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Stempinski PR, Greengo SD, Casadevall A. Growth on Douglas fir media facilitates Cryptococcus virulence factor production and enhances fungal survival against environmental and immune stressors. Med Mycol 2024; 62:myae068. [PMID: 38982313 DOI: 10.1093/mmy/myae068] [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: 04/11/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 07/11/2024] Open
Abstract
The yeasts Cryptococcus neoformans and Cryptococcus gattii are fungal pathogens that can be isolated from the environment, including the surfaces of many plants. Cryptococcus gattii caused an outbreak on Vancouver Island, British Columbia beginning in 1999 that has since spread to the Pacific Northwest of the United States. Coastal Douglas fir (Pseudotsuga menziesii) is an important lumber species and a major component of the ecosystems in this area. Previous research has explored Cryptococcus survival and mating on Douglas fir plants and plant-derived material, but no studies have been done on the production of cryptococcal virulence factors by cells grown on those media. Here, we investigated the effects of growth on Douglas fir-derived media on the production of the polysaccharide capsule and melanin, two of the most important cryptococcal virulence factors. We found that while the capsule was mostly unchanged by growth in Douglas fir media compared to cells grown in defined minimal media, Cryptococcus spp. can use substrates present in Douglas fir to synthesize functional and protective melanin. These results suggest mechanisms by which Cryptococcus species may survive in the environment and emphasize the need to explore how association with Douglas fir trees could affect its epidemiology for human cryptococcosis.
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Affiliation(s)
- Piotr R Stempinski
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, Maryland 21205, USA
| | - Seth D Greengo
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, Maryland 21205, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, Maryland 21205, USA
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2
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Newton HP, Higgins DP, Casteriano A, Wright BR, Krockenberger MB, Miranda LHM. The CARD9 Gene in Koalas ( Phascolarctos cinereus): Does It Play a Role in the Cryptococcus-Koala Interaction? J Fungi (Basel) 2024; 10:409. [PMID: 38921395 PMCID: PMC11205041 DOI: 10.3390/jof10060409] [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: 05/08/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
Cryptococcus is a genus of fungal pathogens that can infect and cause disease in a range of host species and is particularly prominent in koalas (Phascolarctos cinerus). Like other host species, koalas display a range of outcomes upon exposure to environmental Cryptococcus, from external nasal colonization to asymptomatic invasive infection and, in rare cases, severe clinical disease resulting in death. Host factors contributing to these varied outcomes are poorly understood. Due to their close relationship with eucalypt trees (a key environmental niche for Cryptococcus gattii) and suspected continual exposure to the pathogen, koalas provide a unique opportunity to examine host susceptibility in natural infections. Caspase recruitment domain-containing protein 9 (CARD9) is a key intracellular signaling protein in the fungal innate immune response. Humans with mutations in CARD9 succumb to several different severe and chronic fungal infections. This study is the first to sequence and explore CARD9 variation in multiple koalas using Sanger sequencing. Four CARD9 exons were successfully sequenced in 22 koalas from a New South Wales, Australia population. We found minimal variation between koalas across all four exons, an observation that was also made when CARD9 sequences were compared between koalas and six other species, including humans and mice. Ten single-nucleotide polymorphisms (SNP) were identified in this study and explored in the context of cryptococcal exposure outcomes. While we did not find any significant association with variation in cryptococcal outcomes, we found a high degree of conservation between species at several SNP loci that requires further investigation. The findings from this study lay the groundwork for further investigations of CARD9 and Cryptococcus both in koalas and other species, and highlight several considerations for future studies.
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Affiliation(s)
| | | | | | | | | | - Luisa H. M. Miranda
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia; (H.P.N.); (D.P.H.); (A.C.); (B.R.W.); (M.B.K.)
