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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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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 PMCID: PMC11210188 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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Yoon H, Nakouzi AS, Duong VA, Hung LQ, Binh TQ, Tung NLN, Day JN, Pirofski LA. Shared and unique antibody and B cell profiles in HIV-positive and HIV-negative individuals with cryptococcal meningoencephalitis. Med Mycol 2023; 61:myad102. [PMID: 37771088 PMCID: PMC10599321 DOI: 10.1093/mmy/myad102] [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: 07/15/2023] [Revised: 09/07/2023] [Accepted: 09/27/2023] [Indexed: 09/30/2023] Open
Abstract
Host non-T cell markers to aid in the diagnosis of cryptococcal meningoencephalitis (CM) have not been identified. In this case-control study, we characterized antibody and B cell profiles in HIV-negative and HIV-positive Vietnamese individuals of the Kinh ethnicity recently diagnosed with CM and controls. The study included 60 HIV-negative with no known immunocompromising condition and 60 HIV-positive individuals, with 30 CM cases and 30 controls in each group. Participants were matched by age, sex, HIV serostatus, and CD4 count in the HIV-positive group. Plasma immunoglobulin (Ig) levels, including IgG1, IgG2, IgM, and IgA, Cryptococcus spp. glucuronoxylomannan (GXM)- and laminarin (branched ${\rm{\beta }}$-[1-3]-glucan)-binding IgG, IgM, IgA levels, and peripheral blood B cell subsets were measured. Logistic regression, principal component, and mediation analyses were conducted to assess associations between antibody, B cell levels, and CM. The results showed that GXM-IgG levels were higher and IgG1 and IgG2 were lower in CM cases than controls, regardless of HIV status. In HIV-negative individuals, IgG2 mediated an inverse association between CD19+CD27+CD43+CD5- (B-1b-like) cells and CM. In HIV-positive individuals, lower levels of IgA, laminarin-IgA, and CD19+CD27+IgM+IgD- (IgM+ memory B) cells were each associated with CM. The shared and distinct antibody and B cell profiles identified in HIV-negative and HIV-positive CM cases may inform the identification of non-T-cell markers of CM risk or unsuspected disease, particularly in HIV-negative individuals.
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Affiliation(s)
- Hyunah Yoon
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461, USA
| | - Antonio S Nakouzi
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461, USA
| | - Van Anh Duong
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, Ho Chi Minh City Q5, Vietnam
| | - Le Quoc Hung
- Department of Tropical Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Tran Quang Binh
- Department of Tropical Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Le Nhu Tung
- Hospital for Tropical Diseases, 764 Vo Van Kiet, Ho Chi Minh City Q5, Vietnam
| | - Jeremy N Day
- Oxford University Clinical Research Unit, 764 Vo Van Kiet, Ho Chi Minh City Q5, Vietnam
- Department of Microbiology and Infection, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
| | - Liise-anne Pirofski
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461, USA
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461, USA
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Kakizaki MIT, Melhem MDESC. CRYPTOCOCCOSIS: A bibliographic narrative review on antifungal resistance. AN ACAD BRAS CIENC 2023; 95:e20220862. [PMID: 37466540 DOI: 10.1590/0001-3765202320220862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/15/2022] [Indexed: 07/20/2023] Open
Abstract
Cryptococcosis is an infectious fungal disease widely studied for its epidemiological importance in the context of public health, given the high morbidity and mortality associated with this invasive fungal infection. Many cases of the disease present clinical resistance and progress to death, even in the presence of antifungal therapy. The prolonged use of triazole drugs to maintain the treatment of cryptococcosis in AIDS patients, can lead to selective pressure from mutant strains, among other resistance mechanisms, justifying the poor clinical evolution of some cases. In this study, a narrative review of the literature on the occurrence of antifungal resistance in cryptococcosis agents was performed. Publications from 2010 to 2022 that address this topic were selected using Google Scholars and Scopus website. Data from the studies were analyzed for the values of minimum inhibitory concentration (MIC) of drugs used in the management of cryptococcosis. The review showed that the highest MIC values occurred for voriconazole, especially against C. neoformans. It is concluded that there is a lack of studies with statistical analysis of the data obtained, in order to provide a better dimensioning of the resistance rates of cryptococcosis agents to different antifungal agents, both in geographical and temporal context.
