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de Holanda Fonseca DL, Silva DMWD, de Albuquerque Maranhão FC. Molecular characterization of clinical and environmental isolates from the Cryptococcus neoformans/C. Gattii species complexes of Maceió, Alagoas, Brazil. Braz J Microbiol 2024; 55:1369-1380. [PMID: 38619732 PMCID: PMC11153433 DOI: 10.1007/s42770-024-01313-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 03/21/2024] [Indexed: 04/16/2024] Open
Abstract
Cryptococcosis is one of the major life-threatening opportunistic/systemic fungal diseases of worldwide occurrence, which can be asymptomatic or establish pneumonia and meningoencephalitis mainly in immunosuppressed patients, caused by the Cryptococcus neoformans and C. gattii species complexes. Acquisition is by inhaling fungal propagules from avian droppings, tree hollows and decaying wood, and the association of the molecular types with geographic origin, virulence and antifungal resistance have epidemiological importance. Since data on cryptococcosis in Alagoas are limited, we sought to determine the molecular types of etiological agents collected from clinical and environmental sources. We evaluated 21 isolates previously collected from cerebrospinal fluid and from environment sources (pigeon droppings and tree hollows) in Maceió-Alagoas (Brazil). Restriction fragment length polymorphism of URA5 gene was performed to characterize among the eight standard molecular types (VNI-VNIV and VGI-VGIV). Among isolates, 66.67% (14) were assigned to C. neoformans VNI - 12 of them (12/14) recovered from liquor and 2 from a tree hollow (2/14). One isolate from pigeon droppings (4.76%) corresponded to C. neoformans VNIV, while five strains from tree hollows and one from pigeon droppings (6, 28.57%) to C. gattii VGII. VNI-type was present in clinical and environmental samples and most C. neoformans infections were observed in HIV-positive patients, while types VNIV and VGII were prevalent in environmental sources in Alagoas. This is the first molecular characterization of Cryptococcus spp. in Alagoas, our study provides additional information on the ecoepidemiology of Cryptococcus spp. in Brazil, contributing to a closer view of the endemic species.
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Affiliation(s)
| | - Denise Maria Wanderlei da Silva
- Institute of Biological and Health Sciences, Sector of Microbiology, Laboratory of Clinical Microbiology, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Fernanda Cristina de Albuquerque Maranhão
- Institute of Biological and Health Sciences, Sector of Microbiology, Laboratory of Clinical Microbiology, Federal University of Alagoas, Av. Lourival de Melo Mota, S/N, Tabuleiro do Martins, Maceió, 57072-900, Alagoas, Brazil.
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Alves MJ, Cruz KS, Alves GSB, Grisolia ME, Menescal VVF, do Nascimento IS, Menescal LSF, Pinheiro SB, da Silva FA, Trilles L, de Souza JVB, Lazera MDS, Jackisch-Matsuura AB. Antifungal susceptibility and multilocus sequence typing (MLST) of Cryptococcus neoformans complex from HIV-associated cryptococcal meningitis patients in Manaus, Amazonas, Brazil. Braz J Microbiol 2024:10.1007/s42770-024-01378-y. [PMID: 38755408 DOI: 10.1007/s42770-024-01378-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
Cryptococcus neoformans is primarily responsible for cases of cryptococcal meningitis in individuals with HIV/AIDS. This study evaluated the susceptibility of C. neoformans obtained from individuals with cryptococcal meningitis associated with HIV/AIDS in Manaus, Amazonas, Brazil, against the action of the antifungals amphotericin B, flucytosine, fluconazole, itraconazole and posaconazole and analyzed it using Multilocus Sequence Typing (MLST) in order to identify the Sequence Types (STs). We analyzed 30 isolates of C. neoformans, from 24 HIV/AIDS patients diagnosed with cryptococcosis from 2017 to 2019 in a reference hospital, in addition to 3 environmental isolates: 1 isolate obtained in the home of a patient and 2 isolates obtained from neighboring homes of patients. 86.6% (n = 26/30) of the clinical isolates were identified as C. neoformans VNI ST93, 6.6% (n = 2/30) as C. neoformans VNI ST5, 3.3% (n = 1/30) as C. neoformans VNI ST32 and 3.3% (n = 1/30) as C. neoformans VNB ST232. The environmental isolates were identified as C. neoformans VNI ST93 (n = 3/3). 96.6% (n = 29/30) isolates were sensitive to amphotericin B, though there was variation in the MIC. 60% (n = 18/30) presented a MIC above the proposed epidemiological cutoff values for one or more antifungals. All environmental isolates were sensitive to the tested antifungals. The MLST showed that there is an important relationship between C. neoformans VNI ST93 and individuals with HIV/AIDS, including in the environmental isolates analyzed. C. neoformans VNB ST232 was observed for the first time in Amazonas. Amphotericin B was proven to be the best drug, but fluconazole and posaconazole also showed relevant action.
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Affiliation(s)
- Marla Jalene Alves
- Laboratório de Diversidade Microbiana da Amazônia com importância para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Convenio ILMD/IOC - FIOCRUZ, Manaus, Amazonas, Brazil
| | - Katia Santana Cruz
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Laboratório de Micologia Médica, Manaus, Amazonas, Brazil
| | - Gleica Soyan Barbosa Alves
- Instituto de Ciências Exatas e Tecnologia, Universidade Federal do Amazonas - UFAM, Itacoatiara, Amazonas, Brazil
| | - Maria Eduarda Grisolia
- Laboratório de Diversidade Microbiana da Amazônia com importância para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
| | - Victoria Violeta Fernandes Menescal
- Laboratório de Diversidade Microbiana da Amazônia com importância para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
| | - Izabella Sadalla do Nascimento
- Laboratório de Diversidade Microbiana da Amazônia com importância para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil
| | | | - Silviane Bezerra Pinheiro
- Laboratório de Micologia, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Amazonas, Brazil
- Pós-Graduação em Genética, Conservação e Biologia Evolutiva, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Amazonas, Brazil
| | - Felipe Almeida da Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Luciana Trilles
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Marcia Dos Santos Lazera
- Programa de Pós-Graduação em Medicina Tropical, Convenio ILMD/IOC - FIOCRUZ, Manaus, Amazonas, Brazil
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Ani Beatriz Jackisch-Matsuura
- Laboratório de Diversidade Microbiana da Amazônia com importância para a Saúde, Instituto Leônidas e Maria Deane - FIOCRUZ, Manaus, Amazonas, Brazil.
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Omura M, Satoh K, Tamura T, Komori A, Makimura K. Molecular epidemiological investigation of Cryptococcus spp. carried by captive koalas ( Phascolarctos cinereus) in Japan. Microbiol Spectr 2024; 12:e0290323. [PMID: 38411053 DOI: 10.1128/spectrum.02903-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii cause cryptococcosis, a systemic mycosis that infects a wide range of species. Recent molecular biological investigations have allowed for the genotyping of these species, providing more detailed information on their pathogenicity and infection routes. Koalas (Phascolarctos cinereus) are frequently colonized by Cryptococcus spp., but molecular epidemiological studies have yet to be conducted in Japan. Here, we conducted multi-locus sequence typing (MLST) analysis on Cryptococcus spp. colonization isolates obtained from all koalas kept in seven parks across Japan. Out of 46 koalas examined, 10 (22%) were positive for C. gattii and 3 (6.5%) were positive for C. neoformans. All C. gattii isolates belonged to molecular type VGI and were either sequence type (ST) 51 or a novel ST, and all C. neoformans isolates belonged to molecular type VNI and ST23. Despite the frequent movement of koalas between parks, the STs were relatively park-specific, suggesting that the floor of the rearing barns is a source of infection and may act as a reservoir. MLST analysis confirmed that C. gattii was transported, established, and spread by koalas in areas where C. gattii was not originally present. MLST analysis is considered useful in assessing the pathogenicity and tracing the transmission routes of Cryptococcus spp. carried by koalas.IMPORTANCEThis is the first study to conduct a multi-locus sequence typing analysis on Cryptococcus spp. carried by captive koalas in Japan. Cryptococcosis remains a globally high-fatality fungal infection in humans, and captive koalas are known to carry a high percentage of Cryptococcus spp. Through this research, the molecular types and transmission routes of Cryptococcus spp. carried by koalas have been elucidated, revealing the potential role of enclosure flooring as a reservoir. It has been confirmed that Cryptococcus gattii, which is not endemic in Japan, has become established through koalas and is spreading to new individuals in Japan. This study is believed to provide valuable insights into koala conservation and contribute to the One Health approach for Cryptococcosis, a zoonotic infection.
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Affiliation(s)
- Miki Omura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
| | - Kazuo Satoh
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Takashi Tamura
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Aya Komori
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Koichi Makimura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
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Hamaguchi T, Uchida N, Fujita-Nakata M, Nakanishi M, Tsuchido Y, Nagao M, Iinuma Y, Asahina M. Autochthonous Cryptococcus gattii genotype VGIIb infection in a Japanese patient with anti-granulocyte-macrophage colony-stimulating factor antibodies. J Infect Chemother 2024:S1341-321X(24)00084-9. [PMID: 38479572 DOI: 10.1016/j.jiac.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/01/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
A 31-year-old Japanese man presented with cerebral and pulmonary cryptococcosis. Cryptococcus gattii (C. gattii) genotype VGIIb was detected in the patient's sputum and cerebrospinal fluid specimens. The serum levels of anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) antibodies were elevated in this patient, which has been associated with pulmonary alveolar proteinosis and is considered a risk factor for C. gattii infection. After undergoing >12 months of antifungal treatments, the patient showed improvements in symptoms and findings on brain and lung imaging. Several Japanese patients who develop C. gattii infection have also been reported; however, most of these patients have been infected outside Japan, as C. gattii infection is rare in Japan. Only one patient with C. gattii genotype VGIIb infection has been reported in Japan, and it is believed that this patient contracted the infection in China. In the present case, our patient has never been outside Japan, indicating that the infection originated in Japan. Our findings suggest that C. gattii might be spreading in Japan. Therefore, patients with positive serum anti-GM-CSF antibodies should be thoroughly monitored for C. gattii infection, even those living in Japan.
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Affiliation(s)
| | - Nobuaki Uchida
- Department of Neurology, Kanazawa Medical University, Ishikawa, Japan.
| | | | - Megumi Nakanishi
- Department of Neurology, Kanazawa Medical University, Ishikawa, Japan.
| | - Yasuhiro Tsuchido
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Yoshitsugu Iinuma
- Department of Infectious Diseases, Kanazawa Medical University, Ishikawa, Japan.
| | - Masato Asahina
- Department of Neurology, Kanazawa Medical University, Ishikawa, Japan.
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Kessel J, Rossaert AC, Lingscheid T, Grothe J, Harrer T, Wyen C, Tominski D, Bollinger T, Kehr AK, Kalbitz S, Hoffmann C, Cornely O, Koppe U, Stephan C, Rickerts V. Survival after cryptococcosis in Germany: A retrospective multicenter cohort study of patients diagnosed between 2004 and 2021. Int J Med Microbiol 2024; 314:151614. [PMID: 38368645 DOI: 10.1016/j.ijmm.2024.151614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Cryptococcosis is the most prevalent fungal infection of the central nervous system worldwide. We performed a retrospective multicenter cohort study to gain insights into the epidemiology of cryptococcosis in Germany. We describe the use of diagnostic tests, clinical management and patient outcome. We included 64 patients with underlying HIV infection (55%) or other predispositions. Molecular typing by MLST documented 20 individual sequence types among 42 typed isolates. A fatal outcome was documented in 14% of patients in the first two months after diagnosis.
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Affiliation(s)
- Johanna Kessel
- University Hospital Frankfurt, Infectious Diseases Unit, Theodor Stern Kai 7, Frankfurt 60590, Germany
| | - Anna-Catharina Rossaert
- Robert Koch Institut, Konsiliarlabor für Kryptokokkose und seltene Systemmykosen, Seestrasse 10, Berlin 13353, Germany
| | - Tilman Lingscheid
- Department of Infectious Diseases, Respiratory and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan Grothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, NRW, Germany
| | - Thomas Harrer
- Infectious Diseases Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany; Deutsche Gesellschaft für Infektiologie, Sektion HIV-Medizin, Germany
| | | | - Daniela Tominski
- Auguste Viktoria Klinikum, Infectious Diseases Unit, Rubensstr. 125, Berlin 12157, Germany
| | - T Bollinger
- Institut für Laboratoriumsmedizin, Mikrobiologie und Hygiene, Klinikum Bayreuth, Germany
| | - Anna Katharina Kehr
- MVZ wagnerstibbe für Medizinische Mikrobiologie, Infektiologie, Hygiene und Tropenmedizin GmbH, Göttingen, Germany
| | - Sven Kalbitz
- Klinik für Infektiologie und Tropenmedizin, Klinikum St. Georg gGmbH, Leipzig, Germany
| | - Christian Hoffmann
- ICH Study Center, Infektionsmedizinisches Centrum Hamburg, Hamburg, Germany
| | - Oliver Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Uwe Koppe
- Robert Koch Institut, Fachgruppe 34, Seestrasse 10, Berlin 13353, Germany
| | - Christoph Stephan
- University Hospital Frankfurt, Infectious Diseases Unit, Theodor Stern Kai 7, Frankfurt 60590, Germany; Deutsche Gesellschaft für Infektiologie, Sektion HIV-Medizin, Germany
| | - Volker Rickerts
- Robert Koch Institut, Konsiliarlabor für Kryptokokkose und seltene Systemmykosen, Seestrasse 10, Berlin 13353, Germany.