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3
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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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4
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Acheson ES, Otterstatter M, Galanis E. Forest Disturbance and Disease: Exploring the Effects of Tree Harvesting Area on Cryptococcus gattii sensu lato Infection Risk, Vancouver Island, Canada, 1998-2014. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:77009. [PMID: 37466219 DOI: 10.1289/ehp12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The disturbance of colonized trees and soil, such as through forestry activities, has been proposed to disperse soil- and tree-inhabiting fungal pathogens. Cryptococcus gattii sensu lato is one such pathogen that was detected on Vancouver Island, British Columbia, Canada, beginning in 1999 and caused human and animal illness. OBJECTIVES Our aim was to determine if C. gattii s.l. human case incidence on Vancouver Island was correlated with the intensity of landscape-level tree harvesting occurring near human settlement areas. METHODS We created buffers around human settlement areas with radii increments of 2.5km, from 2.5 to 20km, and summed the area of annual tree harvests occurring within each buffer zone. We then performed Spearman rank-order correlation to measure the association between case incidence and annual tree harvest intensity at each radius from 1998 through 2014. RESULTS The incidence of C. gattii was positively correlated with tree harvesting intensity only at distances of 7.5km (r=0.66, p=0.004) and 10km (r=0.64, p=0.005) from human settlement areas. As annual tree harvesting area increased between 1999 and 2003, so did annual C. gattii incidence in humans, before both plateaued around 2002 and decreased after 2007. DISCUSSION Our findings suggest that tree harvesting plays a role in the spread of C. gattii on Vancouver Island. This may be due to tree cutting or soil disturbance facilitating the aerosolization of spores to increase infection risk. This research also illustrates the contribution that geographic information systems can make to public health research on environmental disturbance and disease outbreaks. https://doi.org/10.1289/EHP12396.
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Affiliation(s)
- Emily Sohanna Acheson
- Department of Geography, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Otterstatter
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Eleni Galanis
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
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van der Torre MH, Andrews RA, Hooker EL, Rankin A, Dodd S. Systematic review on Cryptococcus neoformans/Cryptococcus gattii species complex infections with recommendations for practice in health and care settings. CLINICAL INFECTION IN PRACTICE 2022. [DOI: 10.1016/j.clinpr.2022.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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6
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Diniz-Lima I, da Fonseca LM, dos Reis JS, Rodrigues da Costa Santos MA, da Costa KM, do Nascimento Santos CA, Barcelos PM, Guimarães-Pinto K, Filardy AA, Freire-de-Lima ME, Decote-Ricardo D, Morrot A, Freire-de-Lima CG, Freire-de-Lima L. The Sweet Side of Fungal Infections: Structural Glycan Diversity and Its Importance for Pathogenic Adaptation. MEDICINES (BASEL, SWITZERLAND) 2022; 9:medicines9060037. [PMID: 35736250 PMCID: PMC9230512 DOI: 10.3390/medicines9060037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 12/11/2022]
Abstract
Fungal infections are the most common secondary infections in debilitated individuals in a state of chronic disease or immunosuppression. Despite this, most fungal infections are neglected, mainly due to the lower frequency of their more severe clinical forms in immunocompetent individuals with a healthy background. However, over the past few years, several cases of severe fungal infections in healthy individuals have provoked a change in the epidemiological dynamics of fungal infections around the world, both due to recurrent outbreaks in previously infrequent regions and the greater emergence of more pathogenic fungal variants affecting healthy individuals, such as in the Cryptococcus genus. Therefore, before the arrival of a scenario of prevalent severe fungal infections, it is necessary to assess more carefully what are the real reasons for the increased incidence of fungal infection globally. What are the factors that are currently contributing to this new possible epidemiological dynamic? Could these be of a structural nature? Herein, we propose a discussion based on the importance of the virulence factors of glycoconjugate composition in the adaptation of pathogenic fungal species into the current scenario of increasing severity of these infections.
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Affiliation(s)
- Israel Diniz-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Leonardo Marques da Fonseca
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Jhenifer Santos dos Reis
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Marcos André Rodrigues da Costa Santos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Kelli Monteiro da Costa
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Carlos Antonio do Nascimento Santos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Pedro Marçal Barcelos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
| | - Kamila Guimarães-Pinto
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (K.G.-P.); (A.A.F.)
| | - Alessandra Almeida Filardy
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (K.G.-P.); (A.A.F.)
| | - Marco Edilson Freire-de-Lima
- Instituto de Química, Departamento de Química Orgânica, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro 23890-000, Brazil;
| | - Debora Decote-Ricardo
- Departamento de Microbiologia e Imunologia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro 23890-000, Brazil;
| | - Alexandre Morrot
- Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro 21040-360, Brazil;
| | - Celio Geraldo Freire-de-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
- Correspondence: ; Tel./Fax: +55-21-3938-6646
| | - Leonardo Freire-de-Lima
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (I.D.-L.); (L.M.d.F.); (J.S.d.R.); (M.A.R.d.C.S.); (K.M.d.C.); (C.A.d.N.S.); (P.M.B.); (L.F.-d.-L.)
