmental samples, and genotyping cryptococcal isolates. URA5 restriction fragment length polymorphism analysis, multilocus sequence typing (MLST), and whole-genome sequencing (WGS) provided supportive evidence that the transfer of koalas from Western Australia and subsequently between several facilities in Queensland spread VGII into uncontaminated environments and environments in which C. gattii VGI was endemic. MLST identified VGII isolates as predominantly sequence type 7, while WGS further confirmed a limited genomic diversity and revealed a basal relationship with isolates from Western Australia. We hypothesize that this represents a founder effect following the introduction of a koala from Western Australia. Our findings suggest a possible competitive advantage for C. gattii VGII over VGI in the context of this captive koala environment. The ability of koalas to seed C. gattii VGII into new environments has implications for the management of captive populations and movements of koalas between zoos.IMPORTANCE Cryptococcus gattii molecular type VGII is one of the causes of cryptococcosis, a severe fungal disease that is acquired from the environment and affects many host species (including humans and koalas). In Australia, disease caused by C. gattii VGII is largely confined to western and central northern parts of the country, with sporadic cases reported in eastern Australia. We investigated an unusual case cluster of cryptococcosis, caused predominantly by C. gattii VGII, in a group of captive koalas in eastern Australia. This research identified that the movements of koalas between wildlife parks, including an initial transfer of a koala from Western Australia, introduced and subsequently spread C. gattii VGII in this captive environment. The spread of this pathogen by koalas could also impact other species, and these findings are significant in the implications they have for the management of koala transfers and captive environments.
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121
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Ceballos-Garzón A, Cortes G, Morio F, Zamora-Cruz EL, Linares MY, Ariza BE, Valderrama SL, Garzón JR, Alvarez-Moreno CA, Le Pape P, Parra-Giraldo CM. Comparison between MALDI-TOF MS and MicroScan in the identification of emerging and multidrug resistant yeasts in a fourth-level hospital in Bogotá, Colombia. BMC Microbiol 2019; 19:106. [PMID: 31122184 PMCID: PMC6533654 DOI: 10.1186/s12866-019-1482-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/07/2019] [Indexed: 02/07/2023] Open
Abstract
Background The introduction of MALDI-TOF MS in the clinical microbiology laboratory has modified the approaches for the identification of fungi. Thanks to this tool, it is possible to identify cryptic species, which possess critical susceptibility patterns. Clinical strains were identified using the MicroScan and MALDI-TOF MS systems. Discrepant results from both methods were investigated using ITS rDNA barcoding. Finally, these isolates were also tested for in vitro susceptibility. Results The percentage of agreement between both methods to 498 yeast isolates was of 93.6% (32 discrepant isolates). The concordance of ITS sequencing with MALDI-TOF MS was higher (99%) than that of MicroScan (94%). Several of these discordant yeasts displayed high MICs for antifungal agents. Conclusions Our study highlights the need of the MS and molecular approaches such as MALDI-TOF MS and ITS rDNA barcoding for the correct identification of emerging or cryptic yeast species; besides, some of these could be multidrug resistant. This work was the first experience in the implementation of the MALDI-TOF MS technology in Colombia. We found the first uncommon yeasts including Candida auris and we could identify Trichosporon faecalis. Our work highlights a clear necessity of an accurate yeast identification as a much more pertinent technique than the susceptibility profiles, because the most unusual yeasts exhibit resistance profiles to the few available antifungals.
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Affiliation(s)
- Andrés Ceballos-Garzón
- Departamento de Microbiología, Facultad de Ciencias, Unidad de Proteomica y Micosis Humanas, Grupo de Enfermedades Infecciosas, Pontificia Universidad Javeriana, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia.,Department of Parasitology and Medical Mycology of the University of Nantes, Nantes Atlantique Universities, Faculty of Pharmacy, Nantes, France
| | - Gloria Cortes
- Laboratorio Clínico, Área de Microbiología, Hospital Universitario San Ignacio, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Florent Morio
- Department of Parasitology and Medical Mycology of the University of Nantes, Nantes Atlantique Universities, Faculty of Pharmacy, Nantes, France
| | - Edna L Zamora-Cruz
- Departamento de Microbiología, Facultad de Ciencias, Unidad de Proteomica y Micosis Humanas, Grupo de Enfermedades Infecciosas, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Melva Y Linares
- Departamento de Microbiología, Facultad de Ciencias, Unidad de Proteomica y Micosis Humanas, Grupo de Enfermedades Infecciosas, Pontificia Universidad Javeriana, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Beatriz E Ariza
- Laboratorio Clínico, Área de Microbiología, Hospital Universitario San Ignacio, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Sandra L Valderrama
- Unidad de Infectología, Departamento de Medicina Interna, Facultad de Medicina, Hospital Universitario San Ignacio, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Javier R Garzón
- Unidad de Infectología, Departamento de Medicina Interna, Facultad de Medicina, Hospital Universitario San Ignacio, Bogotá, Colombia.,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Carlos A Alvarez-Moreno
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Patrice Le Pape
- Department of Parasitology and Medical Mycology of the University of Nantes, Nantes Atlantique Universities, Faculty of Pharmacy, Nantes, France
| | - Claudia M Parra-Giraldo
- Departamento de Microbiología, Facultad de Ciencias, Unidad de Proteomica y Micosis Humanas, Grupo de Enfermedades Infecciosas, Pontificia Universidad Javeriana, Bogotá, Colombia. .,Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia.
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122
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Hurtado JC, Castillo P, Fernandes F, Navarro M, Lovane L, Casas I, Quintó L, Marco F, Jordao D, Ismail MR, Lorenzoni C, Martinez-Palhares AE, Ferreira L, Lacerda M, Monteiro W, Sanz A, Letang E, Marimon L, Jesri S, Cossa A, Mandomando I, Vila J, Bassat Q, Ordi J, Menéndez C, Carrilho C, Martínez MJ. Mortality due to Cryptococcus neoformans and Cryptococcus gattii in low-income settings: an autopsy study. Sci Rep 2019; 9:7493. [PMID: 31097746 PMCID: PMC6522501 DOI: 10.1038/s41598-019-43941-w] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/03/2019] [Indexed: 01/14/2023] Open
Abstract
Cryptococcosis is a major opportunistic infection and is one of the leading causes of death in adults living with HIV in sub-Saharan Africa. Recent estimates indicate that more than 130,000 people may die annually of cryptococcal meningitis in this region. Although complete diagnostic autopsy (CDA) is considered the gold standard for determining the cause of death, it is seldom performed in low income settings. In this study, a CDA was performed in 284 deceased patients from Mozambique (n = 223) and Brazil (n = 61). In depth histopathological and microbiological analyses were carried out in all cases dying of cryptococcosis. We determined the cryptococcal species, the molecular and sero-mating types and antifungal susceptibility. We also described the organs affected and reviewed the clinical presentation and patient management. Among the 284 cases included, 17 fatal cryptococcal infections were diagnosed. Cryptococcus was responsible for 16 deaths among the 163 HIV-positive patients (10%; 95%CI: 6-15%), including four maternal deaths. One third of the cases corresponded to C. gattii (VGI and VGIV molecular types, Bα and Cα strains) and the remaining infections typed were caused by C. neoformans var. Grubii (all VNI and Aα strains). The level of pre-mortem clinical suspicion was low (7/17, 41%), and 7/17 patients (41%) died within the first 72 hours of admission. Cryptococcosis was responsible for a significant proportion of AIDS-related mortality. The clinical diagnosis and patient management were inadequate, supporting the need for cryptococcal screening for early detection of the disease. This is the first report of the presence of C. gattii infection in Mozambique.