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de Souza Rabello VB, de Melo Teixeira M, Meyer W, Irinyi L, Xavier MO, Poester VR, Pereira Brunelli JG, Almeida-Silva F, Bernardes-Engemann AR, Ferreira Gremião ID, Dos Santos Angelo DF, Clementino IJ, Almeida-Paes R, Zancopé-Oliveira RM. Multi-locus sequencing typing reveals geographically related intraspecies variability of Sporothrix brasiliensis. Fungal Genet Biol 2024; 170:103845. [PMID: 38040325 DOI: 10.1016/j.fgb.2023.103845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
Sporotrichosis is a subcutaneous mycosis caused by pathogenic Sporothrix species. Among them, Sporothrix brasiliensis is the main species associated with endemic regions in South America, especially Brazil. It is highly virulent and can be spread through zoonotic transmission. Molecular epidemiological surveys are needed to determine the extent of genetic variation, to investigate outbreaks, and to identify genotypes associated with antifungal resistance and susceptibility. This study investigated the sequence variation of different constitutive genes and established a novel multilocus sequence typing (MLST) scheme for S. brasiliensis. Specific primers were designed for 16 genes using Primer-BLAST software based on the genome sequences of three S. brasiliensis strains (ATCC MYA-4823, A001 and A005). Ninety-one human, animal, and environmental S. brasiliensis isolates from different Brazilian geographic regions (South, Southeast, Midwest and Northeast) andtwo isolates from Paraguay were sequenced. The loci that presented the highest nucleotide diversity (π) were selected for the MLST scheme. Among the 16 studied genetic loci, four presented increased π value and were able to distinguish all S. brasiliensis isolates into seven distinct haplotypes. The PCR conditions were standardized for four loci. Some of the obtained haplotypes were associated with the geographic origin of the strains. This study presents an important advance in the understanding of this important agent of sporotrichosis in Brazil. It significantly increased the discriminatory power for genotyping of S. brasiliensis isolates, and enabled new contributions to the epidemiological studies of this human and animal pathogen in Brazil and in other countries.
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Affiliation(s)
- Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
| | - Marcus de Melo Teixeira
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - Wieland Meyer
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands; Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, Sydney Infectious Diseases Institute, University of Sydney, Westmead Hospital, Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, Sydney Infectious Diseases Institute, University of Sydney, Westmead Hospital, Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
| | - Melissa Orzechowski Xavier
- Laboratório de Micologia e Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande (FAMED-FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Vanice Rodrigues Poester
- Laboratório de Micologia e Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande (FAMED-FURG), Rio Grande, Rio Grande do Sul, Brazil
| | | | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Andrea Reis Bernardes-Engemann
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | | | - Inácio José Clementino
- Departamento de Medicina Veterinária, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
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Wang P, Li Y, Gao L, Tang X, Zheng D, Wu K, Wang L, Guo P, Ye F. In vitro characterization and molecular epidemiology of Cryptococcus spp. isolates from non-HIV patients in Guangdong, China. Front Microbiol 2024; 14:1295363. [PMID: 38287960 PMCID: PMC10823435 DOI: 10.3389/fmicb.2023.1295363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Background The burden of cryptococcosis in mainland China is enormous. However, the in vitro characterization and molecular epidemiology in Guangdong, a key region with a high incidence of fungal infection in China, are not clear. Methods From January 1, 2010, to March 31, 2019, clinical strains of Cryptococcus were collected from six medical centres in Guangdong. The clinical information and characteristics of the strains were analysed. Furthermore, molecular types were determined. Results A total of 84 strains were collected, mostly from male and young or middle-aged adult patients. Pulmonary and cerebral infections (82.1%) were most common. All strains were Cryptococcus neoformans, grew well at 37°C and had capsules around their cells. One melanin- and urea- and one melanin+ and urea- variants were found. Although most strains exhibited a low minimum inhibitory concentration (MIC) value for voriconazole (mean: 0.04 μg/mL) and posaconazole (mean: 0.12 μg/mL), the results for these isolates showed a high degree of variation in the MIC values of fluconazole and 5-fluorocytosine, and resistance was observed for 4 out of 6 drugs. A significant proportion of these strains had MIC values near the ECV values, particularly in the case of amphotericin B. The proportion of strains near the clinical breakpoints was as follows: fluconazole: 3.66%; voriconazole: 3.66%; itraconazole: 6.10%; posaconazole: 13.41%; amphotericin B: 84.15%; 5-fluorocytosine: 2.44%. These strains were highly homogeneous and were dominated by the Grubii variant (95.2%), VNI (94.0%), α mating (100%), and ST5 (89.3%) genotypes. Other rare types, including ST4, 31, 278, 7, 57 and 106, were also found. Conclusion Phenotypically variant and non-wild-type strains were found in Guangdong, and a significant proportion of these strains had MIC values near the ECV values towards the 6 antifungal drugs, and resistance was observed for 4 out of 6 drugs. The molecular type was highly homogeneous but compositionally diverse, with rare types found. Enhanced surveillance of the aetiology and evolution and continuous monitoring of antifungal susceptibility are needed to provide references for decision-making in the health sector and optimization of disease prevention and control.
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Affiliation(s)
- Penglei Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
- Department of Respiratory Medicine, Longgang Central Hospital, Shenzhen, China
| | - Yongming Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
| | - Lei Gao
- Microscopy Core Facility, Biomedical Research Core Facilities, Westlake University, Hangzhou, China
| | - Xiang Tang
- Intensive Care Unit, Guangzhou First People's Hospital, Guangzhou, China
| | - Dandian Zheng
- Department of Hematology Oncology, Jieyang City People's Hospital, Jieyang, China
| | - Kuihai Wu
- Clinical Medicine Laboratory, Foshan City First People's Hospital, Foshan, China
| | - Luxia Wang
- Clinical Medicine Laboratory, Southern Military Region General Hospital, Guangzhou, China
| | - Penghao Guo
- Clinical Medicine Laboratory, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
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Kebabonye K, Jongman M, Loeto D, Moyo S, Choga W, Kasvosve I. Determining Potential Link between Environmental and Clinical Isolates of Cryptococcus neoformans/Cryptococcus gattii Species Complexes Using Phenotypic and Genotypic Characterisation. MYCOBIOLOGY 2023; 51:452-462. [PMID: 38179115 PMCID: PMC10763847 DOI: 10.1080/12298093.2023.2272380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/10/2023] [Indexed: 01/06/2024]
Abstract
Opportunistic infections due to Cryptococcus neoformans and C. gattii species complexes continue to rise unabated among HIV/AIDS patients, despite improved antifungal therapies. Here, we collected a total of 20 environmental and 25 presumptive clinical cryptococcal isolates from cerebrospinal fluid (CSF) samples of 175 patients enrolled in an ongoing clinical trial Ambition 1 Project (Botswana-Harvard Partnership). Identity confirmation of the isolates was done using MALDI-TOF MS and PCR. We describe the diversity of the isolates by PCR fingerprinting and sequencing (Oxford Nanopore Technology) of the intergenic spacer region. Mating types of the isolates were determined by amplification of the MAT locus. We report an unusual prevalence of 42.1% of C. neoformans x C. deneoformans hybrids Serotype AD (n = 16), followed by 39.5% of C. neoformans Serotype A (n = 15), 5.3% of C. deneoformans, Serotype D (n = 2), 7.9% of C. gattii (n = 3), and 5.3% of C. tetragattii (n = 2) in 38 representative isolates that have been characterized. Mating type-specific PCR performed on 38 representative environmental and clinical isolates revealed that 16 (42.1%) were MATa/MATα hybrids, 17 (44.7%) were MATα, and five (13.2%) possessed MATa mating type. We used conventional and NGS platforms to demonstrate a potential link between environmental and clinical isolates and lay a foundation to further describe mating patterns/history in Botswana.
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Affiliation(s)
- Kenosi Kebabonye
- School of Health Allied Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Mosimanegape Jongman
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Daniel Loeto
- Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana
| | - Sikhulile Moyo
- School of Health Allied Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Medical Virology, Stellenbosch University, Cape Town, South Africa
- School of Health Systems of Public Health, University of Pretoria, Pretoria, South Africa
| | - Wonderful Choga
- Research Laboratory, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Ishmael Kasvosve
- School of Health Allied Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
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9
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Bive BZ, Sacheli R, Mudogo CN, Zakayi PK, Bontems S, Lelo GM, Hayette MP. Correlation of antifungal susceptibility and sequence types within Cryptococcus neoformans VNI from HIV patients, and ERG11 gene polymorphism. J Mycol Med 2023; 33:101428. [PMID: 37651769 DOI: 10.1016/j.mycmed.2023.101428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Here we tested the correlation between minimum inhibitory concentrations (MICs) of major antifungal agents and sequence types (STs) within Cryptococcus neoformans VNI isolates, and explored the ERG11 gene of included strains. MATERIALS AND METHODS We analysed 23 C. neoformans strains categorised into two groups according to the distribution of the ST profile in Kinshasa clinics (Democratic Republic of Congo): major ST [ST93 (n = 15)], and less common STs [ST659 (n = 2), ST5 (n = 2), ST4 (n = 1), ST 53 (n = 1), ST31 (n = 1), and ST69 (n = 1)]. The MICs of the major antifungal agents [amphotericin B (AMB), 5-fluorocytosine (5FC) and fluconazole (FCZ)] were determined following EUCAST guidelines. ERG11 gene sequences were extracted from whole genome sequence of the isolates and compared with the wild-type gene sequence of the C. neoformans VNI. RESULTS Although major ST isolates appeared to have lower median MICs for AMB and 5FU than less common ST isolates (0.50 vs. 0.75 mg/L for AMB, 2 vs. 4 mg/L for 5FU, respectively), FCZ susceptibility was similar in both groups (4 mg/L) (p-value >0.05). The susceptibility profile of C. neoformans strains separately considered did not significantly affect the patients' clinical outcomes (p-value >0.05). Furthermore, two structural modalities of the ERG11 gene were observed: (1) that of the reference gene, and (2) that containing two exonic silent point substitutions, and one intronic point substitution located in a sequence potentially involved in pre-mRNA splicing (c.337-22C > T); with no association with the MICs of the isolates (p-value >0.05). CONCLUSIONS The lack of association/correlation found in this study calls for further investigations to better understand the mechanisms of C. neoformans resistance to antifungal agents.
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Affiliation(s)
- Bive Zono Bive
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium.
| | - Rosalie Sacheli
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Celestin Nzanzu Mudogo
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pius Kabututu Zakayi
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Sébastien Bontems
- Department of Clinical Microbiology, Laboratory of Virology and Immunology, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Georges Mvumbi Lelo
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, National Reference Center for Mycosis, Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
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10
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Serna-Espinosa BN, Forero-Castro M, Morales-Puentes ME, Parra-Giraldo CM, Escandón P, Sánchez-Quitian ZA. First report of environmental isolation of Cryptococcus and Cryptococcus-like yeasts from Boyacá, Colombia. Sci Rep 2023; 13:15755. [PMID: 37735454 PMCID: PMC10514045 DOI: 10.1038/s41598-023-41994-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
The Cryptococcus genus comprises more than 100 species, of which C. neoformans and C. gattii are the leading cause of cryptococcosis. The distribution of C. gattii and C. neoformans species complexes has been extensively studied and widely reported globally. Other species such as Naganishia albida, Papiliotrema laurentii, and Papiliotrema flavescens have been reported as pathogenic yeasts. Since there are no reports of environmental isolation in the Boyacá region (Colombia), this study aimed to isolate and characterize Cryptococcus and Cryptococcus-like yeasts from pigeon feces, Eucalyptus, and olive trees distributed in the municipalities of Tunja and Ricaute Alto. The environmental data was recovered, and the isolations obtained were identified by microscopy, biochemical test, MALDI-TOF MS, URA5-RFLP, and sequencing of the ITS and LSU loci. For the 93 pigeon dropping samples collected in Tunja, 23 yielded to C. neoformans, 3 to N. globosa, 2 N. albida and 1 to P. laurentii. Of the 1188 samples collected from olive trees, 17 (1.43%) positive samples were identified as C. gattii species complex (4), C. neoformans species complex (2), P. laurentii (3), N. albida (2), N. globosa (5) and P. flavescens (1). Likewise, specimens of C. neoformans presented molecular type VNI and molecular type VNII; for C. gattii the molecular types found were VGIII and one VGIV by URA5-RFLP but VGIII by MALDI-TOF and sequencing of the ITS and LSU. Therefore, it can be concluded that the species of Cryptococcus, Naganishia and Papiliotrema genera, are present in the environment of Boyacá, and show a predilection for climate conditions that are typical of this region.
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Affiliation(s)
- Briggith-Nathalia Serna-Espinosa
- Facultad de Ciencias, Universidad Pedagógica y Tecnológica de Colombia, Avenida Central del Norte 39-115, Tunja, Boyacá, Colombia
| | - Maribel Forero-Castro
- Facultad de Ciencias, Universidad Pedagógica y Tecnológica de Colombia, Avenida Central del Norte 39-115, Tunja, Boyacá, Colombia
| | - María Eugenia Morales-Puentes
- Facultad de Ciencias, Universidad Pedagógica y Tecnológica de Colombia, Avenida Central del Norte 39-115, Tunja, Boyacá, Colombia
| | - Claudia Marcela Parra-Giraldo
- Unidad de Proteómica y Micosis Humanas, Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, 110231, Colombia
| | - Patricia Escandón
- Grupo de Microbiología, Instituto Nacional de Salud, Calle 26 # 51-20, Bogotá, D.C., Colombia
| | - Zilpa Adriana Sánchez-Quitian
- Grupo de Investigación Gestión Ambiental, Facultad de Ciencias e Ingeniería, Departamento de Biología y Microbiología, Universidad de Boyacá, Carrera 2ª Este No. 64-169, Tunja, Boyacá, Colombia.