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7
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Central Nervous System Cryptococcosis due to Cryptococcus gattii in the Tropics. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:1-7. [PMID: 35378784 PMCID: PMC8967080 DOI: 10.1007/s40475-022-00253-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 10/27/2022]
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8
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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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9
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Fairhead LJ, Smith S, Sim BZ, Stewart AGA, Stewart JD, Binotto E, Law M, Hanson J. The seasonality of infections in tropical Far North Queensland, Australia: A 21-year retrospective evaluation of the seasonal patterns of six endemic pathogens. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000506. [PMID: 36962353 PMCID: PMC10021965 DOI: 10.1371/journal.pgph.0000506] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/17/2023]
Abstract
An understanding of the seasonality of infections informs public health strategies and assists clinicians in their management of patients with undifferentiated illness. The seasonality of infections is driven by a variety of environmental and human factors; however, the role of individual climatic factors has garnered much attention. This study utilises Poisson regression models to assess the seasonality of six important infections in tropical Australia and their association with climatic factors and severe weather events over a 21-year period. Melioidosis and leptospirosis showed marked wet season predominance, while more cases of rickettsial disease and cryptococcosis were seen in cooler, drier months. Staphylococcus aureus infections were not seasonal, while influenza demonstrated inter-seasonality. The climate did not significantly change during the 21 years of the study period, but the incidence of melioidosis and rickettsial disease increased considerably, highlighting the primacy of other factors-including societal inequality, and the impact of urban expansion-in the incidence of these infections. While anthropogenic climate change poses a threat to the region-and may influence the burden of these infections in the future-this study highlights the fact that, even for seasonal diseases, other factors presently have a greater effect on disease incidence. Public health strategies must also target these broader drivers of infection if they are to be effective.
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Affiliation(s)
- Lee J Fairhead
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Beatrice Z Sim
- Infectious Diseases Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - James D Stewart
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Enzo Binotto
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Matthew Law
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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10
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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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11
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Yamamura D, Xu J. Update on Pulmonary Cryptococcosis. Mycopathologia 2021; 186:717-728. [PMID: 34181160 DOI: 10.1007/s11046-021-00575-9] [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: 12/31/2020] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
Pulmonary cryptococcosis is a common but underdiagnosed opportunistic fungal infection in both immunocompromised and immunocompetent patients. The causal agents include at least eight evolutionary distinct haploid lineages as well as their hybrids of the human pathogenic Cryptococcus complex. In this update, we review recent advances in epidemiology, mode of transmission, risk factors, diagnostic methods, and therapy of pulmonary cryptococcosis. Our review suggests significant challenges and opportunities for research, from bedside to benchside and back to bedside.
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Affiliation(s)
- Deborah Yamamura
- Microbiology Department, Hamilton Regional Laboratory Medicine Program, Hamilton General Hospital, Hamilton, ON, L8L 2X2, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, L8S 4K1, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, L8S 4K1, Canada.
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12
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Baddley JW, Chen SCA, Huisingh C, Benedict K, DeBess EE, Galanis E, Jackson BR, MacDougall L, Marsden-Haug N, Oltean H, Perfect JR, Phillips P, Sorrell TC, Pappas PG. MSG07: An International Cohort Study Comparing Epidemiology and Outcomes of Patients with Cryptococcus neoformans or Cryptococcus gattii infections. Clin Infect Dis 2021; 73:1133-1141. [PMID: 33772538 DOI: 10.1093/cid/ciab268] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/24/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cryptococcosis due to Cryptococcus neoformans and Cryptococcus gattii varies with geographic region, populations affected, disease manifestations and severity of infection, which impact treatment. METHODS We developed a retrospective cohort of patients diagnosed with culture-proven cryptococcosis during 1995-2013 from five centers in North America and Australia. We compared underlying diseases, clinical manifestations, treatment and outcomes in patients with C. gattii or C. neoformans infection. RESULTS A total of 709 patients (452 C. neoformans; 257 C. gattii) were identified. Mean age was 50.2 years; 61.4% were male; and 52.3% were Caucasian. Time to diagnosis was prolonged in C. gattii patients compared with C. neoformans (mean 52.2 vs 36.0 days; p<0.003) and there was a higher proportion of C. gattii patients without underlying disease (40.5% vs 10.2%; p<0.0001). Overall, 59% had central nervous system (CNS) infection, with lung (42.5%) and blood (24.5%) being common sites. Pulmonary infection was more common in patients with C. gattii than those with C. neoformans (60.7% vs 32.1%; p<0.0001). CNS or blood infections were more common in C. neoformans-infected patients (p≤0.0001 for both). Treatment of CNS disease with induction therapy of amphotericin B and flucytosine occurred in 76.4% of patients. Crude 12-month mortality was higher in patients with C neoformans (28.4% vs 20.2%; Odds Ratio 1.56; 95% CI 1.08, 2.26). CONCLUSIONS This study emphasizes differences in species-specific epidemiology and outcomes of patients with cryptococcosis, including underlying diseases, site of infection and mortality. Species identification in patients with cryptococcosis is necessary to discern epidemiologic patterns, guide treatment regimens and predict clinical progression and outcomes.