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Affiliation(s)
- Juan Carlos Hurtado
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Paola Castillo
- Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Fabiola Fernandes
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Mireia Navarro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Lucilia Lovane
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Isaac Casas
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Llorenç Quintó
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Francesc Marco
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Dercio Jordao
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Mamudo R Ismail
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Cesaltina Lorenzoni
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | | | - Luiz Ferreira
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado, Manaus, Amazonas, Brazil
| | - Marcus Lacerda
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado, Manaus, Amazonas, Brazil.,Instituto de Pesquisas Leônidas & Maria Deane, Fiocruz, Manaus, Brazil
| | - Wuelton Monteiro
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado, Manaus, Amazonas, Brazil
| | - Ariadna Sanz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Emilio Letang
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Hospital del Mar. Service of Infectious Diseases, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Lorena Marimon
- Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Susan Jesri
- Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Jordi Vila
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ICREA, Catalan Institution for Research and Advanced Studies, Pg. Lluís Companys 23, 08010, Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
| | - Jaume Ordi
- Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carla Carrilho
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Miguel J Martínez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. .,Department of Microbiology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.
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123
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Firacative C, Torres G, Meyer W, Escandón P. Clonal Dispersal of Cryptococcus gattii VGII in an Endemic Region of Cryptococcosis in Colombia. J Fungi (Basel) 2019; 5:jof5020032. [PMID: 30991682 PMCID: PMC6616963 DOI: 10.3390/jof5020032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 12/15/2022] Open
Abstract
This study characterized the genotype and phenotype of Cryptococcus gattii VGII isolates from Cucuta, an endemic region of cryptococcal disease in Colombia, and compared these traits with those from representative isolates from the Vancouver Island outbreak (VGIIa and VGIIb). Genetic diversity was assessed by multilocus sequence typing (MLST) analysis. Phenotypic characteristics, including growth capacity under different temperature and humidity conditions, macroscopic and microscopic morphology, phenotypic switching, mating type, and activity of extracellular enzymes were studied. Virulence was studied in vivo in a mouse model. MLST analysis showed that the isolates from Cucuta were highly clonal, with ST25 being the most common genotype. Phenotypically, isolates from Cucuta showed large cell and capsular sizes, and shared phenotypic traits and enzymatic activities among them. The mating type a prevailed among the isolates, which were fertile and of considerable virulence in the animal model. This study highlights the need for a continuous surveillance of C. gattii in Colombia, especially in endemic areas like Cucuta, where the highest number of cryptococcosis cases due to this species is reported. This will allow the early detection of potentially highly virulent strains that spread clonally, and can help prevent the occurrence of outbreaks in Colombia and elsewhere.
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Affiliation(s)
- Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia.
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Hospital (Research and Education Network), Westmead Institute for Medical Research, Westmead, NSW 2145, Australia.
| | - Germán Torres
- Microbiology Group, Instituto Nacional de Salud, Bogota 11321, Colombia.
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Hospital (Research and Education Network), Westmead Institute for Medical Research, Westmead, NSW 2145, Australia.
| | - Patricia Escandón
- Microbiology Group, Instituto Nacional de Salud, Bogota 11321, Colombia.
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124
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Florek M, Król J, Woźniak-Biel A. Atypical URA5 gene restriction fragment length polymorphism banding profile in Cryptococcus neoformans strains. Folia Microbiol (Praha) 2019; 64:857-860. [PMID: 30963417 PMCID: PMC6861435 DOI: 10.1007/s12223-019-00699-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/14/2019] [Indexed: 12/24/2022]
Abstract
URA5-RFLP is one of the most widely used genotyping methods relating to Cryptococcus neoformans and C. gattii consensus genotype nomenclature. In order to identify a molecular type, this method uses a visual comparison of digested PCR products of tested and reference strains, therefore any anomaly in RFLP patterns of studied isolates makes recognition difficult or impossible. This report describes a strain of VNIV type showing an atypical URA5-RFLP pattern as well as a group of AD hybrids displaying the same anomaly. The atypical RFLP pattern is the result of a point mutation and emergence of a new restriction site. Emergence of the allele presenting a new banding pattern may lead to misidentification using the URA5-RFLP technique; the results of this study as well as the literature data may suggest the spread of the allele in the environment.
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Affiliation(s)
- Magdalena Florek
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland.
| | - Jarosław Król
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland
| | - Anna Woźniak-Biel
- Department of Epizootiology and Clinic of Birds and Exotic Animals, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, pl. Grunwaldzki 45, 50-366, Wrocław, Poland
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125
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Cogliati M, Andrianarivelo MR, Ellabib M, Nnadi EN, Cornet M. Molecular-Type Specific Multiplex PCR produces a distinct VNII PCR pattern among Cryptococcus neoformans species complex. Med Mycol 2019; 57:384-386. [PMID: 29762748 DOI: 10.1093/mmy/myy022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/26/2018] [Accepted: 04/04/2018] [Indexed: 01/08/2023] Open
Abstract
Prevalence of molecular type VNII among Cryptococcus neoformans species complex is probably underestimated since it can be distinguished from VNI only using molecular typing methods such as URA5-RFLP, AFLP, MLST, or whole genome sequencing. Previously, we described a multiplex polymerase chain reaction (PCR) method able to identify VNI, VNIV, and VNIII hybrids, but, at that time, VNII molecular type was not described yet. In this study, 16 VNII global isolates were analyzed by our multiplex PCR method, and results showed that it was able to produce a specific pattern for all the studied VNII isolates, which was different from those of VNI, VNIV, and VNIII.
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Affiliation(s)
- Massimo Cogliati
- Lab. Medical Mycology, Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | | | | | - Emmanuel N Nnadi
- Department of Microbiology, Plateau State University, Bokkos, Plateau State, Nigeria
| | - Muriel Cornet
- Université Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France
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126
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Cogliati M, Desnos-Ollivier M, McCormick-Smith I, Rickerts V, Ferreira-Paim K, Meyer W, Boekhout T, Hagen F, Theelen B, Inácio J, Alonso B, Colom MF, Trilles L, Montagna MT, De Donno A, Susever S, Ergin C, Velegraki A, Ellabib MS, Nardoni S, Macci C, Trovato L, Dipineto L, Akcaglar S, Mlinaric-Missoni E, Bertout S, Vencá ACF, Sampaio AC, Criseo G, Ranque S, Çerikçioğlu N, Marchese A, Vezzulli L, Ilkit M, Pasquale V, Polacheck I, Lockhart SR. Genotypes and population genetics of cryptococcus neoformans and cryptococcus gattii species complexes in Europe and the mediterranean area. Fungal Genet Biol 2019; 129:16-29. [PMID: 30953839 DOI: 10.1016/j.fgb.2019.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023]
Abstract
A total of 476 European isolates (310 Cryptococcus neoformans var. grubii, 150 C. neoformans var. neoformans, and 16 C. gattii species complex) from both clinical and environmental sources were analyzed by multi-locus sequence typing. Phylogenetic and population genetic analyses were performed. Sequence analysis identified 74 sequence types among C. neoformans var. neoformans (VNIV), 65 among C. neoformans var. grubii (56 VNI, 8 VNII, 1 VNB), and 5 among the C. gattii species complex (4 VGI and 1 VGIV) isolates. ST23 was the most frequent genotype (22%) among VNI isolates which were mostly grouped in a large clonal cluster including 50% of isolates. Among VNIV isolates, a predominant genotype was not identified. A high percentage of autochthonous STs were identified in both VNI (71%) and VNIV (96%) group of isolates. The 16 European C. gattii species complex isolates analyzed in the present study originated all from the environment and all belonged to a large cluster endemic in the Mediterranean area. Population genetic analysis confirmed that VNI group of isolates were characterized by low variability and clonal expansion while VNIV by a higher variability and a number of recombination events. However, when VNI and VNIV environmental isolates were compared, they showed a similar population structure with a high percentage of shared mutations and the absence of fixed mutations. Also linkage disequilibrium analysis reveals differences between clinical and environmental isolates showing a key role of PLB1 allele combinations in host infection as well as the key role of LAC1 allele combinations for survival of the fungus in the environment. The present study shows that genetic comparison of clinical and environmental isolates represents a first step to understand the genetic characteristics that cause the shift of some genotypes from a saprophytic to a parasitic life style.