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11
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Pllana-Hajdari D, Chidebelu EP, Cogliati M. Fertile Cryptococcus neoformans var. neoformans (C. deneoformans) isolates from natural environment in Kosovo. Med Mycol 2023; 61:myad096. [PMID: 37667541 DOI: 10.1093/mmy/myad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/06/2023] Open
Abstract
A total of 300 tree-associated samples were collected from green areas in three towns in Kosovo, and cultured to isolate Cryptococcus species. One soil sample from Prizren tested positive, yielding three isolates identified as C. neoformans var. neoformans (C. deneoformans), molecular type VNIV, two MATα, and one MATa. Mating experiments revealed that they were fertile when crossed together, and multilocus sequence typing analysis showed unique sequence types not found in the global database. The study reports the presence of C. neoformans strains in the environment in Kosovo and highlights the importance of monitoring pathogen distribution and the potential impacts of climate change.
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Affiliation(s)
| | - Ekene P Chidebelu
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Massimo Cogliati
- Laboratorio di Micologia Medica, Dipartimento Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
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12
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Andrade-Silva LE, Vilas-Boas A, Ferreira-Paim K, Andrade-Silva J, Santos DDA, Ferreira TB, Borges AS, Mora DJ, Melhem MDSC, Silva-Vergara ML. Genotyping Analysis of Cryptococcus deuterogattii and Correlation with Virulence Factors and Antifungal Susceptibility by the Clinical and Laboratory Standards Institute and the European Committee on Antifungal Susceptibility Testing Methods. J Fungi (Basel) 2023; 9:889. [PMID: 37754997 PMCID: PMC10532325 DOI: 10.3390/jof9090889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
Data about the relationship between their molecular types, virulence factors, clinical presentation, antifungal susceptibility profile, and outcome are still limited for Cryptococcus deuterogattii. This study aimed to evaluate the molecular and phenotypic characteristics of 24 C. deuterogattii isolates from the southeast region of Brazil. The molecular characterization was performed by multilocus sequence typing (MLST). The antifungal susceptibility profile was obtained according to CLSI-M27-A3 and EUCAST-EDef 7.1 methods. The virulence factors were evaluated using classic techniques. The isolates were divided into four populations. The molecular analysis suggests recombinant events in most of the groups evaluated. Resistance and susceptibility dose-dependent to fluconazole were evidenced in four isolates (16%) by EUCAST and in four isolates (16%) by CLSI methods. The agreement at ±two dilutions for both methods was 100% for itraconazole, ketoconazole, and voriconazole, 96% for amphotericin B, and 92% for fluconazole. Significant differences in virulence factor expression and antifungal susceptibility to itraconazole and amphotericin B were found. The mixed infection could be suggested by the presence of variable sequence types, differences in virulence factor production, and decreased antifungal susceptibility in two isolates from the same patient. The data presented herein corroborate previous reports about the molecular diversity of C. deuterogattii around the world.
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Affiliation(s)
- Leonardo Euripedes Andrade-Silva
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
| | - Anderson Vilas-Boas
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
| | - Kennio Ferreira-Paim
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
| | - Juliana Andrade-Silva
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
| | - Daniel de Assis Santos
- Microbiology Department, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil;
| | - Thatiana Bragine Ferreira
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
| | - Aercio Sebastião Borges
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Uberlândia, Uberlândia 38496-017, MG, Brazil
| | - Delio Jose Mora
- Center of Health Sciences, Federal University of Sul da Bahia, Teixeira de Freitas 85866-000, BA, Brazil;
| | | | - Mario Léon Silva-Vergara
- Infectious Diseases Unit, Internal Medicine Department, Federal University of Triangulo Mineiro, Uberaba 38001-170, MG, Brazil; (A.V.-B.); (K.F.-P.); (J.A.-S.); (T.B.F.); (M.L.S.-V.)
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13
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Spiliopoulou A, Lekkou A, Vrioni G, Leonidou L, Cogliati M, Christofidou M, Marangos M, Kolonitsiou F, Paliogianni F. Fungemia due to rare non-Candida yeasts between 2018 and 2021 in a Greek tertiary care university hospital. J Mycol Med 2023; 33:101386. [PMID: 37031651 DOI: 10.1016/j.mycmed.2023.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/01/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Non-Candida yeasts, although rare, are increasingly encountered and recognized as a growing threat. METHODS Cases of bloodstream infections (BSIs) due to non-Candida yeasts (NCYs) during the last four years (2018-2021) are presented. RESULTS During the study period, 16 cases caused by non-Candida yeasts out of 400 cases of yeast BSIs were recorded, corresponding to an incidence of 4%. Yeasts that were isolated included Cryptococcus spp (4 isolates-25%), Rhodotorula mucilaginosa (2 isolates-12.5%), Trichosporon asahii (7 isolates-43.75%) and Saccharomyces cerevisiae (3 isolates-18.75%). Predisposing factors involved mostly hematological malignancies, long term hospitalization or major surgical interventions. Most isolates, 15 out of 16 were susceptible to amphotericin B. Voriconazole was the most active azole in vitro. All isolates, except Saccharomyces spp., were resistant to echinocandins. DISCUSSION Early recognition of rare yeasts as causative agents of BSIs and prompt initiation of appropriate treatment based on current guidelines and expertise remain crucial in efficient patient management.
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Affiliation(s)
| | - Alexandra Lekkou
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
| | - Georgia Vrioni
- Dept of Microbiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Lydia Leonidou
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
| | - Massimo Cogliati
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | | | - Markos Marangos
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
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14
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Sousa NSOD, Almeida JDRD, Frickmann H, Lacerda MVG, Souza JVBD. Searching for new antifungals for the treatment of cryptococcosis. Rev Soc Bras Med Trop 2023; 56:e01212023. [PMID: 37493736 PMCID: PMC10367226 DOI: 10.1590/0037-8682-0121-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/19/2023] [Indexed: 07/27/2023] Open
Abstract
There is a consensus that the antifungal repertoire for the treatment of cryptococcal infections is limited. Standard treatment involves the administration of an antifungal drug derived from natural sources (i.e., amphotericin B) and two other drugs developed synthetically (i.e., flucytosine and fluconazole). Despite treatment, the mortality rates associated with fungal cryptococcosis are high. Amphotericin B and flucytosine are toxic, require intravenous administration, and are usually unavailable in low-income countries because of their high cost. However, fluconazole is cost-effective, widely available, and harmless with regard to its side effects. However, fluconazole is a fungistatic agent that has contributed considerably to the increase in fungal resistance and frequent relapses in patients with cryptococcal meningitis. Therefore, there is an unquestionable need to identify new alternatives or adjuvants to conventional drugs for the treatment of cryptococcosis. A potential antifungal agent should be able to kill cryptococci and "bypass" the virulence mechanism of the yeast. Furthermore, it should have fungicidal action, low toxicity, high selectivity, easily penetrate the central nervous system, and widely available. In this review, we describe cryptococcosis, its conventional therapy, and failures arising from the use of drugs traditionally considered to be the reference standard. Additionally, we present the approaches used for the discovery of new drugs to counteract cryptococcosis, ranging from the conventional screening of natural products to the inclusion of structural modifications to optimize anticryptococcal activity, as well as drug repositioning and combined therapies.
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Affiliation(s)
| | | | - Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Germany
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Germany
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil
- Instituto de Pesquisas Leônidas & Maria Deane, Fiocruz, Manaus, AM, Brasil
- University of Texas Medical Branch, Galveston, USA
| | - João Vicente Braga de Souza
- Programa de Pós-Graduação em Biodiversidade e Biotecnologia da Rede BIONORTE, Manaus, AM, Brasil
- Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
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15
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Tshekiso K, Loeto D, Muzila M, Seetswane E, Kenosi K, Jongman M. Prevalence, molecular and phenotypic profiles of arboreal associated Cryptococcus neoformans in Botswana. Fungal Biol 2023; 127:1129-1135. [PMID: 37495303 DOI: 10.1016/j.funbio.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/28/2023]
Abstract
Mopane tree (Colophospermum mopane) is one of the main ecological niches of Cryptococcus neoformans, an opportunistic fungal pathogen that causes cryptococcosis primarily on immunocompromised hosts after inhalation of basidiospores from the environment. Hence, we investigated the prevalence, and phenotypically (antifungal resistance and biofilm formation capacity) and genotypically (mating type and genetic structure) characterized C. neoformans isolated from C. mopane, Acacia tortilis, Adansonia digitata and Ziziphus mucronata in Botswana. We report 7.1% and 2.9% prevalence of C. neoformans in C. mopane and other trees, respectively. All tested C. neoformans isolates were determined to be non-WT to fluconazole. Most isolates (65%) of C. neoformans isolates were biofilm producers. Mating type determination revealed a higher proportion of the globally rare MATa allele (53%) and a single MATα/MATa hybrid. The observed genotypeswere VNI (71%), VNB (23%) and VNB/VNB hybrids (6%). Native trees other than C. mopane are alternative ecological niches of antifungal resistant C. neoformans, and this represents a serious public health concern,and this represents a serious public health concern, especially for high-risk populations. Prevalence of C. neoformans on native trees and the observed emergence of hybrids (evidence of sexual recombination) highlight the need for increased surveillance and risk assessment within a One Health paradigm.
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Affiliation(s)
- Kgomotso Tshekiso
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag 0022, Gaborone, Botswana
| | - Daniel Loeto
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag 0022, Gaborone, Botswana
| | - Mbaki Muzila
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag 0022, Gaborone, Botswana
| | - Eunicah Seetswane
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag 0022, Gaborone, Botswana
| | - Kebabonye Kenosi
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Private Bag 0022, Gaborone, Botswana
| | - Mosimanegape Jongman
- Department of Biological Sciences, Faculty of Science, University of Botswana, Private Bag 0022, Gaborone, Botswana.
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Jackson KM, Ding M, Nielsen K. Importance of Clinical Isolates in Cryptococcus neoformans Research. J Fungi (Basel) 2023; 9:364. [PMID: 36983532 PMCID: PMC10056780 DOI: 10.3390/jof9030364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
The human pathogenic fungus Cryptococcus neoformans is a global health concern. Previous research in the field has focused on studies using reference strains to identify virulence factors, generate mutant libraries, define genomic structures, and perform functional studies. In this review, we discuss the benefits and drawbacks of using reference strains to study C. neoformans, describe how the study of clinical isolates has expanded our understanding of pathogenesis, and highlight how studies using clinical isolates can further develop our understanding of the host-pathogen interaction during C. neoformans infection.
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Affiliation(s)
| | | | - Kirsten Nielsen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, USA
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Characteristics and prognostic risk factors of patients with sequence type 5 lineage-associated cryptococcosis in China. Int J Infect Dis 2023; 128:244-253. [PMID: 36646413 DOI: 10.1016/j.ijid.2023.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Cryptococcus neoformans sequence type 5 (ST5) lineage could infect immunocompetent hosts and cause a significant medical burden. We sought to identify characteristics and prognostic risk factors of ST5 lineage-associated cryptococcosis. METHODS Multilocus sequence typing and antifungal susceptibility testing were conducted for Cryptococcus isolates. The clinical and laboratory characteristics of cryptococcosis patients were investigated. The multivariable logistic regression identified variables independently associated with 30-day mortality in patients with ST5 lineage-associated cryptococcosis without HIV. RESULTS The infection rate of the ST5 isolates was 89.4% (370/414) in China. The proportion of ST5 isolates with nonwild-type minimum inhibitory concentrations to amphotericin B, 5-flucytosine, voriconazole, posaconazole, itraconazole, and fluconazole were 0%, 5.4%, 0.3%, 1.4%, 0.3%, and 8.1%, respectively. The ST5 lineage-infected group exhibited significantly higher blood platelet count, lower blood cryptococcal antigen (CrAg) titer, lower cerebrospinal fluid (CSF) CrAg titer than the non-ST5 lineage-infected group, and lower hemoglobin and lower CSF CrAg titer than the Cryptococcus gattii isolates-infected group. Seven baseline parameters, including underlying disease, dyskinesia, anemia, high peripheral blood neutrophils, low platelet count, high CSF fungal burden, and high CSF opening pressure, were associated independently with the 30-day mortality of patients with ST5 lineage-associated cryptococcosis without HIV. CONCLUSION Our study has provided an understanding of the ST5 lineage associated with cryptococcosis.
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Hitchcock M, Xu J. Global Analyses of Multi-Locus Sequence Typing Data Reveal Geographic Differentiation, Hybridization, and Recombination in the Cryptococcus gattii Species Complex. J Fungi (Basel) 2023; 9:jof9020276. [PMID: 36836390 PMCID: PMC9967412 DOI: 10.3390/jof9020276] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Cryptococcus gattii species complex (CGSC) is a basidiomycete haploid yeast and globally distributed mammalian pathogen. CGSC is comprised of six distinct lineages (VGI, VGII, VGIII, VGIV, VGV, and VGVI); however, the geographical distribution and population structure of these lineages is incompletely described. In this study, we analyze published multi-locus sequence data at seven loci for 566 previously recorded sequence types (STs) encompassing four distinct lineages (VGI, VGII, VGIII, and VGIV) within the CGSC. We investigate indicators of both clonal dispersal and recombination. Population genetic analyses of the 375 STs representing 1202 isolates with geographic information and 188 STs representing 788 isolates with ecological source data suggested historically differentiated geographic populations with infrequent long-distance gene flow. Phylogenetic analyses of sequences at the individual locus and of the concatenated sequences at all seven loci among all 566 STs revealed distinct clusters largely congruent with four major distinct lineages. However, 23 of the 566 STs (4%) each contained alleles at the seven loci belonging to two or more lineages, consistent with their hybrid origins among lineages. Within each of the four major lineages, phylogenetic incompatibility analyses revealed evidence for recombination. However, linkage disequilibrium analyses rejected the hypothesis of random recombination across all samples. Together, our results suggest evidence for historical geographical differentiation, sexual recombination, hybridization, and both long-distance and localized clonal expansion in the global CGSC population.