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Affiliation(s)
- John W Baddley
- University of Maryland School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology, Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, The University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Carrie Huisingh
- University of Alabama at Birmingham, Department of Medicine, Birmingham, Alabama, USA
| | - Kaitlin Benedict
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Eleni Galanis
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada.,British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Laura MacDougall
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Hanna Oltean
- Washington State Department of Health, Olympia, Washington, USA
| | - John R Perfect
- Duke University Medical Center, Department of Medicine, Durham, North Carolina, USA
| | - Peter Phillips
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada.,St Paul's Hospital, Department of Medicine, Vancouver, British Columbia, Canada
| | - Tania C Sorrell
- Centre for Infectious Diseases and Microbiology, Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, The University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.,Westmead Institute for Medical Research, Infectious Diseases Group, Sydney, Australia
| | - Peter G Pappas
- University of Alabama at Birmingham, Department of Medicine, Birmingham, Alabama, USA
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13
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Huang YM, Tao XH, Xu DF, Yu Y, Teng Y, Xie WQ, Fan YB. HOG1 has an essential role in the stress response, virulence and pathogenicity of Cryptococcus gattii. Exp Ther Med 2021; 21:476. [PMID: 33767771 PMCID: PMC7976431 DOI: 10.3892/etm.2021.9907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 02/05/2021] [Indexed: 12/25/2022] Open
Abstract
Cryptococcus gattii (C. gattii) is a lethal pathogen that causes the majority of cryptococcosis cases in previously healthy individuals. This pathogen poses an increasing threat to global public health, but the mechanisms underlying the pathogenesis have remained to be fully elucidated. In the present study, the role of high-osmolarity glycerol (HOG)1 in the stress reaction and virulence control of C. gattii was characterized by deleting the HOG1 gene using the clinical isolate strain CZ2012, and finally, the virulence and pathogenic traits of the deletion strain were defined. Deletion of the HOG1 gene resulted in notable growth defects under stress conditions (high salt and antifungal drugs), but different traits were observed under oxidative stress conditions (hydrogen peroxide). Similarly, the C. gattii hog1Δ strains (deletion of HOG1) also displayed decreased capsule production and melanin synthesis. Furthermore, mice infected with the hog1Δ strain had longer survival times than those infected with the wild-type strain and the reconstituted strain. The hog1Δ strain recovered from infected organs exhibited significant growth defects in terms of decreased colony count and size. The present results suggested that HOG1 has a significant role in the virulence of C. gattii and these results may help to elucidate the pathogenesis of C. gattii.