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Affiliation(s)
- Massimo Cogliati
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
| | - Marie Desnos-Ollivier
- Institut Pasteur, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungal, CNRS UMR2000, Paris, France
| | | | | | - Kennio Ferreira-Paim
- Molecular Mycology Research Laboratory, Center for Infectious Diseases, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Marie Bashier Institute for Emerging Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital, (Research and Educational Network) Westmead Institute for Medical Research, Westmead, NSW, Australia; Department of Microbiology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Center for Infectious Diseases, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Marie Bashier Institute for Emerging Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital, (Research and Educational Network) Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; Institute of Biodiversity and Ecosystem Dynamic (IBED), University of Amsterdam, Amsterdam, the Netherlands
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Joäo Inácio
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Beatriz Alonso
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK; Instituto de Investigación Sanitaria Gregorio Marañón (IisGM), Hospital Gegorio Marañón, Madrid, Spain
| | | | | | | | | | | | | | - Aristea Velegraki
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Cristina Macci
- National Research Council, Research Institute on Terrestrial Ecosystems (IRET), Pisa, Italy
| | | | | | | | | | - Sebastien Bertout
- Unité Mixte Internationale "Recherches Translationnelles sur l'infection à VIH et les Maladies Infectieuses", Université de Montpellier, Montpellier, France
| | - Ana C F Vencá
- Instituto de Higiene e Medicina Tropical, Lisbon, Portugal
| | - Ana C Sampaio
- Universidade de Trás-os-Montes e Alto Douro, CITAB, Quinta dos Prados, Vila Real, Portugal
| | - Giuseppe Criseo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Stéphane Ranque
- Aix-Marseille University, IRD, APHM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | | | - Anna Marchese
- Sezione di Microbiologia del DISC, Università di Genova-IRCCS Policlinico San Martino Genova, Genova, Italy
| | - Luigi Vezzulli
- Dipartimento di Scienze della Terra, dell'Ambiente e della Vita (DISTAV), Università di Genova, Genova, Italy
| | - Macit Ilkit
- University of Çukurova Sarıçam, Adana, Turkey
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127
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Berejnoi A, Taverna CG, Mazza M, Vivot M, Isla G, Córdoba S, Davel G. First case report of cryptococcosis due to Cryptococcus decagattii in a pediatric patient in Argentina. Rev Soc Bras Med Trop 2019; 52:e20180419. [PMID: 30942260 DOI: 10.1590/0037-8682-0419-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/17/2018] [Indexed: 12/23/2022] Open
Abstract
We report the first case of cryptococcosis due to Cryptococcus decagattii in an immunocompetent pediatric patient from an indigenous community in Argentina with a successful outcome. Two isolates (blood, cerebrospinal fluid) were genotyped by restriction fragment length polymorphism of the orotidine monophosphate pyrophosphorylase (URA5) gene as VGIV and identified by multi-locus sequence typing as C. decagattii. Matrix-assisted laser desorption/ionization time of flight mass spectrometry identification indicated genotype VGIII. The minimum inhibitory concentration of amphotericin B, fluconazole, itraconazole, and voriconazole was determined (cerebrospinal fluid: 0.25, 16, 0.12, and 0.12, blood: 0.25, 4, 0.12, and 0.06, respectively, all in mg/L).
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Affiliation(s)
- Ana Berejnoi
- Hospital Público Materno Infantil, Salta, Argentina
| | - Constanza Giselle Taverna
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Mazza
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
| | - Matías Vivot
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
| | - Guillermina Isla
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
| | - Susana Córdoba
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela Davel
- Departamento Micología, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. Carlos G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Ciudad Autónoma de Buenos Aires, Argentina
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128
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Cryptococcus gattii VGII isolated from native forest and river in Northern Brazil. Braz J Microbiol 2019; 50:495-500. [PMID: 30852797 DOI: 10.1007/s42770-019-00066-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/07/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. In the northern region of Brazil, this disease is caused by Cryptococcus neoformans genotype VNI and Cryptococcus gattii genotype VGII. However, few environmental studies have been conducted in this large tropical area. AIMS This study was performed to isolate, genotype, and determine the frequency of cryptococcal agents in environmental samples near Manaus, Amazonas, Brazil. METHODS A total of 970 environmental samples (290 from soil, 290 from decaying plants, 5 from insects, 280 from the Negro river, and 105 from small streams within the city of Manaus) were collected and plated on Niger seed agar. In addition, 20 sub-cultures obtained from each positive sample were analyzed by PCR-RFLP (URA5) and PCR for genotyping and determination of mating type. RESULTS Six samples were positive for isolates from the C. gattii species complex. Of those, three samples were from Adolpho Ducke Forest Reserve and three were from the Negro river. All isolates were C. gattii genotype VGII (mating type MATα). CONCLUSION Genotype VGII proved to be the most important genotype found in the environmental samples. The genotype VGII has been described as one of the most virulent and less susceptible to antifungals and responsible for important outbreaks. This is the first study to demonstrate isolation of C. gattii (VGII) from the Negro river.
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Maruyama FH, de Paula DAJ, Menezes IDG, Favalessa OC, Hahn RC, de Almeida ADBPF, Sousa VRF, Nakazato L, Dutra V. Genetic Diversity of the Cryptococcus gattii Species Complex in Mato Grosso State, Brazil. Mycopathologia 2019; 184:45-51. [PMID: 30627957 DOI: 10.1007/s11046-018-0313-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Abstract
Cryptococcosis is caused by fungi of the genus Cryptococcus. Owing to its importance, this study aimed to analyze the genetic diversity of C. gattii isolates from animals, humans, and the environment in Mato Grosso State (MT), Brazil, during November 2010-December 2017. All isolates of the C. gattii species complex were subjected to molecular genotyping via Restriction Fragment Length Polymorphism (PCR-RFLP) and Multi-locus Sequence Typing (MLST). PCR-RFLP analysis revealed that 21 isolates presented the genotype VGII, which is considered the most common and virulent genotype globally among. MLST analysis revealed the presence of 14 sequence types (STs), of which 5 are considered new genotypes. Clonal Complex (CC) CC182 (n = 5; 23,80%) and CC309 (n = 3; 14,28%) were the most frequent. CC distribution in relation to origin revealed that three CCs were found in animals with a predominance of CC182 (66,66%), while nine were found in humans, and two CCs were found in the environment. Extensive genetic variability was observed among the isolates in the State of Mato Grosso. STs belonging to the already described clonal complexes (CC) indicate the global expansion and adaptation of isolates in several other countries. Therefore, detection of clonal complexes and STs already described in other regions and the occurrence of new STs in the present study help further the current understanding of the geographic dispersion and genetic origin of the C. gattii species complex.
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Affiliation(s)
- Fernanda Harumi Maruyama
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil.
| | - Daphine Ariadne Jesus de Paula
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Isabela de Godoy Menezes
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Olívia Cometti Favalessa
- Postgraduate Course in Health Sciences, Department of Molecular Biology, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Rosane Christine Hahn
- Postgraduate Course in Health Sciences, Department of Molecular Biology, Federal University of Mato Grosso, Cuiabá, Brazil
| | | | - Valéria Régia Franco Sousa
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Luciano Nakazato
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Valéria Dutra
- Postgraduate Course in Veterinary Sciences, Department of Veterinary Sciences, Federal University of Mato Grosso, Cuiabá, Brazil
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130
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Meyer W, Arthur I, Ellis D, Kan A, Kidd S, Maszewska K, Weeks K. Australian medical mycology culture collections: fundamental resources for mycological diagnosis and research. MICROBIOLOGY AUSTRALIA 2019. [DOI: 10.1071/ma19035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Currently in Australia, there are four major medical mycology culture collections that form a close collaborative network. They provide fundamental resources for diagnosis and research and are part of the World Federation of Culture Collections.