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Taverna CG, Arias BA, Firacative C, Vivot ME, Szusz W, Vivot W, Mazza M, Córdoba SB, Canteros CE. Genotypic Diversity and Antifungal Susceptibility of Clinical Isolates of Cryptococcus Gattii Species Complex from Argentina. Mycopathologia 2023; 188:51-61. [PMID: 36609823 DOI: 10.1007/s11046-022-00705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/24/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study was to determine the genotypic diversity of 22 Cryptococcus gattii species complex clinical isolates from Argentina and to place these genotypes within the diversity of clinical, veterinary and environmental isolates from Latin America. Mating type and antifungal susceptibility of the isolates were also determined. By URA5-RFLP, nine isolates were identified as molecular type VGI, 10 as VGII, one as VGIII and two as VGIV. Multilocus sequence typing (MSLT), following the International Society for Human and Animal Mycology (ISHAM) consensus MLST scheme, was used to determine the genotypic diversity. Our results suggest that, in Argentina, VGI isolates have low genetic diversity, while VGII isolates have high genetic diversity. Both isolates identified as VGIV by URA5-RFLP were genotyped by MLST as belonging to the currently named VGVI clade. From all isolates, eight sequence types (STs) were unique for Argentina, while five STs have been reported already in other countries, being of high interest the genotypes ST20 and ST7 since they belong to the subtypes VGIIa and VGIIb, respectively, which are associated with hypervirulent strains responsible for outbreaks in North America. To note, geographical analysis showed that some genotypes may be associated with some regions in Argentina. Most isolates were MATα, but we are reporting one isolate MATa for the first time in the country. Antifungal susceptibility tests showed that itraconazole, voriconazole and posaconazole had high activity against all isolates, while amphotericin B, fluconazole and 5-fluorocytosine were the least active drugs against all studied isolates.
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Affiliation(s)
- Constanza Giselle Taverna
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Barbara Abigail Arias
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá, Colombia
| | - Matías Ezequiel Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Wanda Szusz
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Walter Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Mazza
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Susana Beatriz Córdoba
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Cristina Elena Canteros
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
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Beardsley J, Dao A, Keighley C, Garnham K, Halliday C, Chen SCA, Sorrell TC. What's New in Cryptococcus gattii: From Bench to Bedside and Beyond. J Fungi (Basel) 2022; 9:jof9010041. [PMID: 36675862 PMCID: PMC9865494 DOI: 10.3390/jof9010041] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Cryptococcus species are a major cause of life-threatening infections in immunocompromised and immunocompetent hosts. While most disease is caused by Cryptococcus neoformans, Cryptococcus gattii, a genotypically and phenotypically distinct species, is responsible for 11-33% of global cases of cryptococcosis. Despite best treatment, C. gattii infections are associated with early mortality rates of 10-25%. The World Health Organization's recently released Fungal Priority Pathogen List classified C. gattii as a medium-priority pathogen due to the lack of effective therapies and robust clinical and epidemiological data. This narrative review summarizes the latest research on the taxonomy, epidemiology, pathogenesis, laboratory testing, and management of C. gattii infections.
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Affiliation(s)
- Justin Beardsley
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, New South Wales Health, Sydney, NSW 2145, Australia
- Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
- Correspondence:
| | - Aiken Dao
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, New South Wales Health, Sydney, NSW 2145, Australia
- Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
| | - Caitlin Keighley
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
| | - Katherine Garnham
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Sunshine Coast University Hospital, Sunshine Coast University, Birtinya, QLD 4575, Australia
| | - Catriona Halliday
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, New South Wales Health, Sydney, NSW 2145, Australia
- Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Sydney, NSW 2145, Australia
| | - Sharon C.-A. Chen
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, New South Wales Health, Sydney, NSW 2145, Australia
- Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Sydney, NSW 2145, Australia
| | - Tania C. Sorrell
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, New South Wales Health, Sydney, NSW 2145, Australia
- Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
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21
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Firacative C, Zuluaga-Puerto N, Guevara J. Cryptococcus neoformans Causing Meningoencephalitis in Adults and a Child from Lima, Peru: Genotypic Diversity and Antifungal Susceptibility. J Fungi (Basel) 2022; 8:jof8121306. [PMID: 36547639 PMCID: PMC9781953 DOI: 10.3390/jof8121306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis, caused predominantly by Cryptococcus neoformans, is a potentially fatal, opportunistic infection that commonly affects the central nervous system of immunocompromised patients. Globally, this mycosis is responsible for almost 20% of AIDS-related deaths, and in countries like Peru, its incidence remains high, mostly due to the annual increase in new cases of HIV infection. This study aimed to establish the genotypic diversity and antifungal susceptibility of C. neoformans isolates causing meningoencephalitis in 25 adults and a 9-year-old girl with HIV and other risk factors from Lima, Peru. To identify the genotype of the isolates, multilocus sequence typing was applied, and to establish the susceptibility of the isolates to six antifungals, a YeastOne® broth microdilution was used. From the isolates, 19 were identified as molecular type VNI, and seven as VNII, grouped in eight and three sequence types, respectively, which shows that the studied population was highly diverse. Most isolates were susceptible to all antifungals tested. However, VNI isolates were less susceptible to fluconazole, itraconazole and voriconazole than VNII isolates (p < 0.05). This study contributes data on the molecular epidemiology and the antifungal susceptibility profile of the most common etiological agent of cryptococcosis, highlighting a pediatric case, something which is rare among cryptococcal infection.
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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 de Rosario, Bogota 111221, Colombia
- Correspondence:
| | | | - José Guevara
- Facultad de Medicina “San Fernando”, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
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Zhang J, Wang Z, Chen Y, Zhou Z, Yang Q, Fu Y, Zhao F, Li X, Chen Q, Fang L, Jiang Y, Yu Y. Antifungal susceptibility and molecular characteristics of Cryptococcus spp. based on whole-genome sequencing in Zhejiang Province, China. Front Microbiol 2022; 13:991703. [PMID: 36466641 PMCID: PMC9712201 DOI: 10.3389/fmicb.2022.991703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/31/2022] [Indexed: 06/05/2024] Open
Abstract
Cryptococcus spp. is a complex species that often causes cryptococcosis, which is one of the most common opportunistic infections in adults living with HIV and has very high morbidity and mortality rates. This study aimed to investigate the antifungal susceptibility profiles and epidemiological characteristics of the Cryptococcus neoformans species complex (CNSC) and the Cryptococcus gattii species complex (CGSC) in Zhejiang Province, China. A total of 177 CNSC and 3 CGSC isolates were collected, and antifungal susceptibility was tested by FUNGUS 3 and verified with an E-test. Moreover, multiple classification methods and genomic analyses were performed. The majority of the isolates (96.11%) were C. neoformans (formerly C. neoformans var. grubii) (ST5-VNI-A-α). Our study highlights that most of the patients with cryptococcosis were non-HIV patients in China, and nearly half of them did not have underlying diseases that led to immune insufficiency. Most of the Cryptococcus spp. isolates in this study were sensitive to common antifungal drugs. Two 5-flucytosine (5-FC)-resistant strains were identified, and FUR1 mutation was detected in the 5-FC-resistant isolates. Typing based on whole-genome sequencing (WGS) showed better discrimination than that achieved with multilocus sequence typing (MLST) and indicated a clear population structure. A phylogenetic analysis based on WGS included more genomic information than traditional classification methods.
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Affiliation(s)
- Junli Zhang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Zhengan Wang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Yan Chen
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Zhihui Zhou
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Qing Yang
- Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Fu
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Zhao
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xi Li
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Qiong Chen
- Department of Clinical Laboratory, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Fang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Yan Jiang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
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Hitchcock M, Xu J. Analyses of the Global Multilocus Genotypes of the Human Pathogenic Yeast Cryptococcus neoformans Species Complex. Genes (Basel) 2022; 13:2045. [PMID: 36360282 PMCID: PMC9691084 DOI: 10.3390/genes13112045] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/18/2023] Open
Abstract
Cryptococcus neoformans species complex (CNSC) is a globally distributed human opportunistic yeast pathogen consisting of five major molecular types (VNI, VNII, VNB, VNIII and VNIV) belonging to two species, C. neoformans (VNI, VNII and VNB, collectively called serotype A) and C. deneoformans (VNIV, commonly called serotype D), and their hybrids (VNIII, serotype AD). Over the years, many studies have analyzed the geographical distribution and genetic diversity of CNSC. However, the global population structure and mode of reproduction remain incompletely described. In this study, we analyze the published multilocus sequence data at seven loci for CNSC. The combined sequences at the seven loci identified a total of 657 multilocus sequence types (STs), including 296 STs with known geographic information, representing 4200 non-redundant isolates from 31 countries and four continents. Among the 296 STs, 78 and 52 were shared among countries and continents, respectively, representing 3643 of the 4200 isolates. Except for the clone-corrected serotype D sample among countries, our analysis of the molecular variance of the 4200 isolates revealed significant genetic differentiations among countries and continents in populations of CNSC, serotype A, and serotype D. Phylogenetic analyses of the concatenated sequences of all 657 STs revealed several large clusters corresponding to the major molecular types. However, several rare but distinct STs were also found, representing potentially novel molecular types and/or hybrids of existing molecular types. Phylogenetic incompatibility analyses revealed evidence for recombination within all four major molecular types-VNI, VNII, VNIV and VNB-as well as within two VNB subclades, VNBI and VNBII, and two ST clusters around the most common STs, ST5 and ST93. However, linkage disequilibrium analyses rejected the hypothesis of random recombination across most samples. Together, our results suggest evidence for historical differentiation, frequent recent gene flow, clonal expansion and recombination within and between lineages of the global CNSC population.
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Affiliation(s)
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada
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Zhao H, Cheng J, Zhou L, Luo Y, Zhu R, Jiang Y, Wang X, Zhu L. Induction therapy with high dose fluconazole plus flucytosine for human immunodeficiency virus‐uninfected cryptococcal meningitis patients: Feasible or not? Mycoses 2022; 66:59-68. [PMID: 36111370 PMCID: PMC10087831 DOI: 10.1111/myc.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cryptococcal meningitis (CM) is increasingly recognised in human immunodeficiency virus (HIV)-uninfected patients with high mortality. The efficacy and safety profiles of induction therapy with high-dose fluconazole plus flucytosine remain unclear. METHODS HIV-uninfected CM patients who received high-dose fluconazole (800 mg/d) for initial therapy in Huashan Hospital were included in this retrospective study from January 2013 to December 2018. Efficacy and safety of initial therapy, clinical outcomes and risk factors were evaluated. RESULTS Twenty-seven (71.1%) patients who received high-dose fluconazole with flucytosine combination therapy and 11 (28.9%) having fluconazole alone for induction therapy were included. With a median duration of 42 days (IQR, 28-86), the successful response rate of initial therapy was 76.3% (29/38), while adverse drug reactions occurred in 14 patients (36.8%). The rate of persistently positive cerebrospinal fluid (CSF) culture results was 30.6% at 2 weeks, which was significantly associated with CSF CrAg titre >1:1280 (OR 9.56; 95% CI 1.40-103.65; p = .010) and CSF culture of Cryptococcus >3.9 log10 CFU/ml (OR 19.20; 95% CI 1.60-920.54; p = .011), and decreased to 8.6% at 4 weeks. One-year mortality was 15.8% (6/38), and low serum albumin (35 g/L) was found as an independent risk factor for 1-year mortality (HR 6.31; 95% CI 1.150-34.632; p = .034). CONCLUSIONS Induction therapy with high-dose fluconazole (800 mg/d), combined with flucytosine, effectively treated HIV-uninfected CM and was well tolerated. Long-term fluconazole treatment with continued monitoring is beneficial for patients with persistent infection.
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Affiliation(s)
- Hua‐Zhen Zhao
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Jia‐Hui Cheng
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Ling‐Hong Zhou
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Yu Luo
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Rong‐Sheng Zhu
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Ying‐Kui Jiang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Xuan Wang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
| | - Li‐Ping Zhu
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital Fudan University Shanghai China
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The Predominance of a Specific Genotype of Cryptococcus neoformans var. Grubii in China and Japan. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8162096. [PMID: 36035289 PMCID: PMC9410922 DOI: 10.1155/2022/8162096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022]
Abstract
Background The extensive deployment of molecular genotyping methods is the top reliable keyword to characterize the population genetic structure of C. neoformans in the past decade. However, studies involving genotypic analysis of C. neoformans var. grubii from China and Japan are limited. Objectives We address this challenge to determine the genotype distribution of C. neoformans var. grubii strains from China and Japan. Methods Genotypic analysis of 52 C. neoformans var. grubii isolates was performed using multilocus microsatellite typing (MLMT) based on the sequence analysis of 3 functional genes. In order to place the herein-studied strains into the global picture, 22 strains randomly selected from the 52 strains studied by MLMT were also analyzed by restriction fragment length polymorphism analysis of the orotidine monophosphate pyrophosphorylase gene (URA5-RFLP), M13 PCR-fingerprinting, and multilocus sequence typing (MLST). Results MLMT classified 46 (88.5%) of the 52 strains as genotype MLMT-17. The high prevalence of the MLMT-17 type was observed for environmental and clinical isolates from China and Japan. URA5-RFLP analysis, M13 PCR-fingerprinting, and MLST showed that most of these belong to the VNI/ST5 (M5) genotype. Conclusions Our study suggests the predominance of a specific genotype of C. neoformans var. grubii in China and Japan.