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Affiliation(s)
- You-Ming Huang
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
| | - Xiao-Hua Tao
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
| | - Dan-Feng Xu
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
| | - Yong Yu
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
| | - Yan Teng
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
| | - Wen-Qing Xie
- Department of Orthopedics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410000, P.R. China
| | - Yi-Bin Fan
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, P.R. China
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14
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Kunin JR, Blasco LF, Hamid A, Fuss C, Sauer D, Walker CM. Thoracic Endemic Fungi in the United States: Importance of Patient Location. Radiographics 2021; 41:380-398. [PMID: 33544664 DOI: 10.1148/rg.2021200071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The digitization of radiographic studies along with high-speed transmission of images has formed the basis of teleradiology, which has become an integral component in the workflow of a contemporary radiology practice. It is with this advent and growing utilization of teleradiology that the significance of the source location of images has gained importance. Specifically, the importance of where the patient resides and what endemic fungi occur in that location cannot be underestimated. In the United States, histoplasmosis, coccidioidomycosis, blastomycosis, and cryptococcosis are caused by endemic fungi occurring in the Ohio and Mississippi river valleys, the Southwest, the Upper Midwest, and the Pacific Northwest, respectively. All of these organisms enter the body through the respiratory system and have the potential to cause significant morbidity and mortality. Patients infected with these fungi are often asymptomatic but may present with acute flulike symptoms such as fever, cough, or dyspnea. Patients may also present with vague chronic symptoms including cough, fever, malaise, and weight loss. Thoracic manifestations at radiography and CT include consolidation, nodules, cavities, lymphadenopathy, and pleural disease. PET may show fluorine 18-fluorodeoxyglucose uptake with active acute or chronic infections, and it is difficult to distinguish infections from malignancy. Imaging findings may be nonspecific and can be confused with other disease processes, including malignancy. The patient demographics, clinical history, and location are clues that may lead to a proper diagnosis of endemic fungal disease. The radiologist should be cognizant of the patient location to provide a correct and timely radiologic diagnosis that helps guide the clinician to initiate appropriate therapy. ©RSNA, 2021.
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Affiliation(s)
- Jeffrey R Kunin
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
| | - Lucia Flors Blasco
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
| | - Aws Hamid
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
| | - Cristina Fuss
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
| | - David Sauer
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
| | - Christopher M Walker
- From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.)
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15
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Fu Y, Huang X, Zhou Z. Insight into the Assembling Mechanism of Cryptococcus Capsular Glucuronoxylomannan Based on Molecular Dynamics Simulations. ACS OMEGA 2020; 5:29351-29356. [PMID: 33225166 PMCID: PMC7676341 DOI: 10.1021/acsomega.0c04164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
Cryptococcus spp. is an invasive fungal pathogen and causes life-threatening cryptococcosis. Opportunistic cryptococcal infections among the immunocompromised population are mostly caused by Cryptococcus neoformans, whereas the geographical dissemination of Cryptococcus gattii in recent years has threatened lives of even immunocompetent people. The capsule, mainly composed of glucuronoxylomannan (GXM) polysaccharides, plays important roles in the virulence of Cryptococcus spp. The assembling mechanism of GXM polysaccharides into the capsule is little understood because of insufficient experimental data. Molecular modeling and molecular dynamics simulation provide insight into the assembling process. We first built GXM oligosaccharide models of serotypes D, A, B, and C and extracted their secondary structure information from simulation trajectories. All the four mainchains tend to take the nearly twofold helical conformation, whereas peripheral sidechains prefer to form left-handed helices, which are further stabilized by intramolecular hydrogen bonds. Based on the obtained secondary structure information, GXM polysaccharide arrays were built to simulate capsule-assembling processes of C. neoformans and C. gattii using serotypes A and C as representatives, respectively. Trajectory analysis illustrates that electrostatic neutralization of acidic sidechain residues of GXM is a prerequisite for capsule assembling, followed by formation of intermolecular hydrogen bond networks. Further insight into the assembling mechanism of GXM polysaccharides provides the possibility to develop novel treatment and prevention solutions for cryptococcosis.
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Affiliation(s)
- Yankai Fu
- Key
Laboratory of Bioactive Materials, Ministry of Education, College
of Life Sciences, and State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
- Beijing
Key Laboratory for Mechanism Study and Precision Diagnosis of Invasive
Fungal Diseases, Dynamiker Biotechnology
Sub-Center, Tianjin 300467, China
| | - Xinglu Huang
- Key
Laboratory of Bioactive Materials, Ministry of Education, College
of Life Sciences, and State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin 300071, China
| | - Zeqi Zhou
- Beijing
Key Laboratory for Mechanism Study and Precision Diagnosis of Invasive
Fungal Diseases, Dynamiker Biotechnology
Sub-Center, Tianjin 300467, China
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16
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Acheson ES, Galanis E, Bartlett K, Klinkenberg B. Climate Classification System-Based Determination of Temperate Climate Detection of Cryptococcus gattii sensu lato. Emerg Infect Dis 2020; 25:1723-1726. [PMID: 31441746 PMCID: PMC6711209 DOI: 10.3201/eid2509.181884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We compared 2 climate classification systems describing georeferenced environmental Cryptococcus gattii sensu lato isolations occurring during 1989–2016. Each system suggests the fungus was isolated in temperate climates before the 1999 outbreak on Vancouver Island, British Columbia, Canada. However, the Köppen-Geiger system is more precise and should be used to define climates where pathogens are detected.