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131
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Birkhead M, Naicker SD, Blasich NP, Rukasha I, Thomas J, Sriruttan C, Abrahams S, Mavuso GS, Govender NP. Cryptococcus neoformans: Diagnostic Dilemmas, Electron Microscopy and Capsular Variants. Trop Med Infect Dis 2018; 4:E1. [PMID: 30577542 PMCID: PMC6473520 DOI: 10.3390/tropicalmed4010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/16/2022] Open
Abstract
Two cases of cryptococcal meningitis went undetected by a cryptococcal antigen (CrAg) lateral flow assay on blood in a reflex CrAg screen-and-treat programme in South Africa, although Cryptococcus neoformans was identified by culturing the cerebrospinal fluid specimens. Further investigations into these discordant diagnostic results included multilocus sequence typing (which showed no mutations in the CAP59 gene) and transmission electron microscopy using a capsule-staining protocol (which revealed a >50% reduction in capsular material in both cases, relative to a control culture). A multi-disciplinary approach for resolving discordant diagnostic test results is recommended.
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Affiliation(s)
- Monica Birkhead
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
| | - Serisha D Naicker
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Nozuko P Blasich
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
| | - Ivy Rukasha
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
| | - Juno Thomas
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Charlotte Sriruttan
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Shareef Abrahams
- National Health Laboratory Service, Port Elizabeth Provincial Hospital, Cnr Buckingham & Eastbourne Road, Port Elizabeth 6001, South Africa.
| | - Grisselda S Mavuso
- National Health Laboratory Service, Tambo Memorial Hospital, Cnr Hospital & Railway Street, Boksburg 1459, South Africa.
| | - Nelesh P Govender
- National Institute for Communicable Diseases-a Division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2192, South Africa.
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
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132
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Wiederhold NP, Gibas CFC. From the Clinical Mycology Laboratory: New Species and Changes in Fungal Taxonomy and Nomenclature. J Fungi (Basel) 2018; 4:E138. [PMID: 30558386 PMCID: PMC6308937 DOI: 10.3390/jof4040138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022] Open
Abstract
Fungal taxonomy is the branch of mycology by which we classify and group fungi based on similarities or differences. Historically, this was done by morphologic characteristics and other phenotypic traits. However, with the advent of the molecular age in mycology, phylogenetic analysis based on DNA sequences has replaced these classic means for grouping related species. This, along with the abandonment of the dual nomenclature system, has led to a marked increase in the number of new species and reclassification of known species. Although these evaluations and changes are necessary to move the field forward, there is concern among medical mycologists that the rapidity by which fungal nomenclature is changing could cause confusion in the clinical literature. Thus, there is a proposal to allow medical mycologists to adopt changes in taxonomy and nomenclature at a slower pace. In this review, changes in the taxonomy and nomenclature of medically relevant fungi will be discussed along with the impact this may have on clinicians and patient care. Specific examples of changes and current controversies will also be given.
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Affiliation(s)
- Nathan P Wiederhold
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
| | - Connie F C Gibas
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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133
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Seyedmousavi S, Bosco SDMG, de Hoog S, Ebel F, Elad D, Gomes RR, Jacobsen ID, Jensen HE, Martel A, Mignon B, Pasmans F, Piecková E, Rodrigues AM, Singh K, Vicente VA, Wibbelt G, Wiederhold NP, Guillot J. Fungal infections in animals: a patchwork of different situations. Med Mycol 2018. [PMID: 29538732 DOI: 10.1093/mmy/myx104] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The importance of fungal infections in both human and animals has increased over the last decades. This article represents an overview of the different categories of fungal infections that can be encountered in animals originating from environmental sources without transmission to humans. In addition, the endemic infections with indirect transmission from the environment, the zoophilic fungal pathogens with near-direct transmission, the zoonotic fungi that can be directly transmitted from animals to humans, mycotoxicoses and antifungal resistance in animals will also be discussed. Opportunistic mycoses are responsible for a wide range of diseases from localized infections to fatal disseminated diseases, such as aspergillosis, mucormycosis, candidiasis, cryptococcosis and infections caused by melanized fungi. The amphibian fungal disease chytridiomycosis and the Bat White-nose syndrome are due to obligatory fungal pathogens. Zoonotic agents are naturally transmitted from vertebrate animals to humans and vice versa. The list of zoonotic fungal agents is limited but some species, like Microsporum canis and Sporothrix brasiliensis from cats, have a strong public health impact. Mycotoxins are defined as the chemicals of fungal origin being toxic for warm-blooded vertebrates. Intoxications by aflatoxins and ochratoxins represent a threat for both human and animal health. Resistance to antifungals can occur in different animal species that receive these drugs, although the true epidemiology of resistance in animals is unknown, and options to treat infections caused by resistant infections are limited.
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Affiliation(s)
- Seyedmojtaba Seyedmousavi
- Molecular Microbiology Section, Laboratory of Clinical Microbiology and Immunology (LCMI), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Sandra de M G Bosco
- Department of Microbiology and Immunology, Institute of Biosciences-UNESP Univ Estadual Paulista Botucatu, São Paulo, Brazil
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, and Center of Expertise in Mycology of Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Frank Ebel
- Institut für Infektionsmedizin und Zoonosen, Munich, Germany
| | - Daniel Elad
- Department of Clinical Bacteriology and Mycology, Kimron Veterinary Institute, Veterinary Services, Ministry of Agriculture, Beit Dagan, Israel
| | - Renata R Gomes
- Microbiology, Parasitology and Pathology Graduate Programme, Curitiba Department of Basic Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Ilse D Jacobsen
- Research Group Microbial Immunology, Hans Knöll Institute, Jena, Germany
| | | | - An Martel
- Department of Pathology, Bacteriology and Avian Diseases. Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Bernard Mignon
- Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, FARAH (Fundamental and Applied Research for Animals & Health), University of Liège, Liège, Belgium
| | - Frank Pasmans
- Department of Pathology, Bacteriology and Avian Diseases. Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elena Piecková
- Faculty of Medicine, Slovak Medical University, Faculty of Chemical and Food Technology, Slovak University of Technology, Bratislava, Slovakia
| | - Anderson Messias Rodrigues
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Karuna Singh
- Department of Zoology, Mahila Mahavidyalaya, Banaras Hindu University, Varanasi, India
| | - Vania A Vicente
- Research Group Microbial Immunology, Hans Knöll Institute, Jena, Germany
| | - Gudrun Wibbelt
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Nathan P Wiederhold
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jacques Guillot
- Department of Parasitology, Mycology and Dermatology, EA Dynamyc UPEC, EnvA, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France
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134
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Acheson ES, Galanis E, Bartlett K, Mak S, Klinkenberg B. Searching for clues for eighteen years: Deciphering the ecological determinants of Cryptococcus gattii on Vancouver Island, British Columbia. Med Mycol 2018; 56:129-144. [PMID: 28525610 DOI: 10.1093/mmy/myx037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 04/06/2017] [Indexed: 12/19/2022] Open
Abstract
Cryptococcus gattii emerged on Vancouver Island in 1999 for unknown reasons, causing human and animal fatalities and illness. The apparent emergence of this fungus in another temperate area, this time in the Pacific Northwest, suggests the fungus may have expanded its ecological niche. Yet studies that directly examine the potential roles of climatic and land use changes on C. gattii are still lacking. We aim to summarize the existing global literature on the ecology of C. gattii, with particular focus on the gap in knowledge surrounding the potential effects of climatic and land use changes. We systematically reviewed English peer-reviewed literature on the ecological determinants of C. gattii. We included studies published from January 1970 through June 2016 and identified 56 relevant studies for our review. We identified environmental isolations of C. gattii from 18 countries, spanning 72 separate regions across six continents. Fifty-three tree species were associated with C. gattii, spanning 10 climate classifications and 36 terrestrial ecoregions. No studies directly tested the potential effects of climatic changes (including climatic oscillations and global climate change) on C. gattii, while only one study directly assessed those of land use change. To improve model predictions of current and future distributions of C. gattii, more focus is needed on the potential effects of climatic and land use changes to help decrease the public health risk. The apparent emergence of C. gattii in British Columbia is also an opportunity to explore the factors behind emerging infectious diseases in Canada and elsewhere.