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Kassaza K, Wasswa F, Nielsen K, Bazira J. Cryptococcus neoformans Genotypic Diversity and Disease Outcome among HIV Patients in Africa. J Fungi (Basel) 2022; 8:jof8070734. [PMID: 35887489 PMCID: PMC9325144 DOI: 10.3390/jof8070734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/24/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022] Open
Abstract
Cryptococcal meningoencephalitis, a disease with poor patient outcomes, remains the most prevalent invasive fungal infection worldwide, accounting for approximately 180,000 deaths each year. In several areas of sub-Saharan Africa with the highest HIV prevalence, cryptococcal meningitis is the leading cause of community-acquired meningitis, with a high mortality among HIV-infected individuals. Recent studies show that patient disease outcomes are impacted by the genetics of the infecting isolate. Yet, there is still limited knowledge of how these genotypic variations contribute to clinical disease outcome. Further, it is unclear how the genetic heterogeneity of C. neoformans and the extensive phenotypic variation observed between and within isolates affects infection and disease. In this review, we discuss current knowledge of how various genotypes impact disease progression and patient outcome in HIV-positive populations in sub-Saharan African, a setting with a high burden of cryptococcosis.
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Affiliation(s)
- Kennedy Kassaza
- Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, Uganda; (K.K.); (F.W.)
| | - Fredrickson Wasswa
- Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, Uganda; (K.K.); (F.W.)
| | - Kirsten Nielsen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence: (K.N.); (J.B.)
| | - Joel Bazira
- Department of Microbiology and Parasitology, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, Uganda; (K.K.); (F.W.)
- Correspondence: (K.N.); (J.B.)
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Su XH, Li WP, Liu JY, Wang YJ, Liu J, Xu XF, Yang L, Xia H, Jiang Y, Peng FH. Comparison of features and outcomes between HIV-negative patients with Cryptococcus gattii meningitis and Cryptococcus neoformans meningitis in South China. Mycoses 2022; 65:887-896. [PMID: 35793429 DOI: 10.1111/myc.13491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare the epidemiologic, clinical, laboratory, and imaging features, and outcomes in patients with Cryptococcus gattii meningitis (CGM) and Cryptococcus neoformans meningitis (CNM). METHODS We performed a retrospective study of HIV-negative patients with CGM and CNM (2015-2021) distinguished by metagenomic next-generation sequencing in cerebrospinal fluid in South China. RESULTS 81 patients (17 CGM, 64 CNM) were enrolled (72.8% male, median age 49 years, range 21-77 years), and CGM patients were younger (median, 43 vs 53 years, p = 0.005). Of 17 CGM, VGI and VGII accounted for 70.6% and 29.4%, respectively. CGM patients had less underlying diseases (7/17 [41.2%] vs 48/64 [75%], p=0.018) and focal neurologic deficit (3/17 [17.6%] vs 35/64 [54.7%], p = 0.022), had higher intracranial pressure (15/17 [88.2%] vs 25/64 [39.1%], p=0.002), more meningeal enhancement (14/17 [82.4%] vs 32/64 [50%], p = 0.034), less parenchymal involvement (median, 1 vs 3, p = 0.018), more lung cryptococcomas (6/12 [50%] vs 6/47 [12.8%], p = 0.014), faster CSF fungal clearance (p = 0.004), less complications (median, 1 vs 3, p < 0.001), and more favorable outcomes (16/17 [94.1%] vs 41/64 [64.1%], p =0.035). CONCLUSIONS This study demonstrated that species identification helps to guide therapy and predict outcomes.
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Affiliation(s)
- Xiao-Hong Su
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Wei-Peng Li
- Department of Neurology, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, P. R. China
| | - Jun-Yu Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Yi-Jie Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Jia Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Xiao-Feng Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Lu Yang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Han Xia
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, P. R. China
| | - Ying Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
| | - Fu-Hua Peng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P. R. China
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Zhou Z, Zhu C, Ip M, Liu M, Zhu Z, Liu R, Li X, Zeng L, Wu W. Molecular Epidemiology and Antifungal Resistance of Cryptococcus neoformans From Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Patients in Eastern China. Front Microbiol 2022; 13:942940. [PMID: 35865921 PMCID: PMC9294546 DOI: 10.3389/fmicb.2022.942940] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Cryptococcosis is an opportunistic and potentially lethal infection caused by Cryptococcus neoformans and Cryptococcus gattii complex, which affects both immunocompromised and immunocompetent people, and it has become a major public health concern worldwide. In this study, we characterized the molecular epidemiology and antifungal susceptibility of 133 C. neoformans isolates from East China Invasive Fungal Infection Group (ECIFIG), 2017–2020. Isolates were identified to species level by matrix-assisted laser desorption ionization-time of flight mass spectrometry and confirmed by IGS1 sequencing. Whole-genome sequencing (WGS) was conducted on three multidrug-resistant isolates. Among the 133 strains, 61 (45.86%) were isolated from HIV-positive patients and 72 (54.16%) were isolated from HIV-negative patients. In total, C. neoformans var. grubii accounted for 97.74% (130/133), while C. neoformans var. neoformans was rare (2.06%, 3/133). The strains were further classified into nine sequence types (STs) dominated by ST5 (90.23%, 120/133) with low genetic diversity. No association was observed between STs and HIV status. All strains were wild type to voriconazole, while high antifungal minimal inhibitory concentrations (MICs) above the epidemiological cutoff values (ECVs) were observed in C. neoformans strains, and more than half of isolates were non-wild-type to amphotericin B (89.15%, 109/133). Eight isolates were resistant to fluconazole, and eight isolates were non-wild type to 5-fluorocytosine. Furthermore, WGS has verified the novel mutations of FUR1 in 5-fluorocytosine-resistant strains. In one isolate, aneuploidy of chromosome 1 with G484S mutation of ERG11 was observed, inducing high-level resistance (MIC: 32 μg/ml) to fluconazole. In general, our data showed that there was no significant difference between HIV-positive and HIV-negative patients on STs, and we elucidate the resistant mechanisms of C. neoformans from different perspectives. It is important for clinical therapy and drug usage in the future.
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Affiliation(s)
- Ziyi Zhou
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chendi Zhu
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Manjiao Liu
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Zhaoqin Zhu
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Ryon Liu
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Xiaomin Li
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Lingbing Zeng
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Lingbing Zeng,
| | - Wenjuan Wu
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Wenjuan Wu,
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Naicker SD, Firacative C, van Schalkwyk E, Maphanga TG, Monroy-Nieto J, Bowers JR, Engelthaler DM, Meyer W, Govender NP. Molecular type distribution and fluconazole susceptibility of clinical Cryptococcus gattii isolates from South African laboratory-based surveillance, 2005–2013. PLoS Negl Trop Dis 2022; 16:e0010448. [PMID: 35767529 PMCID: PMC9242473 DOI: 10.1371/journal.pntd.0010448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
As is the case globally, Cryptococcus gattii is a less frequent cause of cryptococcosis than Cryptococcus neoformans in South Africa. We performed multilocus sequence typing (MLST) and fluconazole susceptibility testing of 146 isolates randomly selected from 750 South African patients with C. gattii disease identified through enhanced laboratory surveillance, 2005 to 2013. The dominant molecular type was VGIV (101/146, 70%), followed by VGI (40/146, 27%), VGII (3/146, 2%) and VGIII (2/146, 1%). Among the 146 C. gattii isolates, 99 different sequence types (STs) were identified, with ST294 (14/146, 10%) and ST155 (10/146, 7%) being most commonly observed. The fluconazole MIC50 and MIC90 values of 105 (of 146) randomly selected C. gattii isolates were 4 μg/ml and 16 μg/ml, respectively. VGIV isolates had a lower MIC50 value compared to non-VGIV isolates, but these values were within one double-dilution of each other. HIV-seropositive patients had a ten-fold increased adjusted odds of a VGIV infection compared to HIV-seronegative patients, though with small numbers (99/136; 73% vs. 2/10; 20%), the confidence interval (CI) was wide (95% CI: 1.93–55.31, p = 0.006). Whole genome phylogeny of 98 isolates of South Africa’s most prevalent molecular type, VGIV, identified that this molecular type is highly diverse, with two interesting clusters of ten and six closely related isolates being identified, respectively. One of these clusters consisted only of patients from the Mpumalanga Province in South Africa, suggesting a similar environmental source. This study contributed new insights into the global population structure of this important human pathogen. Cryptococcus is the most common cause of meningitis among adults in South Africa. Most human disease is caused by the members of two species complexes within the genus, Cryptococcus neoformans and Cryptococcus gattii. The environmental range of these species complexes, both found in soil, overlaps in southern Africa though C. gattii is a less common human pathogen. C. gattii is divided into six molecular types: VGI, VGII, VGIII, VGIV, VGV and VGVI. In earlier molecular epidemiology studies including relatively few isolates, most southern African isolates were confirmed as molecular type VGIV. We aimed to determine the molecular diversity of C. gattii in South Africa by genotyping patient isolates obtained through laboratory surveillance, 2005–2013. We confirmed that VGIV was the dominant molecular type and that HIV-seropositive patients were more likely to be infected with VGIV compared to those HIV-seronegative. Analysis of the genomes of South African VGIV isolates revealed that they spanned the whole VGIV clade and confirmed that most isolates did not cluster specifically. However, we observed two interesting clusters of closely related isolates, consisting of patients from three neighbouring provinces in South Africa, suggesting a similar environmental source. Further studies of clinical and environmental African C. gattii isolates are needed to gain a better understanding of this pathogen.
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Affiliation(s)
- Serisha D. Naicker
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Erika van Schalkwyk
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Tsidiso G. Maphanga
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Juan Monroy-Nieto
- Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America
| | - Jolene R. Bowers
- Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America
| | - David M. Engelthaler
- Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, New South Wales, Australia
- Westmead Institute for Medical Research, Westmead, New South Wales, Australia
- Research and Educational Network, Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia
- Curtin Medical School, Curtin University, Perth, Australia
| | - Nelesh P. Govender
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Medical Research Council Centre for Medical Mycology, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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Xue X, Zang X, Xiao M, Wang L, Wu H, Ma X, Wu N, Deng H, Zhou M, Pan L, Shen D, Wang J. Significance of differential expression profiles of ABC transporters in azole susceptibility between Cryptococcus gattii VGI and VGII strains. Med Mycol 2022; 60:6596290. [PMID: 35641230 DOI: 10.1093/mmy/myac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/27/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Azoles were used as the primary antifungal agents to treat the Cryptococcus gattii (C. gattii) infection. Evidence showed that subtypes of C. gattii respond differently to azoles, but the mechanism is largely elusive. In this study, we aimed to find the mechanisms of differences in azole drug susceptibility in different subtypes of C.gattii. Eight clinical strains of C. gattii were collected for molecular typing, multilocus sequence typing (MLST) analysis, and antifungal susceptibility testing. Based on drug susceptibility differences, the RNA sequencing data were analyzed to find candidate azole drug susceptibility genes, and qPCR validation was performed. Five VGI subtypes and three VGII subtypes were identified among the eight strains of C.gattii. The clinical isolates showed high genetic diversity, and seven sequence types (STs) were identified. The geometric mean (GM) of minimum inhibitory concentration (MIC) for fluconazole, voriconazole, and itraconazole of VGI subtype was significantly lower than that of VGII subtype, and genes related to transporter activities were differentially expressed between VGI and VGII strains. The results of the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the DEGs (differential expressed genes) were found to be enriched in multiple ABC transporters. We further performed qPCR to quantify the expression level of seven ABC transporters. We found that ABC transporters ATM1, MDR1, PDR5, PDR5-3, and PXA2 were expressed significantly higher in VGII strains than in VGI strains. Our work revealed four novel ABC transporters, ATM1, PDR5, PDR5-3, and PXA2, promising candidate targets regulating azole susceptibility in C. gattii strains.
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Affiliation(s)
- Xinying Xue
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University; Peking University Ninth School of Clinical Medicine, Beijing, China.,Department of Respiratory and Critical Care, Chinese PLA General Hospital, Beijing, China.,Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Xuelei Zang
- Medical School of Chinese PLA, Beijing, China.,Medical laboratory center, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Meng Xiao
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Lifeng Wang
- Medical laboratory center, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Hua Wu
- Department of clinical laboratory, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical College, Haikou, China
| | - Xidong Ma
- Department of Respiratory and Critical Care, Chinese PLA General Hospital, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Ningxin Wu
- Department of Cadres, 971 Hospital of the Chinese People's Liberation Army Navy, Qingdao, China
| | - Hengyu Deng
- Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Meng Zhou
- School of Medical Imaging, Binzhou Medical University, Yantai, China
| | - Lei Pan
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University; Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Dingxia Shen
- Medical laboratory center, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Jianxin Wang
- Department of Respiratory and Critical Care, Chinese PLA General Hospital, Beijing, China
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Clinical epidemiology and high genetic diversity amongst Cryptococcus spp. isolates infecting people living with HIV in Kinshasa, Democratic Republic of Congo. PLoS One 2022; 17:e0267842. [PMID: 35587939 PMCID: PMC9119562 DOI: 10.1371/journal.pone.0267842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/14/2022] [Indexed: 11/19/2022] Open
Abstract
Neuromeningeal cryptococcosis (NMC) is a life-threatening opportunistic infection in advanced HIV disease patients (AHDP). It is caused by Cryptococcus spp. complexes and mainly occurs in sub-Saharan Africa. In this study, we performed molecular characterization and antifungal susceptibility profiling of Cryptococcus isolates from AHDP in Kinshasa (DRC). Additionally, we investigated a possible association between NMC severity factors and the Cryptococcus neoformans (Cn) multilocus sequence typing (MLST) profiles. We characterized the isolates using PCR serotyping, MALDI-TOF MS, internal transcribed spacer (ITS) sequencing, and MLST. Susceptibility testing for the major antifungal drugs was performed according to the EUCAST guidelines. Parameters associated with NMC severity, such as hypoglycorrhachia (< 50 mg/dL), increased cerebral spinal fluid opening pressure (> 30 cm H2O), and poor therapeutic outcome were compared with the Cn MLST sequences type (ST). Twenty-three out of 29 Cryptococcus isolates were identified as serotype A using PCR serotyping (79.3%; 95% IC: 65.5–93.1), while six (20.7%; 95% IC: 6.9–34.5) were not serotypable. The 29 isolates were identified by ITS sequencing as follows: Cryptococcus neoformans (23/29, 79.3%), Cutaneotrichosporon curvatus (previously called Cryptococcus curvatus) (5/29, 17.2%), and Papiliotrema laurentii (Cryptococcus laurentii) (1/29, 3.5%). Using the ISHAM MLST scheme, all Cn isolates were identified as molecular type VNI. These comprised seven different STs: ST93 (n = 15), ST5 (n = 2), ST53 (n = 1), ST31 (n = 1), ST4 (n = 1), ST69 (n = 1), and one novel ST that has not yet been reported from other parts of the world and was subsequently assigned as ST659 (n = 2). Of the included strains, only Papiliotrema laurentii was resistant to amphoterin B (1/29, 3.5%), 6.8% (2/29) were resistant to 5-flucytosine (the single Papiliotrema laurentii strain and one Cryptococcus neoformans isolate), and 13.8% (4/29) to fluconazole, including two of five (40%) Cutaneotrichosporon curvatus and two of 23 (8.7%) C. neoformans strains. We found a significative association between poor therapeutic outcome and a non-ST93 sequence type of causative strains (these concerned the less common sequence types: ST53, ST31, ST5, ST4, ST659, and ST69) (87.5% versus 40%, p = 0.02). Molecular analysis of Cryptococcus spp. isolates showed a wide species diversity and genetic heterogenicity of Cn within the VNI molecular type. Furthermore, it is worrying that among included strains we found resistances to several of the commonly used antifungals.