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17
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First Autochthonous Case of Cryptococcal Meningitis in an Immunocompetent Host Due to Cryptococcus gattii VGIin Northern Italy. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-019-00208-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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18
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Cryptococcus gattii infection in an immunocompetent host in Greece. Med Mycol Case Rep 2019; 27:1-3. [PMID: 31867171 PMCID: PMC6906646 DOI: 10.1016/j.mmcr.2019.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/03/2019] [Accepted: 12/02/2019] [Indexed: 12/28/2022] Open
Abstract
We report a case of a 31-year-old otherwise healthy female with pulmonary cryptococcoma along with cryptococcal meningitis due to Cryptococcus gattii molecular type VGI, in Greece. Combined antifungal treatment and surgical excision of pulmonary cryptococcoma yielded a good response.
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19
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Ergin Ç, Şengül M, Aksoy L, Döğen A, Sun S, Averette AF, Cuomo CA, Seyedmousavi S, Heitman J, Ilkit M. Cryptococcus neoformans Recovered From Olive Trees ( Olea europaea) in Turkey Reveal Allopatry With African and South American Lineages. Front Cell Infect Microbiol 2019; 9:384. [PMID: 31788454 PMCID: PMC6856141 DOI: 10.3389/fcimb.2019.00384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/25/2019] [Indexed: 11/13/2022] Open
Abstract
Cryptococcus species are life-threatening human fungal pathogens that cause cryptococcal meningoencephalitis in both immunocompromised and healthy hosts. The natural environmental niches of Cryptococcus include pigeon (Columba livia) guano, soil, and a variety of tree species such as Eucalyptus camaldulensis, Ceratonia siliqua, Platanus orientalis, and Pinus spp. Genetic and genomic studies of extensive sample collections have provided insights into the population distribution and composition of different Cryptococcus species in geographic regions around the world. However, few such studies examined Cryptococcus in Turkey. We sampled 388 Olea europaea (olive) and 132 E. camaldulensis trees from seven locations in coastal and inland areas of the Aegean region of Anatolian Turkey in September 2016 to investigate the distribution and genetic diversity present in the natural Cryptococcus population. We isolated 84 Cryptococcus neoformans strains (83 MATα and 1 MAT a) and 3 Cryptococcus deneoformans strains (all MATα) from 87 (22.4% of surveyed) O. europaea trees; a total of 32 C. neoformans strains were isolated from 32 (24.2%) of the E. camaldulensis trees, all of which were MATα. A statistically significant difference was observed in the frequency of C. neoformans isolation between coastal and inland areas (P < 0.05). Interestingly, the MAT a C. neoformans isolate was fertile in laboratory crosses with VNI and VNB MATα tester strains and produced robust hyphae, basidia, and basidiospores, thus suggesting potential sexual reproduction in the natural population. Sequencing analyses of the URA5 gene identified at least five different genotypes among the isolates. Population genetics and genomic analyses revealed that most of the isolates in Turkey belong to the VNBII lineage of C. neoformans, which is predominantly found in southern Africa; these isolates are part of a distinct minor clade within VNBII that includes several isolates from Zambia and Brazil. Our study provides insights into the geographic distribution of different C. neoformans lineages in the Mediterranean region and highlights the need for wider geographic sampling to gain a better understanding of the natural habitats, migration, epidemiology, and evolution of this important human fungal pathogen.