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Affiliation(s)
- Maria Ismênia T Kakizaki
- Instituto de Assistência Médica ao Servidor Público Estadual: Iamspe, Setor de Oncologia e Hematologia, Rua Pedro de Toledo, 1800, Vila Clementino, 04039-901 São Paulo, SP, Brazil
| | - Marcia DE S C Melhem
- Departmento de Micologia, Associado de pesquisa sênior, Instituto Adolfo Lutz, Av. Dr. Arnaldo, 355, Cerqueira César, 01246-000 São Paulo, SP, Brazil
- Universidade Federal do Mato Grosso do Sul, Departamento de Medicina, Av. Costa e Silva, s/n, Pioneiros, 79070-900 Campo Grande, MS, Brazil
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Langner KFA, Yang WJ. Clinical performance of the IMMY cryptococcal antigen lateral flow assay in dogs and cats. Vet Med (Auckl) 2022; 36:1966-1973. [PMID: 36254569 DOI: 10.1111/jvim.16555] [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: 03/06/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cryptococcal lateral flow antigen assays (CLFAs) have been assessed in comparison to the latex cryptococcal antigen agglutination test but their clinical performance is unknown. OBJECTIVE Determine clinical performance of IMMY CLFA (Immuno-Mycologics Inc, Oklahoma) using patients with and without cryptococcosis as the reference standard. ANIMALS One-hundred ninety-seven serum samples from client-owned dogs and cats. METHODS Review of medical records of a referral population of dogs and cats that had CLFA performed between 2012 and 2020. Animals were classified as cryptococcosis positive (Cr+) or negative (Cr-) based on clinical information. Clinical diagnosis was used to calculate positive and negative percent agreement of the CLFA. RESULTS Twelve specimens (4 canine, 8 feline) were obtained from Cr+ animals and had positive CLFA results. One-hundred eighty-five specimens (139 canine, 46 feline) were collected from Cr- animals. Negative CLFA results were recorded in 129 canine and 44 feline Cr- samples. Positive CLFA results were noted for 10 canine and 2 feline Cr- samples. Positive percent agreement of CLFA was 100% (confidence interval [CI], 39.8%-100% dogs; 63.1%-100% cats). Negative percent agreements were 92.8% (CI, 87.2%-96.5%) for dogs and 95.7% (CI, 85.2%-99.5%) for cats. CONCLUSIONS AND CLINICAL IMPORTANCE A negative IMMY CLFA result enables reliable exclusion of cryptococcal infection in dogs and cats. By contrast, a positive result must be interpreted cautiously and further testing should be performed to verify a diagnosis of cryptococcosis.
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Affiliation(s)
- Kathrin F A Langner
- Western Australian Veterinary Emergency and Specialty, Success, Western Australia, Australia
| | - Wen-Jie Yang
- Veterinary Specialists Aotearoa, Auckland, New Zealand
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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: 4] [Impact Index Per Article: 2.0] [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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Bertout S, Gouveia T, Krasteva D, Pierru J, Pottier C, Bellet V, Arianiello E, Salipante F, Roger F, Drakulovski P. Search for Cryptococcus neoformans/gattii Complexes and Related Genera (Filobasidium, Holtermanniella, Naganishia, Papiliotrema, Solicoccozyma, Vishniacozyma) spp. Biotope: Two Years Surveillance of Wild Avian Fauna in Southern France. J Fungi (Basel) 2022; 8:jof8030227. [PMID: 35330229 PMCID: PMC8948691 DOI: 10.3390/jof8030227] [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: 01/05/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Fungi belonging to the Cryptococcus genus and related genera (Filobasidium, Holtermanniella, Naganishia, Papiliotrema, Solicoccozyma, Vishniacozyma) are encapsulated yeasts found in either the environment or animal sources. However, the precise biotopes of most species remain poorly defined. To assess whether wild birds from southern France can carry or spread the most pathogenic species (i.e., species belonging to the C. neoformans and C. gattii complexes), as well as lesser-studied species (non-neoformans/gattii Cryptococcus and former Cryptococcus spp.), 669 birds belonging to 89 species received for care over a two-year period at the Centre de Protection de la Faune Sauvage of Villeveyrac (Bird Protection League nongovernmental organization (NGO) care center) were sampled. Samples were cultured, and Cryptococcus and former Cryptococcus yeasts were identified by PCR sequencing. The purpose was to evaluate whether there was any health risk to local populations or care personnel in aviaries and gather new data on the ecological niches of lesser-known species. One hundred and seven birds (16%) were found to be positive for at least one Cryptococcus or former Cryptococcus species. No yeasts belonging to the highly pathogenic C. neoformans or C. gattii complexes were isolated. However, diversity was notable, with 20 different Cryptococcus or former Cryptococcus species identified. Furthermore, most bird–yeast species associations found in this study have never been described before.