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A Possible Link between the Environment and Cryptococcus gattii Nasal Colonisation in Koalas ( Phascolarctos cinereus) in the Liverpool Plains, New South Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084603. [PMID: 35457470 PMCID: PMC9028200 DOI: 10.3390/ijerph19084603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 01/25/2023]
Abstract
Cryptococcosis caused by yeasts of the Cryptococcus gattii species complex is an increasingly important mycological disease in humans and other mammals. In Australia, cases of C. gattii-related cryptococcosis are more prevalent in the koala (Phascolarctos cinereus) compared to humans and other animals, likely due to the close association that both C. gattii and koalas have with Eucalyptus species. This provides a cogent opportunity to investigate the epidemiology of spontaneous C. gattii infections in a free-living mammalian host, thereby offering insights into similar infections in humans. This study aimed to establish a link between nasal colonisation by C. gattii in free-ranging koalas and the tree hollows of Eucalyptus species, the key environmental source of the pathogen. We (i) detected and genotyped C. gattii from nine out of 169 free-ranging koalas and representative tree hollows within their home range in the Liverpool Plains, New South Wales, and (ii) examined potential environmental predictors of nasal colonisation in koalas and the presence of C. gattii in tree hollows. Phylogenetic analyses based on multi-locus sequence typing (MLST) revealed that the koalas were most likely colonised by the most abundant C. gattii genotypes found in the Eucalyptus species, or closely related genotypes. Importantly, the likelihood of the presence of C. gattii in tree hollows was correlated with increasing hollow size.
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Suzuki K, Cho O, Nagahama T, Sugita T. Short sequence repeats of the intergenic spacer regions of ribosomal RNA genes in Malassezia globosa and M. restricta colonizing the scalps of male individuals with and without androgenetic alopecia. Microbiol Immunol 2022; 66:350-352. [PMID: 35396869 DOI: 10.1111/1348-0421.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
We analyzed the short sequence repeats (SSRs) of the intergenic spacer (IGS) region 1 of the rRNA genes in Malassezia globosa and M. restricta, which predominantly colonize the scalp in androgenetic alopecia (AGA). No AGA-specific SSRs were found in the M. globosa IGS region, whereas a (CT)6 :(AT)8 SSR was predominantly detected in the M. restricta IGS region in the AGA group. Malassezia colonization was higher in the scalps of patients with M. restricta (CT)6 :(AT)8 SSRs than in the scalps of patients without M. restricta (CT)6 :(AT)8 SSRs. These observations suggest that this specific SSR type in M. restricta is involved in the development or exacerbation of AGA. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kazuhiro Suzuki
- Department of Microbiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan.,Research & Development Headquarters Self-Medication, Taisho Pharmaceutical Co., Ltd.; Saitama, Saitama, Japan
| | - Otomi Cho
- Department of Microbiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan
| | - Tohru Nagahama
- Research & Development Headquarters Self-Medication, Taisho Pharmaceutical Co., Ltd.; Saitama, Saitama, Japan
| | - Takashi Sugita
- Department of Microbiology, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan
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Rathore SS, Sathiyamoorthy J, Lalitha C, Ramakrishnan J. A holistic review on Cryptococcus neoformans. Microb Pathog 2022; 166:105521. [DOI: 10.1016/j.micpath.2022.105521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 12/21/2022]
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Deciphering the Association among Pathogenicity, Production and Polymorphisms of Capsule/Melanin in Clinical Isolates of Cryptococcus neoformans var. grubii VNI. J Fungi (Basel) 2022; 8:jof8030245. [PMID: 35330247 PMCID: PMC8950468 DOI: 10.3390/jof8030245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Cryptococcus neoformans is an opportunistic fungal pathogen that can cause meningitis in immunocompromised individuals. The objective of this work was to study the relationship between the phenotypes and genotypes of isolates of clinical origin from different cities in Colombia. Methods: Genome classification of 29 clinical isolates of C. neoformans var. grubii was performed using multilocus sequence typing (MLST), and genomic sequencing was used to genotype protein-coding genes. Pathogenicity was assessed in a larval model, and melanin production and capsule size were evaluated in vitro and in vivo. Results: Eleven MLST sequence types (STs) were found, the most frequent being ST69 (n = 9), ST2, ST93, and ST377 (each with n = 4). In the 29 isolates, different levels of pigmentation, capsule size and pathogenicity were observed. Isolates classified as highly pathogenic showed a tendency to exhibit larger increases in capsule size. In the analysis of polymorphisms, 48 non-synonymous variants located in the predicted functional domains of 39 genes were found to be associated with capsule size change, melanin, or pathogenicity. Conclusions: No clear patterns were found in the analysis of the phenotype and genotype of Cryptococcus. However, the data suggest that the increase in capsule size is a key variable for the differentiation of pathogenic isolates, regardless of the method used for its induction.
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Zang X, Ke W, Wang L, Wu H, Huang Y, Deng H, Zhou M, Wu N, Xue X, Shen D. Molecular epidemiology and microbiological characteristics of Cryptococcus gattii VGII isolates from China. PLoS Negl Trop Dis 2022; 16:e0010078. [PMID: 35196319 PMCID: PMC8901052 DOI: 10.1371/journal.pntd.0010078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/07/2022] [Accepted: 02/01/2022] [Indexed: 01/27/2023] Open
Abstract
Cryptococcus gattii (C. gattii) is a fungal pathogen that once caused an outbreak of cryptococcosis on Vancouver Island, and had spread worldwide, while few data were available in China. In this study, seven clinical isolates of C. gattii VGII were collected from 19 hospitals, Multi-locus Sequence Typing (MLST) analysis and whole-genome sequencing (WGS) was performed, combined with published data for phylogenetic analysis. In addition, in vitro antifungal susceptibility testing, phenotypic analysis, and in vivo virulence studies were performed, subsequently, histopathological analysis of lung tissue was performed. C.gattii VGII infected patients were mainly immunocompetent male, and most of them had symptoms of central nervous system (CNS) involvement. MLST results showed that isolates from China exhibited high genetic diversity, and sequence type (ST) 7 was the major ST among the isolates. Some clinical isolates showed a close phylogenetic relationship with strains from Australia and South America. All clinical isolates did not show resistance to antifungal drugs. In addition, there was no correlation between virulence factors (temperature, melanin production, and capsule size) and virulence while in vivo experiments showed significant differences in virulence among strains. Lung fungal burden and damage to lung tissue correlated with virulence, and degree of damage to lung tissue in mice may highlight differences in virulence. Our work seeks to provide useful data for molecular epidemiology, antifungal susceptibility, and virulence differences of C. gattii VGII in China.
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Affiliation(s)
- Xuelei Zang
- Medical School of Chinese PLA, Beijing, China
- Center of Clinical Laboratory Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Weixin Ke
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Lifeng Wang
- Center of Clinical Laboratory Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Hua Wu
- Department of clinical laboratory, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical College, Haikou, China
| | - Yemei Huang
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University; Peking University Ninth School of Clinical Medicine, Beijing, China
| | | | - Meng Zhou
- School of Medical Imaging, Binzhou Medical University, Yantai, China
| | - Ningxin Wu
- Department of Cadres, 971 Hospital of the Chinese People’s Liberation Army Navy, Qingdao, China
| | - Xinying Xue
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University; Peking University Ninth School of Clinical Medicine, Beijing, China
- Weifang Medical University, Weifang, China
- * E-mail: (XX); (DS)
| | - Dingxia Shen
- Center of Clinical Laboratory Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- * E-mail: (XX); (DS)
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Birkenfeld ZM, Dittel N, Harrer T, Stephan C, Kiderlen AF, Rickerts V. Phenotypic Diversity of C. neoformans var. neoformans Clinical Isolates from Localized and Disseminated Infections. Microorganisms 2022; 10:microorganisms10020321. [PMID: 35208777 PMCID: PMC8878387 DOI: 10.3390/microorganisms10020321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 12/02/2022] Open
Abstract
Cryptococcus neoformans var. neoformans is the second most prevalent agent of cryptococcosis in central Europe. Infections mostly present with localized skin and disseminated infections. Previous studies did not find these presentations to be determined by the fungal genotype as detected by multilocus sequence typing (MLST). However, phenotypic fungal traits may impact clinical presentation. Here, we studied the growth and virulence factors of C. neoformans var. neoformans isolates from disseminated and localized infections and an environmental isolate. We used coincubation with Acanthamoeba castellanii and the Galleria mellonella infection model to identify phenotypic characteristics potentially associated with clinical presentation. Clinical isolates of C. neoformans var. neoformans present a substantial phenotypic variability. Median survival of G. mellonella varied between 6 and 14 days. C. neoformans var. neoformans isolates from disseminated infections showed stronger melanization and larger capsules. They demonstrated superior uptake into an amoeba and increased cytotoxicity for the amoeba. Differences of strains from localized and disseminated infections in coincubation with amoeba are in line with the importance of phagocytes in the pathogenesis of disseminated cryptococcosis. Phenotypic traits and non-vertebrate infection models may help understand the virulence potential of C. neoformans var. neoformans isolates.
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Affiliation(s)
- Zena M. Birkenfeld
- Department of Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, 13353 Berlin, Germany; (Z.M.B.); (N.D.); (A.F.K.)
| | - Nikita Dittel
- Department of Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, 13353 Berlin, Germany; (Z.M.B.); (N.D.); (A.F.K.)
| | - Thomas Harrer
- Medizinische Klinik 3, Sektion Klinische Infektiologie und Immundefizienz, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Christoph Stephan
- Medizinische Klinik 2, Infektiologie und Therapie der HIV Infektion, Universitätsklinikum Frankfurt, 60596 Frankfurt am Main, Germany;
| | - Albrecht F. Kiderlen
- Department of Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, 13353 Berlin, Germany; (Z.M.B.); (N.D.); (A.F.K.)
| | - Volker Rickerts
- Department of Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, 13353 Berlin, Germany; (Z.M.B.); (N.D.); (A.F.K.)
- Correspondence:
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Harun A, Kan A, Schwabenbauer K, Gilgado F, Perdomo H, Firacative C, Losert H, Abdullah S, Giraud S, Kaltseis J, Fraser M, Buzina W, Lackner M, Blyth CC, Arthur I, Rainer J, Lira JFC, Artigas JG, Tintelnot K, Slavin MA, Heath CH, Bouchara JP, Chen SCA, Meyer W. Multilocus Sequence Typing Reveals Extensive Genetic Diversity of the Emerging Fungal Pathogen Scedosporium aurantiacum. Front Cell Infect Microbiol 2022; 11:761596. [PMID: 35024355 PMCID: PMC8744116 DOI: 10.3389/fcimb.2021.761596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/26/2021] [Indexed: 01/19/2023] Open
Abstract
Scedosporium spp. are the second most prevalent filamentous fungi after Aspergillus spp. recovered from cystic fibrosis (CF) patients in various regions of the world. Although invasive infection is uncommon prior to lung transplantation, fungal colonization may be a risk factor for invasive disease with attendant high mortality post-transplantation. Abundant in the environment, Scedosporium aurantiacum has emerged as an important fungal pathogen in a range of clinical settings. To investigate the population genetic structure of S. aurantiacum, a MultiLocus Sequence Typing (MLST) scheme was developed, screening 24 genetic loci for polymorphisms on a tester strain set. The six most polymorphic loci were selected to form the S. aurantiacum MLST scheme: actin (ACT), calmodulin (CAL), elongation factor-1α (EF1α), RNA polymerase subunit II (RPB2), manganese superoxide dismutase (SOD2), and β-tubulin (TUB). Among 188 global clinical, veterinary, and environmental strains, 5 to 18 variable sites per locus were revealed, resulting in 8 to 23 alleles per locus. MLST analysis observed a markedly high genetic diversity, reflected by 159 unique sequence types. Network analysis revealed a separation between Australian and non-Australian strains. Phylogenetic analysis showed two major clusters, indicating correlation with geographic origin. Linkage disequilibrium analysis revealed evidence of recombination. There was no clustering according to the source of the strains: clinical, veterinary, or environmental. The high diversity, especially amongst the Australian strains, suggests that S. aurantiacum may have originated within the Australian continent and was subsequently dispersed to other regions, as shown by the close phylogenetic relationships between some of the Australian sequence types and those found in other parts of the world. The MLST data are accessible at http://mlst.mycologylab.org. This is a joined publication of the ISHAM/ECMM working groups on “Scedosporium/Pseudallescheria Infections” and “Fungal Respiratory Infections in Cystic Fibrosis”.