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Affiliation(s)
- Çağri Ergin
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Mustafa Şengül
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Levent Aksoy
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Aylin Döğen
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Mersin, Mersin, Turkey
| | - Sheng Sun
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Anna F Averette
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Seyedmojtaba Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey
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20
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Trovato L, Oliveri S, Esposto MC, Prigitano A, Romanò L, Cogliati M. Cryptococcus neoformans and Cryptococcus gattii Species Complex Isolates on the Slopes of Mount Etna, SICILY, Italy. Front Microbiol 2019; 10:2390. [PMID: 31681242 PMCID: PMC6813189 DOI: 10.3389/fmicb.2019.02390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/02/2019] [Indexed: 12/23/2022] Open
Abstract
This study investigated the presence of Cryptococcus neoformans and Cryptococcus gattii species complex isolates on olive trees growing in the Eastern part of Sicily (Italy) characterized by the presence of the volcano Etna and the ability of these fungal pathogens to sexually reproduce on medium containing volcanic soil. Samples from 124 olive trees were collected from 14 different sites around Mount Etna. Eighteen trees (14.5%) resulted colonized by C. neoformans VNI-αA isolates, one (0.8%) by VNIV-αD isolates, and two (1.6%) by C. gattii VGI-αB isolates. The ability of environmental and reference strains belonging to VNI, VNIV, and VGI molecular types to sexually reproduce on a medium containing volcanic soil was also tested. VNI and VNIV strains were able to produce filaments and basiodiospores more vigorously than on the control medium, whereas VGI strains were not fertile. In conclusion, the present study identified which C. neoformans and C. gattii species complex genotypes are circulating in Eastern Sicily and confirmed the ecological role of olive trees as environmental reservoir of these pathogens. It also showed that Cryptococcus is able to colonize and sexually reproduce in inhospitable environments such as the slopes of a volcano.
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Affiliation(s)
- Laura Trovato
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Salvatore Oliveri
- U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-Vittorio Emanuele", Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maria Carmela Esposto
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Anna Prigitano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Luisa Romanò
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Cogliati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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21
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Rickerts V. [Climate change and systemic fungal infections]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:646-651. [PMID: 30923845 DOI: 10.1007/s00103-019-02931-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Climate change may cause profound and complex changes in the prevalence of infectious diseases. Obligate pathogenic fungi causing endemic mycoses and the agents of cryptococcosis are environmental pathogens adapted to environmental niches. They may be exposed to changing climatic conditions, which may change the epidemiology of human infections. OBJECTIVES To review documented changes in the epidemiology of endemic fungal infections and cryptococcosis. To review evidence that changing climate is a potential mechanism for changes in the epidemiology of these infections. METHODS A selective literature review focusing on endemic mycoses and cryptococcosis. RESULTS Changes in endemic regions of infections caused by C. gattii and selected endemic mycoses have been well documented. Significant increases in the incidence of infections have been demonstrated for some areas. Climatic factors (temperature, precipitation, and extreme weather events), changes in land use, distribution of potential host animals, and global trade routes are discussed as contributory factors. CONCLUSIONS Improved surveillance of fungal infections of humans and animals including molecular typing of clinical and environmental isolates is necessary to understand the epidemiology of these infections. The characterization of environmental niches, mechanisms of distribution of fungi, and fungal adaptation mechanisms are needed to guide prevention strategies.
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Affiliation(s)
- Volker Rickerts
- FG 16, Erreger von Mykosen, Mykobakteriosen und Parasitosen, Konsiliarlabor für Kryptokokkose und seltene Systemmykosen, Robert Koch-Institut, Seestraße 10, 13353, Berlin, Deutschland.
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22
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Denham ST, Wambaugh MA, Brown JCS. How Environmental Fungi Cause a Range of Clinical Outcomes in Susceptible Hosts. J Mol Biol 2019; 431:2982-3009. [PMID: 31078554 PMCID: PMC6646061 DOI: 10.1016/j.jmb.2019.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/18/2019] [Accepted: 05/01/2019] [Indexed: 12/11/2022]
Abstract
Environmental fungi are globally ubiquitous and human exposure is near universal. However, relatively few fungal species are capable of infecting humans, and among fungi, few exposure events lead to severe systemic infections. Systemic infections have mortality rates of up to 90%, cost the US healthcare system $7.2 billion annually, and are typically associated with immunocompromised patients. Despite this reputation, exposure to environmental fungi results in a range of outcomes, from asymptomatic latent infections to severe systemic infection. Here we discuss different exposure outcomes for five major fungal pathogens: Aspergillus, Blastomyces, Coccidioides, Cryptococcus, and Histoplasma species. These fungi include a mold, a budding yeast, and thermal dimorphic fungi. All of these species must adapt to dramatically changing environments over the course of disease. These dynamic environments include the human lung, which is the first exposure site for these organisms. Fungi must defend themselves against host immune cells while germinating and growing, which risks further exposing microbe-associated molecular patterns to the host. We discuss immune evasion strategies during early infection, from disruption of host immune cells to major changes in fungal cell morphology.