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Affiliation(s)
- Emily Sohanna Acheson
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
| | - Eleni Galanis
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Karen Bartlett
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Sunny Mak
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Brian Klinkenberg
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
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135
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Hong N, Chen M, Xu N, Al-Hatmi AMS, Zhang C, Pan WH, Hagen F, Boekhout T, Xu J, Zou XB, Liao WQ. Genotypic diversity and antifungal susceptibility of Cryptococcus neoformans isolates from paediatric patients in China. Mycoses 2018; 62:171-180. [PMID: 30341799 DOI: 10.1111/myc.12863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/20/2018] [Accepted: 10/14/2018] [Indexed: 12/11/2022]
Abstract
Cryptococcosis is a life-threatening mycosis primarily occurring in adult patients particularly those with immunosuppression such as HIV infection/AIDS. The number of reported cases of paediatric cryptococcosis has increased in the last decade around the world, including China. However, current information on the characteristics of cryptococcosis in children, particularly the genotypic diversity and antifungal susceptibility of the isolates, is limited. In the present study, a total of 25 paediatric isolates of Cryptococcus neoformans were genotyped using the ISHAM-MLST scheme. In vitro susceptibility to antifungal agents of the 22 isolates was tested using the CLSI M27-A3 method. Our analyses revealed that the genotypic diversity of C. neoformans isolates from Chinese paediatric patients was low, with ST 5 (80%) and ST 31 (12%) being the two major sequence types. Reduced susceptibility to fluconazole (FLU), 5-flucytosine (5-FC) and itraconazole (ITR) was observed among C. neoformans isolates from Chinese paediatric patients, particularly among the ST5 isolates, which was similar to observations made on C. neoformans isolates from Chinese adult patients. In addition, the majority of isolates (3/4, 75%) obtained from deceased patients showed decreased antifungal susceptibility, which indicates that further monitoring of antifungal susceptibility of Cryptococcus isolates is warranted in management of paediatric cryptococcosis.
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Affiliation(s)
- Nan Hong
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Min Chen
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Nan Xu
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Abdullah M S Al-Hatmi
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Centre of Expertise in Mycology, Radboud University Medical Centre/Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Ministry of Health, Directorate General of Health Services, Ibri, Oman
| | - Chao Zhang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wei H Pan
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ferry Hagen
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Teun Boekhout
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Department of Yeast and Basidiomycete Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
| | - Xian B Zou
- Department of Dermatology, First Affiliated Hospital of PLA General Hospital, Beijing, China
| | - Wan Q Liao
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Damasceno-Escoura AH, de Souza ML, de Oliveira Nunes F, Pardi TC, Gazotto FC, Florentino DH, Mora DJ, Silva-Vergara ML. Epidemiological, Clinical and Outcome Aspects of Patients with Cryptococcosis Caused by Cryptococcus gattii from a Non-endemic Area of Brazil. Mycopathologia 2018; 184:65-71. [PMID: 30415450 DOI: 10.1007/s11046-018-0304-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/19/2018] [Indexed: 11/28/2022]
Abstract
Cryptococcosis by Cryptococcus gattii occurs mainly in immunocompetent hosts, however, during the last decades, a growing number of cases in immunocompromised individuals have been noticed around the world. This report presents epidemiological, clinical and outcome aspects of patients with cryptococcosis caused by this species from a non-endemic area in Brazil. Of 278 Cryptococcus spp. clinical isolates recovered during the same period, 267 (96%) were molecularly identified as Cryptococcus neoformans VNI genotype and 11 (4%) as C. gattii VGII genotype by URA-5 RFLP. Of the 11 C. gattii patients, eight were male, mean age of 47.5 years. Of these, four were HIV-infected, one was kidney transplanted, one presented low CD4+ T cells values of unknown cause, another presented chronic liver disease meanwhile the remaining four were apparently immunocompetent. Disseminated disease and cryptococcal meningitis were present in four patients each. Most patients received amphotericin B plus fluconazole. Seven out of the 11 patients cured and four died before or during the therapy. The increased number of individuals with cryptococcosis by this species during the last decades needs to be carefully evaluated specially those who are HIV-infected. Nevertheless, Cryptococcus species differentiation is currently relevant in order to better know their relation with geographical, clinical host preference and outcome particularities.
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Affiliation(s)
- Alessandro Henrique Damasceno-Escoura
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Matheus Lucas de Souza
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Felipe de Oliveira Nunes
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Thiago César Pardi
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Fernanda Castro Gazotto
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Danilo Heitor Florentino
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Delio José Mora
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil
| | - Mario León Silva-Vergara
- Internal Medicine Department, Infectious Diseases Unit, Triângulo Mineiro Federal University, Medicina Tropical, Caixa Postal 118, Uberaba, Minas Gerais, CEP 38001-170, Brazil.
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137
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Phenotypic Variability Correlates with Clinical Outcome in Cryptococcus Isolates Obtained from Botswanan HIV/AIDS Patients. mBio 2018; 9:mBio.02016-18. [PMID: 30352938 PMCID: PMC6199498 DOI: 10.1128/mbio.02016-18] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pathogenic species of Cryptococcus cause hundreds of thousands of deaths annually. Considerable phenotypic variation is exhibited during infection, including increased capsule size, capsule shedding, giant cells (≥15 μm), and micro cells (≤1 μm). We examined 70 clinical isolates of Cryptococcus neoformans and Cryptococcus tetragattii from HIV/AIDS patients in Botswana to determine whether the capacity to produce morphological variants was associated with clinical parameters. Isolates were cultured under conditions designed to simulate in vivo stresses. Substantial variation was seen across morphological and clinical data. Giant cells were more common in C. tetragattii, while micro cells and shed capsule occurred in C. neoformans only. Phenotypic variables fell into two groups associated with differing symptoms. The production of "large" phenotypes (greater cell and capsule size and giant cells) was associated with higher CD4 count and was negatively correlated with intracranial pressure indicators, suggesting that these are induced in early stage infection. "Small" phenotypes (micro cells and shed capsule) were associated with lower CD4 counts, negatively correlated with meningeal inflammation indicators, and positively correlated with intracranial pressure indicators, suggesting that they are produced later during infection and may contribute to immune suppression and promote proliferation and dissemination. These trends persisted at the species level, indicating that they were not driven by association with particular Cryptococcus species. Isolates possessing giant cells, micro cells, and shed capsule were rare, but strikingly, they were associated with patient death (P = 0.0165). Our data indicate that pleomorphism is an important driver in Cryptococcus infection.IMPORTANCE Cryptococcosis results in hundreds of thousands of deaths annually, predominantly in sub-Saharan Africa. Cryptococcus is an encapsulated yeast, and during infection, cells have the capacity for substantial morphological changes, including capsule enlargement and shedding and variations in cell shape and size. In this study, we examined 70 Cryptococcus isolates causing meningitis in HIV/AIDS patients in Botswana in order to look for associations between phenotypic variation and clinical symptoms. Four variant phenotypes were seen across strains: giant cells of ≥15 µm, micro cells of ≤1 µm, shed extracellular capsule, and irregularly shaped cells. We found that "large" and "small" phenotypes were associated with differing disease symptoms, indicating that their production may be important during the disease process. Overall, our study indicates that Cryptococcus strains that can switch on cell types under different situations may be more able to sustain infection and resist the host response.
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138
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Genotypic Diversity Is Independent of Pathogenicity in Colombian Strains of Cryptococcus neoformans and Cryptococcus gattii in Galleria mellonella. J Fungi (Basel) 2018; 4:jof4030082. [PMID: 29976849 PMCID: PMC6162678 DOI: 10.3390/jof4030082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 12/15/2022] Open
Abstract
Cryptococcosis is a potentially fatal opportunistic mycosis that affects the lungs and central nervous system. It has been suggested that certain strains of C. neoformans/C. gattii may have the potential to be more virulent according to the molecular type. This study aims to investigate the association between virulence in the G. mellonella model and genotypic diversity of Colombian clinical and environmental isolates of C. neoformans/C. gattii. A total of 33 clinical and 12 environmental isolates were selected according to their geographical origin and sequence types (STs). Pathogenicity was determined using the G. mellonella model, and the cell and capsular size before and after inoculation was determined. For C. neoformans, virulence in G. mellonella revealed that death occurred on average on day 6 (p < 0.05) and that ST5C, 6C, 25C and 71C were the most virulent. In C. gattii, death occurred at 7.3 days (p < 0.05), and ST47C, 58C, 75A and 106C were the most virulent. Capsular size increased for both species after passage in G. mellonella. In conclusion, the pathogenicity of Cryptococcus strains in the G. mellonella invertebrate model is independent of molecular type or pathogenicity factor, even within the same ST, but it is possible to find variable degrees of pathogenicity.