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Affiliation(s)
- Azian Harun
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Alex Kan
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Katharina Schwabenbauer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Felix Gilgado
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Haybrig Perdomo
- Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | - Carolina Firacative
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | | | - Sarimah Abdullah
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Sandrine Giraud
- UNIV Angers, Université de Bretagne Occidentale, Centre Hospitalier Universitaire (CHU) d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP), EA3142, Structure Fédérative de Recherche "Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
| | - Josef Kaltseis
- Institute of Hygiene and Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - Mark Fraser
- UK National Mycology Reference Laboratory, National Infection Service, Public Health England South-West, Bristol, United Kingdom
| | - Walter Buzina
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University, Graz, Austria
| | - Michaela Lackner
- Institute of Hygiene and Microbiology, Medical University Innsbruck, Innsbruck, Austria
| | - Christopher C Blyth
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia.,Telethon Kids Institute and Medical School, University of Western Australia, Perth, WA, Australia
| | - Ian Arthur
- Mycology Laboratory, Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine Western Australia, Perth, WA, Australia
| | - Johannes Rainer
- Institute of Microbiology, Leopold Franzens University Innsbruck, Innsbruck, Austria
| | - José F Cano Lira
- Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Guarro Artigas
- Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, Universitat Rovira i Virgili, Reus, Spain
| | | | - Monica A Slavin
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, Melbourne, VIC, Australia
| | - Christopher H Heath
- Department of Microbiology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch; & Infectious Diseases Department, Fiona Stanley Hospital, Murdoch; Department of Microbiology & Infectious Diseases, Royal Perth Hospital, Perth; & the University of Western Australia, Perth, WA, Australia
| | - Jean-Philippe Bouchara
- UNIV Angers, Université de Bretagne Occidentale, Centre Hospitalier Universitaire (CHU) d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP), EA3142, Structure Fédérative de Recherche "Interactions Cellulaires et Applications Thérapeutiques (SFR ICAT), Angers, France
| | - Sharon C A Chen
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia.,Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Sydney Medical School, Westmead Clinical School, Sydney Institute for Infectious Diseases, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
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Mohammed R, Nader SM, Hamza DA, Sabry MA. Horse: a potential source of Cryptococcus neoformans and Cryptococcus gattii in Egypt. BMC Vet Res 2022; 18:17. [PMID: 34983525 PMCID: PMC8725405 DOI: 10.1186/s12917-021-03127-x] [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: 07/24/2021] [Accepted: 12/23/2021] [Indexed: 11/12/2022] Open
Abstract
Background Cryptococcosis is an opportunistic mycozoonosis of global significance in a wide variety of host species. In equines, cryptococcosis is uncommon, and sporadic cases have been reported with rhinitis, sinusitis, pneumonia, and meningitis. Cryptococcus spp. represents a potential risk for immunosuppressed and healthy persons. In Egypt, epidemiological data on cryptococcal infection in horses are limited. The current study was carried out to investigate the occurrence of Cryptococcus spp. in horses and its possible role in the epidemiology of such disease in Egypt. A total of 223 samples was collected from different localities in Egypt included 183 nasal swabs from horses, 28 nasal swabs from humans, and 12 soil samples. Bacteriological examination and the identification of Cryptococcus spp. were performed. Molecular serotyping of Cryptococcus spp. was determined by multiplex PCR using CNa-70S/A-CNb-49S/A. The virulence genes (LAC1, CAP59, and PLB1) of the identified isolates were detected by PCR. Moreover, sequencing and phylogenetic analysis of the C. gattii gene from horses, humans, and soil isolates found nearby were performed. Result The overall occurrence of Cryptococcus spp. in horses were 9.3, 25, and 10.7% in horses, the soil, and humans, respectively. Molecular serotyping of the Cryptococcus spp. isolates recovered from the nasal passages of horses proved that C. gattii (B), C. neoformans, and two hybrids between C. neoformans (A) and C. gattii (B) were identified. Meanwhile, in case of soil samples, the isolates were identified as C. gattii (B). The human isolates were serotyped as C. gattii in two isolates and C. neoformans in only one isolate. Molecular detection of some virulence genes (LAC1), (CAP59), and (PLB1) were identified in both C. gattii and C. neoformans isolates. The C. gattii gene amplicons of the isolates from horses, humans, and the soil were closely related. Conclusion This study provides the first insights into the Egyptian horse ecology of Cryptococcus species and highlights the role of horses as asymptomatic carriers in disseminating the potentially pathogenic Cryptococcus spp. It also presents the possible risk of cryptococcosis infection in humans.
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Affiliation(s)
- Rahma Mohammed
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
| | - Sara M Nader
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
| | - Dalia A Hamza
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt.
| | - Maha A Sabry
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, PO Box 12211, Giza, Egypt
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Climate Change and Global Distribution of Cryptococcosis. Fungal Biol 2022. [DOI: 10.1007/978-3-030-89664-5_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chang CC, Hall V, Cooper C, Grigoriadis G, Beardsley J, Sorrell TC, Heath CH. Consensus guidelines for the diagnosis and management of cryptococcosis and rare yeast infections in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:118-142. [PMID: 34937137 DOI: 10.1111/imj.15590] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cryptococcosis caused by the Cryptococcus neoformans-Cryptococcus gattii complex is an important opportunistic infection in people with immunodeficiency, including in the haematology/oncology setting. This may manifest clinically as cryptococcal meningitis or pulmonary cryptococcosis, or be detected incidentally by cryptococcal antigenemia, a positive sputum culture or radiological imaging. Non-Candida, non-Cryptococcus spp. rare yeast fungaemia are increasingly common in this population. These consensus guidelines aim to provide clinicians working in the Australian and New Zealand haematology/oncology setting with clear guiding principles and practical recommendations for the management of cryptococcosis, while also highlighting important and emerging rare yeast infections and their recommended management.
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Affiliation(s)
- Christina C Chang
- Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Therapeutic and Vaccine Research Programme, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.,Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, KwaZulu Natal, South Africa
| | - Victoria Hall
- Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - Celia Cooper
- Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - George Grigoriadis
- Monash Haematology, Monash Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Haematology, Alfred Hospital, Prahran, Victoria, Australia
| | - Justin Beardsley
- Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, Sydney, New South Wales, Australia.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Tania C Sorrell
- Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, New South Wales, Australia.,Infectious Diseases and Sexual Health, Western Sydney Local Health District, Parramatta, New South Wales, Australia
| | - Christopher H Heath
- Department of Microbiology, Fiona Stanley Hospital Network, PathWest Laboratory Medicine, Murdoch, Western Australia, Australia.,Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Department of Infectious Diseases, Royal Perth Hospital, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Murdoch, Western Australia, Australia
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Prevalence, Genetic Structure, and Antifungal Susceptibility of the Cryptococcus neoformans/C. gattii Species Complex Strains Collected from the Arboreal Niche in Poland. Pathogens 2021; 11:pathogens11010008. [PMID: 35055956 PMCID: PMC8780472 DOI: 10.3390/pathogens11010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022] Open
Abstract
Fungi belonging to the Cryptococcus neoformans/C. gattii species complex (CNGSC) are etiological agents of serious and not infrequently fatal infections in both humans and animals. Trees are the main ecological niche and source of potential exposition concerning these pathogens. With regard to epidemiology of cryptococcosis, various surveys were performed worldwide, enabling the establishment of a map of distribution and genetic structure of the arboreal population of the CNGSC. However, there are regions, among them Central and Eastern Europe, in which the data are lacking. The present study shows the results of such an environmental study performed in Wrocław, Poland. The CNGSC strains were detected in 2.2% of the tested trees belonging to four genera. The obtained pathogen population consisted exclusively of C. neoformans, represented by both the major molecular type VNI and VNIV. Within the tested group of isolates, resistance to commonly used antimycotics was not found, except for 5-fluorocytosine, in which about 5% of the strains were classified as a non-wild type.
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Yang C, Bian Z, Blechert O, Deng F, Chen H, Li Y, Yang Y, Chen M, Zhan P. High Prevalence of HIV-Related Cryptococcosis and Increased Resistance to Fluconazole of the Cryptococcus neoformans Complex in Jiangxi Province, South Central China. Front Cell Infect Microbiol 2021; 11:723251. [PMID: 34790585 PMCID: PMC8592285 DOI: 10.3389/fcimb.2021.723251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/10/2021] [Indexed: 11/26/2022] Open
Abstract
Background Cryptococcosis is caused by a fungi of the Cryptococcus neoformans/Cryptococcus gattii complex and is a severe concern for public health worldwide. C. neoformans species are globally distributed, and C. gattii species are mostly found in America, Australia, and Sub-Saharan Africa. Cryptococcus usually infects an immunocompromised population; however, the majority of cryptococcosis in China has been reported in patients without any recognizable immunosuppression, i.e., HIV infection. To date, very few studies investigated this disease in South Central China. Methods The present study recruited 230 clinically suspected cryptococcosis cases in the last 5 years at two hospitals in Jiangxi Province, South Central China. All isolated strains were subjected to multilocus sequence typing (MLST) and phylogenetic analysis. Serotype and mating type were assessed by PCR, in vitro antifungal susceptibility was assessed by the CLSI-M27-A3 protocol. Results A total of 230 patients were identified as infected by C. neoformans, including 12 cases with Talaromyces marneffei coinfection. All seven MLST markers were successfully amplified and used to identify the ST genotype in 199 strains. C. gattii strains were not detected. In contrast to previous studies, 59.3% of the patients had an immunocompromised status, and 61.9% of these patients were infected with HIV. All isolates manifested serotype A and mating type α. The ST5 genotype was common (89.5%) in the Jiangxi region, and three novel genotypes (ST656, ST657, and ST658 in six isolates) were detected in the present study. A total of 86 of the isolates (43.2%) were not sensitive to fluconazole at a MIC50 ≥ 8 μg/ml, most of the isolates were resistant to amphotericin B, and nearly all isolates were resistant to itraconazole and posaconazole. Resistances to 5-Flucytosine and voriconazole were very rare. Conclusions The results of the present study indicated that C. neoformans is the predominant species for cryptococcosis in Jiangxi Province, and a large proportion of the strains were not sensitive to fluconazole, which may be related to treatment failure and relapse. A high percentage of HIV-related C. neoformans infections was reported in Jiangxi, supporting a previous hypothesis that cryptococcosis is more frequent among the HIV-infected population in China. Continuous monitoring of species distribution and antifungal sensitivity is important for the investigation of this severe disease in the Jiangxi region.
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Affiliation(s)
- Chunxi Yang
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zeyuan Bian
- Jiangxi Provincial Chest Hospital, Nanchang, China
| | - Oliver Blechert
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Fengyi Deng
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hui Chen
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Yueting Li
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Yunhong Yang
- Jiangxi Provincial Chest Hospital, Nanchang, China
| | - Min Chen
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, China
| | - Ping Zhan
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
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Reis RS, Bonna ICF, Antonio IMDS, Pereira SA, do Nascimento CRS, Ferraris FK, Brito-Santos F, Ferreira Gremião ID, Trilles L. Cryptococcus neoformans VNII as the Main Cause of Cryptococcosis in Domestic Cats from Rio de Janeiro, Brazil. J Fungi (Basel) 2021; 7:jof7110980. [PMID: 34829267 PMCID: PMC8621350 DOI: 10.3390/jof7110980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Cryptococcosis is a systemic fungal disease acquired from contaminated environments with propagules of the basidiomycetous yeasts of the Cryptococcus neoformans and C. gattii species complexes. The C. neoformans species complex classically comprises four major molecular types (VNI, VNII, VNIII, and VNIV), and the C. gattii species complex comprises another four (VGI, VGII, VGIII, and VGIV) and the newly identified molecular type VGV. These major molecular types differ in their epidemiological and ecological features, clinical presentations, and therapeutic outcomes. Generally, the most common isolated types are VNI, VGI, and VGII. The epidemiological profile of cryptococcosis in domestic cats is poorly studied and cats can be the sentinels for human infections. Therefore, the present study aimed to determine the molecular characterization of Cryptococcus spp. isolated from domestic cats and their dwellings in the metropolitan area of Rio de Janeiro, Brazil. A total of 36 Cryptococcus spp. strains, both clinical and environmental, from 19 cats were subtyped using multilocus sequence typing (MLST). The ploidy was identified using flow cytometry and the mating type was determined through amplification with specific pheromone primers. All strains were mating type alpha and 6/36 were diploid (all VNII). Most isolates (63.88%) were identified as VNII, a rare molecular type, leading to the consideration that this genotype is more likely related to skin lesions, since there was a high percentage (68.75%) of cats with skin lesions, which is also considered rare. Further studies regarding the molecular epidemiology of cryptococcosis in felines are still needed to clarify the reason for the large proportion of the rare molecular type VNII causing infections in cats.
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Affiliation(s)
- Rosani Santos Reis
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabel Cristina Fábregas Bonna
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabela Maria da Silva Antonio
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | | | - Fausto Klabund Ferraris
- Pharmacology Laboratory/INCQS/Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil;
| | - Fábio Brito-Santos
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo)/INI/Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.M.d.S.A.); (S.A.P.); (I.D.F.G.)
| | - Luciana Trilles
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro 21040-900, Brazil; (R.S.R.); (I.C.F.B.); (F.B.-S.)