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Affiliation(s)
- Steven T Denham
- Division of Microbiology and Immunology, Pathology Department, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Morgan A Wambaugh
- Division of Microbiology and Immunology, Pathology Department, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Jessica C S Brown
- Division of Microbiology and Immunology, Pathology Department, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
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23
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Epidemiología de las micosis invasoras: un paisaje en continuo cambio. Rev Iberoam Micol 2018; 35:171-178. [DOI: 10.1016/j.riam.2018.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/25/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022] Open
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24
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Rodriguez-Goncer I, Bongomin F, Doran HM, Novak-Frazer L, Masania R, Moore CB, Richardson MD. A case of pulmonary cryptococcoma due to Cryptococcus gattii in the United Kingdom. Med Mycol Case Rep 2018; 21:23-25. [PMID: 30094128 PMCID: PMC6071375 DOI: 10.1016/j.mmcr.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 11/25/2022] Open
Abstract
We report a case of Cryptococcus gattii infection in the UK in a 76-year-old woman on biologic therapy for intra-abdominal non-Hodgkin lymphoma. An incidental nodular lung lesion was found on a chest imaging and histology, culture and molecular mycology studies of the lobectomy specimen revealed the presence of C. gattii.
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Affiliation(s)
- Isabel Rodriguez-Goncer
- Department of Infectious Diseases, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Felix Bongomin
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.,Global Action Fund for Fungal Infections, Rue de l'Ancien-Port 14, 1211 Geneva 1, Switzerland
| | - Helen M Doran
- Department of Pathology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Lily Novak-Frazer
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.,Mycology Reference Centre, ECMM Excellence Centre of Medical Mycology, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Rikesh Masania
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.,Mycology Reference Centre, ECMM Excellence Centre of Medical Mycology, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Caroline B Moore
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.,Mycology Reference Centre, ECMM Excellence Centre of Medical Mycology, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Malcolm D Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.,Mycology Reference Centre, ECMM Excellence Centre of Medical Mycology, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
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25
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Barcellos VA, Martins LMS, Fontes ACL, Reuwsaat JCV, Squizani ED, de Sousa Araújo GR, Frases S, Staats CC, Schrank A, Kmetzsch L, Vainstein MH. Genotypic and Phenotypic Diversity of Cryptococcus gattii VGII Clinical Isolates and Its Impact on Virulence. Front Microbiol 2018; 9:132. [PMID: 29467743 PMCID: PMC5808156 DOI: 10.3389/fmicb.2018.00132] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/19/2018] [Indexed: 12/11/2022] Open
Abstract
The Cryptococcus gattii species complex harbors the main etiological agents of cryptococcosis in immunocompetent patients. C. gattii molecular type VGII predominates in the north and northeastern regions of Brazil, leading to high morbidity and mortality rates. C. gattii VGII isolates have a strong clinical relevance and phenotypic variations. These phenotypic variations among C. gattii species complex isolates suggest that some strains are more virulent than others, but little information is available related to the pathogenic properties of those strains. In this study, we analyzed some virulence determinants of C. gattii VGII strains (CG01, CG02, and CG03) isolated from patients in the state of Piauí, Brazil. The C. gattii R265 VGIIa strain, which was isolated from the Vancouver outbreak, differed from C. gattii CG01, CG02 and CG03 isolates (also classified as VGII) when analyzed the capsular dimensions, melanin production, urease activity, as well as the glucuronoxylomannan (GXM) secretion. Those differences directly reflected in their virulence potential. In addition, CG02 displayed higher virulence compared to R265 (VGIIa) strain in a cryptococcal murine model of infection. Lastly, we examined the genotypic diversity of these strains through Multilocus Sequence Type (MLST) and one new subtype was described for the CG02 isolate. This study confirms the presence and the phenotypic and genotypic diversity of highly virulent strains in the Northeast region of Brazil.
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Affiliation(s)
- Vanessa A Barcellos
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Liline M S Martins
- Laboratório de Imunogenética e Biologia Molecular, Universidade Federal do Piauí, Teresina, Brazil.,Faculdade de Ciências Médicas da Universidade Estadual do Piauí, Teresina, Brazil
| | - Alide C L Fontes
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Julia C V Reuwsaat
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Eamim D Squizani
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Glauber R de Sousa Araújo
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Susana Frases
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Charley C Staats
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Biologia Molecular e Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Augusto Schrank
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Biologia Molecular e Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Livia Kmetzsch
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Biologia Molecular e Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marilene H Vainstein
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Biologia Molecular e Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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