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139
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Genetic Factors and Genotype-Environment Interactions Contribute to Variation in Melanin Production in the Fungal Pathogen Cryptococcus neoformans. Sci Rep 2018; 8:9824. [PMID: 29959391 PMCID: PMC6026209 DOI: 10.1038/s41598-018-27813-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/05/2018] [Indexed: 01/15/2023] Open
Abstract
Cryptococcosis is a common opportunistic fungal infection that often disseminates into the central nervous system, leading to meningitis. Production of melanin pigments during infections is one of the most important virulence factors of its causal agent, the human pathogenic yeast Cryptococcus neoformans species complex. However, almost nothing is known about the patterns of variation in melanin production among clinical and environmental strains and the potential effects of such variations on virulence. In this study, we assembled a global collection of C. neoformans var. neoformans strains and investigated their patterns of melanin variation and potential contributors to such variations. Our analyses revealed that genetic differences and genotype-environment interactions explained up to 59% and 43% of the population’s melanin variance respectively, depending on the tested environments. In comparison, environmental factors alone contributed relatively little to melanin variance. We also identified specific changes within the LAC1 gene, whose protein product catalyzes melanin synthesis, to be associated with variable melanin levels. This study provides fresh insights into the origin and evolution of virulence traits in fungal pathogens while highlighting the complex interplay between genetic and environmental factors that lead to phenotypic variance.
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140
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Rocha DFS, Cruz KS, Santos CSDS, Menescal LSF, Neto JRDS, Pinheiro SB, Silva LM, Trilles L, Braga de Souza JV. MLST reveals a clonal population structure for Cryptococcus neoformans molecular type VNI isolates from clinical sources in Amazonas, Northern-Brazil. PLoS One 2018; 13:e0197841. [PMID: 29883489 PMCID: PMC5993295 DOI: 10.1371/journal.pone.0197841] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 05/09/2018] [Indexed: 02/08/2023] Open
Abstract
Cryptococcosis is considered endemic in Amazonas state, occurring more frequently in individuals with AIDS, who are predominantly infected by Cryptococcus neoformans molecular type VNI. Infections by Cryptococcus gattii VGII predominate in immunocompetent hosts from the American continent and are associated with outbreaks in North America, particularly the subtypes VGIIa and VGIIb, which are also present in the Brazilian Amazon region. Despite few environmental studies, several aspects of the molecular epidemiology of this disease in Amazonas remain unclear, including the limited use of multilocus sequence typing (MLST) to evaluate the genetic population structure of clinical isolates, mainly C. neoformans. Therefore, we used MLST to identify the sequence types of 38 clinical isolates of C. neoformans VNI and C. gattii VGII and used phylogenetic analysis to evaluate their genetic relationship to global isolates. Records of 30 patients were analyzed to describe the current scenario of cryptococcosis in the region and their associations with the different subtypes. Broth microdilution was also performed to determine the susceptibility profile to the antifungals amphotericin B, fluconazole and itraconazole. MLST identified that patients with HIV (n = 26) were exclusively affected by VNI strains with ST93, and among the VGII strains (n = 4), three STs (ST5, ST172 and the new ST445) were identified. An in-hospital lethality of 54% was observed in the HIV group, and there were no significant differences in the clinical aspects of the disease between the HIV and non-HIV groups of patients. In addition, all isolates were susceptible to the antifungals tested. Therefore, in Amazonas state, VNI isolates are a genetically monotypic group, with ST93 being highly important in HIV individuals.
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Affiliation(s)
- Diego Fernando Silva Rocha
- Medical Mycology Laboratory, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Mycology Laboratory, Coordination of Society, Environment and Health of National Research Institute of Amazonia, Manaus, Amazonas, Brazil
| | - Katia Santana Cruz
- Medical Mycology Laboratory, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | | | - João Ricardo da Silva Neto
- Medical Mycology Laboratory, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Silviane Bezerra Pinheiro
- Mycology Laboratory, Coordination of Society, Environment and Health of National Research Institute of Amazonia, Manaus, Amazonas, Brazil
| | - Lucyane Mendes Silva
- Mycology Laboratory, Coordination of Society, Environment and Health of National Research Institute of Amazonia, Manaus, Amazonas, Brazil
| | - Luciana Trilles
- National Institute of Infectology Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro city, Rio de Janeiro, Brazil
| | - João Vicente Braga de Souza
- Mycology Laboratory, Coordination of Society, Environment and Health of National Research Institute of Amazonia, Manaus, Amazonas, Brazil
- * E-mail:
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141
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Dou H, Wang H, Xie S, Chen X, Xu Z, Xu Y. Molecular characterization of Cryptococcus neoformans isolated from the environment in Beijing, China. Med Mycol 2018; 55:737-747. [PMID: 28431114 DOI: 10.1093/mmy/myx026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
The molecular type of environmental Cryptococcus neoformans in Beijing was not clear. Our study aims to reveal the molecular characterization of C. neoformans complex from environment in Beijing, China. A total of 435 samples of pigeon droppings from 11 different homes in Beijing were collected from August to November in 2015. Pigeon droppings were inoculated onto caffeic acid cornmeal agar (CACA) to screen C. neoformans complex. Bruker Biotyper matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed for species identification. Serotype and mating type was determined by specific primers. Restriction fragment length polymorphisms of URA5 (URA5-RFLP) were applied to genotype. Multi-locus sequence typing (MLST) was done for further identification and sequence type (ST) determination. Altogether, 81 isolates of C. neoformans AFLP1/VNI were recognized from 435 pigeon droppings in this study. The positive rate for C. neoformans AFLP1/VNI from pigeon droppings in different homes varied from 5.0% to 52.6%, the average was 20.2%. All of these cryptococcal strains were serotype A, MATα. They were genotyped as VNI by URA5-RFLP and were confirmed by MLST. No other molecular types of C. neoformans and Cryptococcus gattii isolates were isolated. Their STs were identified as ST 31 (n = 54, 66.7%), followed by ST 53 (n = 10), ST 191 (n = 8), ST 5 (n = 5), ST 57 (n = 3), and ST 38 (n = 1). We concluded that not only clinical but also environmental isolates of C. neoformans need to be investigated more deeply and more extensively. The virulence difference between ST 5 and ST 31 need to be explored in the future.
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Affiliation(s)
- Hongtao Dou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huizhu Wang
- Department of Clinical Laboratory, Beijing Di-Tan Hospital, Capital Medical University, Beijing, China
| | - Shaowei Xie
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinxin Chen
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhipeng Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingchun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Worasilchai N, Tangwattanachuleeporn M, Meesilpavikkai K, Folba C, Kangogo M, Groß U, Weig M, Bader O, Chindamporn A. Diversity and Antifungal Drug Susceptibility of Cryptococcus Isolates in Thailand. Med Mycol 2018; 55:680-685. [PMID: 27915307 DOI: 10.1093/mmy/myw130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/28/2016] [Indexed: 12/31/2022] Open
Abstract
Yeasts of the Cryptococcus species complex are the causative agent of cryptococcosis, especially in human immunodeficiency virus (HIV) positive individuals. Cerebral or disseminated cryptococcosis has a very high mortality rate worldwide, including in Thailand. Additionally, an increasing rate of antifungal drug resistant cryptococcal isolates has been reported in several neighboring countries, complicating therapeutic approaches. To understand the situation of this infection in Thailand, we retrospectively investigated the molecular epidemiology and antifungal drug resistance in a collection of 74 clinical, 52 environmental and two veterinary isolates using the URA5-RFLP for typing and the EUCAST guideline for susceptibility testing. Where no EUCAST breakpoints (AMB and 5FC) were available, CLSI epidemiologic cutoff values were used for interpretation. Cryptococcal molecular type diversity showed most isolates were C. grubii, molecular type VNI. One clinical isolate was C. deuterogattii (mol. type VGII) and another C. grubii (mol. type VNII). One strain from environment was classified as C. grubii (mol. type VNII). No resistant strains were detected in this retrospective study for either of the antimycotics tested; however, monitoring of the epidemiology of Cryptococcus species in infected patients in Thailand needs to be continued to detect emergence of resistance.