- Correspondence:
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Bellet V, Roger F, Krasteva D, Gouveia T, Drakulovski P, Pottier C, Bertout S. Multilocus sequence typing of strains from the Cryptococcus gattii species complex from different continents. Mycoses 2021; 65:88-96. [PMID: 34726802 DOI: 10.1111/myc.13389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cryptococcus neoformans and Cryptococcus gattii species complexes are pathogens causing cryptococcal meningitis, a fungal infection that leads to death unless treated. Worldwide, it is estimated to kill over 180,000 individuals annually. OBJECTIVES We aim to investigate the molecular diversity of C. gattii isolates from strains isolated from 1995 to the present day from different continents. METHOD In this study, we analysed the molecular diversity by MLST and antifungal susceptibility by using the broth microdilution method according to the CLSI M27-A4 protocol of a total of 26 strains from Cryptococcus gattii species complex from both clinical and environmental sources. RESULTS Genotyping showed that most of the strains (17/26; 65.4%) belonged to serotype B and were distributed between three genotypes: VGI (13/17; 76.5%), VGII (3/17; 17.6%) and VGVI (1/17; 5.9%). The serotype C strains (9/26; 34.6%) were distributed between the VGIII (1/9; 11.1%) and VGIV (8/9; 88.9%) genotypes. The 26 strains belonged to 17 different MLST subtypes, and we highlight four new MLST genotypes (ST553, 554, 555 and 556). The two environmental strains were identified as serotype B and genotype VGI, but were of ST 51 and 154. All isolates have wild-type MIC of fluconazole and flucytosine. Regarding amphotericin B, five VGI strains showed MICs to AMB equal to 1 µg/ml, and according to the ECV for these genotypes, they were considered non-wild-type strains. CONCLUSIONS The current study reveals the genetic diversity and new sequence types among strains from the C. gattii complex species.
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Affiliation(s)
- Virginie Bellet
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Frédéric Roger
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Donika Krasteva
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Tiphany Gouveia
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Pascal Drakulovski
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Cyril Pottier
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Sébastien Bertout
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
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Teman SJ, Gaydos JK, Norman SA, Huggins JL, Lambourn DM, Calambokidis J, Ford JKB, Hanson MB, Haulena M, Zabek E, Cottrell P, Hoang L, Morshed M, Garner MM, Raverty S. Epizootiology of a Cryptococcus gattii outbreak in porpoises and dolphins from the Salish Sea. DISEASES OF AQUATIC ORGANISMS 2021; 146:129-143. [PMID: 34672263 DOI: 10.3354/dao03630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cryptococcus gattii is a fungal pathogen that primarily affects the respiratory and nervous systems of humans and other animals. C. gattii emerged in temperate North America in 1999 as a multispecies outbreak of cryptococcosis in British Columbia (Canada) and Washington State and Oregon (USA), affecting humans, domestic animals, and wildlife. Here we describe the C. gattii epizootic in odontocetes. Cases of C. gattii were identified in 42 odontocetes in Washington and British Columbia between 1997 and 2016. Species affected included harbor porpoises Phocoena phocoena (n = 26), Dall's porpoises Phocoenoides dalli (n = 14), and Pacific white-sided dolphins Lagenorhynchus obliquidens (n = 2). The probable index case was identified in an adult male Dall's porpoise in 1997, 2 yr prior to the initial terrestrial outbreak. The spatiotemporal extent of the C. gattii epizootic was defined, and cases in odontocetes were found to be clustered around terrestrial C. gattii hotspots. Case-control analyses with stranded, uninfected odontocetes revealed that risk factors for infection were species (Dall's porpoises), age class (adult animals), and season (winter). This study suggests that mycoses are an emerging source of mortality for odontocetes, and that outbreaks may be associated with anthropogenic environmental disturbance.
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Affiliation(s)
- Sarah J Teman
- The SeaDoc Society, Karen C. Drayer Wildlife Health Center - Orcas Island Office, UC Davis School of Veterinary Medicine, Eastsound, WA 98245, USA
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Chidebelu PE, Nweze EI, Meis JF, Cogliati M, Hagen F. Multi-locus sequence typing reveals genotypic similarity in Nigerian Cryptococcus neoformans AFLP1/VNI of environmental and clinical origin. J Med Microbiol 2021; 70. [PMID: 34665109 DOI: 10.1099/jmm.0.001440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IntroductionPigeon droppings are among the major environmental sources of Cryptococcus neoformans AFLP1/VNI, from where the organism infects susceptible humans and animals resulting in cryptococcosis. Until now, C. neoformans AFLP1B/VNII was the only molecular type reported in Nigeria. Effective clinical treatment of this infection has occasionally been stymied by the emergence of antifungal non-susceptible, and resistant strains of C. neoformans AFLP1/VNI.Hypothesis/Gap StatementPigeon droppings harbour C. neoformans and HIV/AIDS patients are among the susceptible population to develop cryptococcal infection. Epidemiological data on cryptococcal prevalence is limited in Nigeria.AimTo investigate the environmental prevalence of C. neoformans in South-eastern Nigeria and compare the isolates with other lineages by using molecular and microbiological tools.MethodologyA total of 500 pigeon droppings and 300 blood samples of HIV/AIDS patients were collected, respectively, from five market squares and three tertiary healthcare centres within the Nsukka area of South-eastern Nigeria. The antifungal susceptibility of the C. neoformans isolates to amphotericin B, fluconazole, 5-fluorocytosine, itraconazole, voriconazole, posaconazole, and isavuconazole was investigated based on the CLSI M27-A3 protocol. Yeasts were identified by MALDI-TOF MS, thereafter Cryptococcus MLST was performed according to the International Society for Human and Animal Mycology (ISHAM) consensus scheme.Results C. neoformans was recovered from 6 (1.2 %) pigeon droppings and 6 (2 %) blood cultures of HIV/AIDS patients. Molecular analyses indicated that all cryptococcal isolates belong to serotype A and the AFLP1/VNI molecular type with sequence type (ST)32. Infection with C. neoformans was independent of sex and age of the patients investigated. All C. neoformans isolates were susceptible to the seven antifungal agents.ConclusionThis is the first report on the prevalence of C. neoformans AFLP1/VNI (ST32) in environmental and clinical samples from Nigeria. The antifungal susceptibility indicates that antifungal resistance by C. neoformans is yet a rare occurrence in Nigeria.
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Affiliation(s)
- Paul E Chidebelu
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emeka I Nweze
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
- Cleveland State University, Cleveland, Ohio, USA
| | - Jacques F Meis
- Department of Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Centre of Expertise in Mycology RadboudUMC/CWZ, Nijmegen, The Netherlands
| | - Massimo Cogliati
- Laboratorio di Micologia Medica, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Silva C, Juan-Sallés C, Mendes J, Mendes A, Ruivo M, Abad JL, Hagen F, Colom MF. Cryptococcus bacillisporus causing cryptococcoma of the beak of an African grey parrot ( Psittacus erithacus), Portugal. Med Mycol Case Rep 2021; 34:8-12. [PMID: 34522600 PMCID: PMC8427220 DOI: 10.1016/j.mmcr.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 01/11/2023] Open
Abstract
We report a severe case of rhinothecal cryptococcoma in a 13-year-old female African Grey Parrot (Psittacus erithacus). The bird was born and bred in captivity in Portugal. The beak was deformed and showed several round soft masses, and microscopic examination revealed the presence of cells suggestive for Cryptococcus. Phenotypic and molecular analyses identified the obtained yeast culture as C. bacillisporus (AFLP5/VGIII). By phylogenetic analysis the parrot strain clustered with clinical C. bacillisporus strains from Mexico.
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Affiliation(s)
| | - Carles Juan-Sallés
- Noah's Path. Veterinary Pathology Laboratory Specialising in Wildlife and Exotic Species, Elche, Spain
| | - Joana Mendes
- VetExóticos, Clínica Veterinaria, Almada, Portugal
| | - Ana Mendes
- VetExóticos, Clínica Veterinaria, Almada, Portugal
| | | | - Juan L Abad
- Medical Mycology Laboratory, University Miguel Hernández, Sant Joan D'Alacant, Spain
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maria F Colom
- Medical Mycology Laboratory, University Miguel Hernández, Sant Joan D'Alacant, Spain.,Institute for Healthcare and Biomedical Research of Alicante, ISABIAL, Alicante, Spain
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49
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Liu S, Hu Q, Li C, Zhang F, Gu H, Wang X, Li S, Xue L, Madl T, Zhang Y, Zhou L. Wide-Range, Rapid, and Specific Identification of Pathogenic Bacteria by Surface-Enhanced Raman Spectroscopy. ACS Sens 2021; 6:2911-2919. [PMID: 34282892 PMCID: PMC8406416 DOI: 10.1021/acssensors.1c00641] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sensitive, selective, rapid, and label-free detection of pathogenic bacteria with high generality is of great importance for clinical diagnosis, biosecurity, and public health. However, most traditional approaches, such as microbial cultures, are time-consuming and laborious. To circumvent these problems, surface-enhanced Raman spectroscopy (SERS) appears to be a powerful technique to characterize bacteria at the single-cell level. Here, by SERS, we report a strategy for the rapid and specific detection of 22 strains of common pathogenic bacteria. A novel and high-quality silver nanorod SERS substrate, prepared by the facile interface self-assembly method, was utilized to acquire the chemical fingerprint information of pathogens with improved sensitivity. We also applied the mathematical analysis methods, such as the t-test and receiver operating characteristic method, to determine the Raman features of these 22 strains and demonstrate the clear identification of most bacteria (20 strains) from the rest and also the reliability of this SERS sensor. This rapid and specific strategy for wide-range bacterial detection offers significant advantages over existing approaches and sets the base for automated and onsite detection of pathogenic bacteria in a complex real-life situation.
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Affiliation(s)
- Siying Liu
- CAS Key Laboratory of Design and Assembly of Functional Nanostructures, and Fujian Provincial Key Laboratory of Nanomaterials, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, China
- Department of Translational Medicine, Xiamen Institute of Rare Earth Materials, Chinese Academy of Sciences, Xiamen 361021, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qiushi Hu
- State Key Laboratory of Biochemical Engineering, PLA Key Laboratory of Biopharmaceutical Production & Formulation Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Chao Li
- Institute of Medical Equipment, Academy of Military Sciences, Tianjin 300161, China
| | - Fangrong Zhang
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Institute of Molecular Biology & Biochemistry, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Hongjing Gu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Xinrui Wang
- Anti-plague Institute Hebei Province, Zhangjiakou 075000, China
| | - Shuang Li
- State Key Laboratory of Biochemical Engineering, PLA Key Laboratory of Biopharmaceutical Production & Formulation Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Lei Xue
- State Key Laboratory of Biochemical Engineering, PLA Key Laboratory of Biopharmaceutical Production & Formulation Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Tobias Madl
- CAS Key Laboratory of Design and Assembly of Functional Nanostructures, and Fujian Provincial Key Laboratory of Nanomaterials, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, China
- Department of Translational Medicine, Xiamen Institute of Rare Earth Materials, Chinese Academy of Sciences, Xiamen 361021, China
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Institute of Molecular Biology & Biochemistry, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Yun Zhang
- CAS Key Laboratory of Design and Assembly of Functional Nanostructures, and Fujian Provincial Key Laboratory of Nanomaterials, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou 350002, China
- Department of Translational Medicine, Xiamen Institute of Rare Earth Materials, Chinese Academy of Sciences, Xiamen 361021, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lei Zhou
- State Key Laboratory of Biochemical Engineering, PLA Key Laboratory of Biopharmaceutical Production & Formulation Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
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50
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Takahashi Y, Osawa R, Kubota Y, Fujii M, Matsuda N, Watanabe N, Watari T, Otsuka Y, Hosokawa N. Early diagnosis of Cryptococcus neoformans var. grubii meningitis using multiplex PCR assay in an immunocompetent patient. J Infect Chemother 2021; 27:1765-1768. [PMID: 34393039 DOI: 10.1016/j.jiac.2021.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/14/2021] [Accepted: 08/07/2021] [Indexed: 12/01/2022]
Abstract
Cryptococcosis is an invasive fungal infection that mainly affects the lungs and central nervous system. While patients with cell-mediated immunodeficiency are at high risk of developing cryptococcosis, there have been increasing reports of cryptococcosis in immunocompetent individuals with no underlying conditions. Herein, we report a case of cryptococcal meningitis in a 55-year-old apparently immunocompetent man with a history of heavy alcohol consumption. Although the patient was initially treated for tuberculous meningitis and varicella-zoster virus induced vasculopathy due to a history of exposure to tuberculosis and a presence of stroke, a multiplex polymerase chain reaction (PCR) assay of cerebrospinal fluid (CSF) identified Cryptococcus species unexpectedly, enabling swift treatment and a favorable clinical outcome. The multiplex PCR assay, which can identify multiple pathogens simultaneously and instantly, may lead to early diagnosis and treatment by detecting unanticipated pathogens. Furthermore, the strain was identified through multilocus sequence typing (MLST) analysis as Cryptococcus neoformans var. grubii, Sequence Type 5, molecular type: VNI. Although simplified microbial identification techniques such as mass spectrometry have recently been developed, molecular biological assays are still essential for the accurate identification of infectious strains.
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Affiliation(s)
- Yoshinori Takahashi
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan.
| | - Ryosuke Osawa
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Yoshifumi Kubota
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Motoki Fujii
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Naoya Matsuda
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Naoki Watanabe
- Department of Clinical Laboratory, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Tomohisa Watari
- Department of Clinical Laboratory, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Yoshihito Otsuka
- Department of Clinical Laboratory, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
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