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Affiliation(s)
- Navaporn Worasilchai
- Interdisciplinary Program, Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Claudia Folba
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Mourine Kangogo
- Department of Medical Microbiology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Uwe Groß
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael Weig
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Oliver Bader
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Ariya Chindamporn
- Interdisciplinary Program, Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand
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Ferrara G, Panizo MM, Urdaneta E, Alarcón V, García N, Moreno X, Capote AM, Reviakina V, Dolande M. Characterization by PCR-RFLP of the Cryptococcus neoformans and Cryptococcus gattii species complex in Venezuela. ACTA ACUST UNITED AC 2018. [DOI: 10.22209/ic.v59n1a03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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144
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Muñoz M, Camargo M, Ramírez JD. Estimating the Intra-taxa Diversity, Population Genetic Structure, and Evolutionary Pathways of Cryptococcus neoformans and Cryptococcus gattii. Front Genet 2018; 9:148. [PMID: 29740480 PMCID: PMC5928140 DOI: 10.3389/fgene.2018.00148] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/09/2018] [Indexed: 12/20/2022] Open
Abstract
Members of the Cryptococcus complex, includes Cryptococcus neoformans (most common fungal infection of the brain) and Cryptococcus gattii (high-impact emerging pathogen worldwide). Currently, the fungal multilocus sequence typing database (Fungal MLST Database) constitutes a valuable data repository of the genes used for molecular typing of these pathogens. We analyzed the data available in the Fungal MLST Database for seven housekeeping genes, with the aim to evaluate its contribution in the description of intra-taxa diversity, population genetic structure, and evolutionary patterns. Although the Fungal MLST Database has a greater number of reports for C. neoformans (n = 487) than for C. gattii (n = 344), similar results were obtained for both species in terms of allelic diversity. Phylogenetic reconstructions revealed grouping by molecular type in both species and allowed us to propose differences in evolutionary patterns (gradualism in the case of C. neoformans and punctuated evolution in the case of C. gattii). In addition, C. neoformans showed a population genetic structure consisting of 37 clonal complexes (CCs; CC1 being predominant), high crosslinking [without sequence type (ST) grouping by molecular type], marked divergence events in phylogenetic analysis, and few introgression events (mainly between VNI and VNIV). By contrast, C. gattii showed 50 CCs (with greater homogeneity in ST number by CC) and clustering by molecular type with marked crosslinking events in phylogenetic networks being less evident. Understanding relationships at the molecular level for species of the Cryptococcus complex, based on the sequences of the housekeeping genes, provides information for describing the evolutionary history of these emerging pathogens.
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Affiliation(s)
- Marina Muñoz
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
- Centro de Tecnología en Salud (CETESA), Upqua SAS, Bogotá, Colombia
- Posgrado Interfacultades Doctorado en Biotecnología, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Milena Camargo
- Centro de Tecnología en Salud (CETESA), Upqua SAS, Bogotá, Colombia
- Departamento de Biología Molecular e Inmunología, Fundación Instituto de Inmunología de Colombia, Bogotá, Colombia
- Doctorado en Ciencias Biomédicas y Biológicas, Universidad del Rosario, Bogotá, Colombia
| | - Juan D. Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
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Firacative C, Lizarazo J, Illnait-Zaragozí MT, Castañeda E. The status of cryptococcosis in Latin America. Mem Inst Oswaldo Cruz 2018; 113:e170554. [PMID: 29641639 PMCID: PMC5888000 DOI: 10.1590/0074-02760170554] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/06/2018] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis is a life-threatening fungal infection caused by the encapsulated
yeasts Cryptococcus neoformans and C. gattii,
acquired from the environment. In Latin America, as occurring
worldwide, C. neoformans causes more than 90% of the cases of
cryptococcosis, affecting predominantly patients with HIV, while C.
gattii generally affects otherwise healthy individuals. In this
region, cryptococcal meningitis is the most common presentation, with
amphotericin B and fluconazole being the antifungal drugs of choice. Avian
droppings are the predominant environmental reservoir of C.
neoformans, while C. gattii is associated with
several arboreal species. Importantly, C. gattii has a high
prevalence in Latin America and has been proposed to be the likely origin of
some C. gattii populations in North America. Thus, in the
recent years, significant progress has been made with the study of the basic
biology and laboratory identification of cryptococcal strains, in understanding
their ecology, population genetics, host-pathogen interactions, and the clinical
epidemiology of this important mycosis in Latin America.
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Affiliation(s)
- Carolina Firacative
- Westmead Hospital, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jairo Lizarazo
- Internal Medicine Department, Hospital Universitario Erasmo Meoz, Universidad de Pamplona, Cúcuta, Colombia
| | - María Teresa Illnait-Zaragozí
- Diagnosis and Reference Centre, Bacteriology-Mycology Department Research, Tropical Medicine Institute Pedro Kourí, Havana, Cuba
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Andrade-Silva LE, Ferreira-Paim K, Ferreira TB, Vilas-Boas A, Mora DJ, Manzato VM, Fonseca FM, Buosi K, Andrade-Silva J, Prudente BDS, Araujo NE, Sales-Campos H, da Silva MV, Júnior VR, Meyer W, Silva-Vergara ML. Genotypic analysis of clinical and environmental Cryptococcus neoformans isolates from Brazil reveals the presence of VNB isolates and a correlation with biological factors. PLoS One 2018; 13:e0193237. [PMID: 29505557 PMCID: PMC5837091 DOI: 10.1371/journal.pone.0193237] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/07/2018] [Indexed: 11/19/2022] Open
Abstract
Cryptococcal infections are mainly caused by members of the Cryptococcus neoformans species complex (molecular types VNI, VNII, VNB, VNIV and the AD hybrid VNIII). PCR of the mating type loci and MLST typing using the ISHAM-MLST consensus scheme were used to evaluate the genetic relationship of 102 (63 clinical and 39 environmental) C. neoformans isolates from Uberaba, Brazil and to correlate the obtained genotypes with clinical, antifungal susceptibility and virulence factor data. All isolates were mating type alpha. MLST identified 12 known and five new sequence types (ST). Fourteen STs were identified within the VNI isolates, with ST93 (57/102, 56%) and ST77 (19/102, 19%) being the most prevalent. From the nine VNII isolates previously identify by URA5-RFLP only four (ST40) were confirmed by MLST. The remaining five grouped within the VNB clade in the phylogenetic analysis corresponding to the sequence type ST504. Other two environmental isolates also grouped within VNB clade with the new sequence type ST527. The four VNII/ST40 isolates were isolated from CSF. The two VNIV sequence types (ST11 and ST160) were isolated from blood cultures. Two of six patients evaluated with more than one isolates had mixed infections. Amongst the VNI isolates 4 populations were identified, which showed differences in their susceptibility profiles, clinical outcome and virulence factors. These results reinforce that ST93 is the most prevalent ST in HIV-infected patients in the Southeastern region of Brazil. The finding of the VNB molecular type amongst environmental Brazilian isolates highlights that this genotype is not restricted to the African continent.
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Affiliation(s)
- Leonardo Euripedes Andrade-Silva
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
- Clinical Pathology Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | - Kennio Ferreira-Paim
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
- Clinical Pathology Department, Triangulo Mineiro Federal University, Uberaba, Brazil
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Sydney Medical School-Westmead Hospital, The University of Sydney, Westmead Institute for Medical Research, Sydney, Australia
| | | | - Anderson Vilas-Boas
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | - Delio José Mora
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | | | | | - Kelli Buosi
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | - Juliana Andrade-Silva
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | | | - Natalia Evelyn Araujo
- Infectious Disease Department, Triangulo Mineiro Federal University, Uberaba, Brazil
| | | | | | | | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Sydney Medical School-Westmead Hospital, The University of Sydney, Westmead Institute for Medical Research, Sydney, Australia
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Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance. J Fungi (Basel) 2018; 4:jof4010032. [PMID: 29494502 PMCID: PMC5872335 DOI: 10.3390/jof4010032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/16/2018] [Accepted: 02/27/2018] [Indexed: 12/26/2022] Open
Abstract
The passive and voluntary surveillance of cryptococcosis in Colombia since 1997 has seen an increasing participating rate, revealing its importance to both in immunosuppressed and immunocompetent people. The present work details the national data gathered in 1997-2016, through a retrospective analysis of the information collected in the survey. From a total of 1974 cases reported, an overall incidence of 0.23 cases per 100,000 people was found. This incidence rose to 1.1 cases per 1000 people in the Acquired Immunodeficiency Syndrome (AIDS) population. Cryptococcosis was most common in male young adults (26-40 years), with a male:female ratio of 3.9:1 in the general population and 5.4:1 in Human Immunodeficiency Virus (HIV) patients. Culture was the most common form of diagnosis in 96.3% of cases, recovering C. neoformans species in 87.5% and C. gattii in 3.1% of samples. VNI was the most prevalent (96.1%) molecular type, while VGII predominated in C. gattii isolates (54.3%). Early mortality was reported as the outcome in 47.5% of patients. Cryptococcosis remains an important opportunistic disease in Colombia and is gaining status as a primary pathogen in apparently immunocompetent patients. Our findings show the importance of including cryptococcosis as a notifiable disease, which will allow for improving opportune diagnosis and treatment, resulting in better patient outcomes.
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Herkert PF, Meis JF, Lucca de Oliveira Salvador G, Rodrigues Gomes R, Aparecida Vicente V, Dominguez Muro M, Lameira Pinheiro R, Lopes Colombo A, Vargas Schwarzbold A, Sakuma de Oliveira C, Simão Ferreira M, Queiroz-Telles F, Hagen F. Molecular characterization and antifungal susceptibility testing of Cryptococcus neoformans sensu stricto from southern Brazil. J Med Microbiol 2018; 67:560-569. [PMID: 29461182 DOI: 10.1099/jmm.0.000698] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Cryptococcosis is acquired from the environment by the inhalation of Cryptococcus cells and may establish from an asymptomatic latent infection into pneumonia or meningoencephalitis. The genetic diversity of a Cryptococcus neoformans species complex has been investigated by several molecular tools, such as multi-locus sequence typing, amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism and microsatellite analysis. This study aimed to investigate the genotype distributions and antifungal susceptibility profiles of C. neoformans sensu lato isolates from southern Brazil. METHODOLOGY We studied 219 C. neoformans sensu lato isolates with mating- and serotyping, AFLP fingerprinting, microsatellite typing and antifungal susceptibility testing.Results/Key findings. Among the isolates, 136 (69 %) were from HIV-positive patients. Only C. neoformans mating-type α and serotype A were observed. AFLP fingerprinting analysis divided the isolates into AFLP1/VNI (n=172; 78.5 %), AFLP1A/VNII (n=19; 8.7 %), AFLP1B/VNII (n=4; 1.8 %) and a new AFLP pattern AFLP1C (n=23; 10.5 %). All isolates were susceptible to tested antifungals and no correlation between antifungal susceptibility and genotypes was observed. Through microsatellite analysis, most isolates clustered in a major microsatellite complex and Simpson's diversity index of this population was D=0.9856. CONCLUSION The majority of C. neoformans sensu stricto infections occurred in HIV-positive patients. C. neoformans AFLP1/VNI was the most frequent genotype and all antifungal drugs had high in vitro activity against this species. Microsatellite analyses showed a high genetic diversity within the regional C. neoformans sensu stricto population, and correlation between environmental and clinical isolates, as well as a temporal and geographic relationship.
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Affiliation(s)
- Patricia Fernanda Herkert
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | | | - Renata Rodrigues Gomes
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil.,Department of Biological Science, State University of Parana/Campus Paranaguá, Paranaguá, PR, Brazil
| | - Vania Aparecida Vicente
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil
| | - Marisol Dominguez Muro
- Laboratory of Mycology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | | | | | | | - Carla Sakuma de Oliveira
- Hospital Universitário do Oeste do Paraná, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | | | - Flávio Queiroz-Telles
- Comunnitarian Health Department, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Ferry Hagen
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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149
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Cuomo CA, Rhodes J, Desjardins CA. Advances in Cryptococcus genomics: insights into the evolution of pathogenesis. Mem Inst Oswaldo Cruz 2018. [PMID: 29513784 PMCID: PMC5851040 DOI: 10.1590/0074-02760170473] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Cryptococcus species are the causative agents of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals. Initial work on the molecular epidemiology of this fungal pathogen utilized genotyping approaches to describe the genetic diversity and biogeography of two species, Cryptococcus neoformans and Cryptococcus gattii. Whole genome sequencing of representatives of both species resulted in reference assemblies enabling a wide array of downstream studies and genomic resources. With the increasing availability of whole genome sequencing, both species have now had hundreds of individual isolates sequenced, providing fine-scale insight into the evolution and diversification of Cryptococcus and allowing for the first genome-wide association studies to identify genetic variants associated with human virulence. Sequencing has also begun to examine the microevolution of isolates during prolonged infection and to identify variants specific to outbreak lineages, highlighting the potential role of hyper-mutation in evolving within short time scales. We can anticipate that further advances in sequencing technology and sequencing microbial genomes at scale, including metagenomics approaches, will continue to refine our view of how the evolution of Cryptococcus drives its success as a pathogen.
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Affiliation(s)
| | - Johanna Rhodes
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Sykes JE, Hodge G, Singapuri A, Yang ML, Gelli A, Thompson GR. In vivo development of fluconazole resistance in serial Cryptococcus gattii isolates from a cat. Med Mycol 2018; 55:396-401. [PMID: 28339594 DOI: 10.1093/mmy/myw104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/22/2016] [Indexed: 11/14/2022] Open
Abstract
Elevated fluconazole minimum inhibitory concentrations (MICs) are more frequently observed in Cryptococcus gattii compared to C. neoformans isolates; however, the development of in vivo resistance and the molecular mechanisms responsible have not been reported for this species. We report a case of Cryptococcus gattii (molecular type VGIII) that developed reduced susceptibility to fluconazole during therapy and delineate the molecular mechanisms responsible. Multilocus sequence typing and quantitative DNA analysis of the pre- and post-treatment isolates was performed using well-characterized methods. Pre- and post-treatment clinical isolates were confirmed isogenic, and no differences in ERG11 or PDR11 sequences were found. qPCR found an overexpression of ERG11 and the efflux pump PDR11 in the resistant isolate compared to the isolate collected prior to initiation of antifungal therapy. Reversion to wild-type susceptibility was observed when maintained in antifungal-free media confirming the in vivo development of heteroresistance. The in vivo development of heteroresistance to fluconazole in our patient with C. gattii is secondary to overexpression of the efflux pump PDR11 and the drug target ERG11. Additional work in other clinical isolates with elevated fluconazole MICs is warranted to evaluate the frequency of heteroresistance versus point mutations as a cause of resistance.
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Affiliation(s)
- Jane E Sykes
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis
| | - Greg Hodge
- Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, University of California, Davis
| | - Anil Singapuri
- Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, University of California, Davis
| | - Mai Lee Yang
- Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, University of California, Davis
| | - Angie Gelli
- Department of Pharmacology, School of Medicine, University of California, Davis, California
| | - George R Thompson
- Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, University of California, Davis.,Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, 4150 V Street, Suite G500; University of California, Davis
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