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Affiliation(s)
- Sébastien Bertout
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Tiphany Gouveia
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Donika Krasteva
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Julie Pierru
- Centre Régional de Sauvegarde de la Faune Sauvage, LPO Hérault, 15 rue de Faucon Crécelerette, 34560 Villeveyrac, France; (J.P.); (E.A.)
| | - Cyrille Pottier
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Virginie Bellet
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Emilie Arianiello
- Centre Régional de Sauvegarde de la Faune Sauvage, LPO Hérault, 15 rue de Faucon Crécelerette, 34560 Villeveyrac, France; (J.P.); (E.A.)
| | - Florian Salipante
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, Nîmes University Hospital Center, University of Montpellier, 34000 Nîmes, France;
| | - Frédéric Roger
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
| | - Pascal Drakulovski
- Laboratoire de Parasitologie et Mycologie Médicale, UMI 233 TransVIHMI, University of Montpellier, IRD, INSERM U1175, 15 Avenue Charles Flahaut, 34093 Montpellier, France; (S.B.); (T.G.); (D.K.); (C.P.); (V.B.); (F.R.)
- Correspondence: ; Tel.: +33-4-11-75-94-24
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Attempted Isolation of Cryptococcus Species and Incidental Isolation of Exophiala dermatitidis from Human Oral Cavities. Mycopathologia 2020; 185:1051-1055. [PMID: 32949296 DOI: 10.1007/s11046-020-00490-5] [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: 07/24/2020] [Accepted: 09/09/2020] [Indexed: 10/20/2022]
Abstract
Recent molecular studies suggest that Cryptococcus may inhabit the normal human mouth. We attempted to isolate Cryptococcus from 21 adult non-acutely ill patients and 40 volunteer medical and non-medical staff in Southeastern Wisconsin, USA. An upper lip sulcus culture and an oral rinse specimen were inoculated separately onto Staib (birdseed) agar containing chloramphenicol and incubated in gas impermeable zip lock bags at 35 °C. No cryptococci were grown from any of the 122 samples from the 61 subjects. Both specimens from a woman with no risk factors for fungal disease yielded a black yeast at 4 days on Staib agar. This isolate was shown to be Exophiala dermatitidis by colony and microscopic morphology, analysis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and sequencing through the internal transcribed spacer ribosomal RNA gene. This appears to be a novel isolation of E. dermatitidis from the oral cavity of a generally healthy human.
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Cogliati M, Patrizia P, Vincenzo C, Esposto MC, Prigitano A, Romanò L, Puccianti E. Cryptococcus neoformans species complex isolates living in a tree micro-ecosystem. FUNGAL ECOL 2020. [DOI: 10.1016/j.funeco.2019.100889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Madani GF, Ashman KR, Mella VSA, Whisson DA. A review of the 'noose and flag' method to capture free-ranging koalas. AUSTRALIAN MAMMALOGY 2020. [DOI: 10.1071/am19064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The capture of free-ranging individuals is often needed for research, population management and health assessment. Because of its iconic and threatened species status, methods to capture koalas (Phascolarctos cinereus) receive disproportionate scrutiny. We collated data on koala capture frequency, duration held by noose and incidents from six studies of koalas in Victoria and New South Wales that all used the ‘noose and flag’ method as the primary method of capture. Adverse events occurred in less than 1% of all captures (7 of 1236). Mean capture time in three of four locations recording duration held by noose was less than five minutes, minimising the duration of distress to the koala while allowing researchers to maintain control over the animal. The exception to this was a study in far south-west Victoria where trees were tall and koalas were relatively unresponsive to flagging, resulting in a longer mean duration held by noose (11.2 minutes). The reviewed capture data of the ‘noose and flag’ method suggest that this is an effective and safe capture method, allowing for capture of multiple individuals in a short period, and suitable for most habitat types and situations.
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Schmertmann LJ, Wardman A, Setyo L, Kan A, Meyer W, Malik R, Krockenberger MB. Identification of the environmental source of infection for a domestic ferret with cryptococcosis. J Vet Diagn Invest 2019; 31:828-835. [PMID: 31551015 DOI: 10.1177/1040638719876968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cryptococcosis, caused by the Cryptococcus gattii and C. neoformans species complexes, is an environmentally acquired mycosis affecting a broad range of host species. Among 9 communally housed ferrets, a 5-y-old castrated male ferret domiciled in an outdoor enclosure in Sydney, Australia was diagnosed with sinonasal cryptococcosis. Clinical signs resolved during 18 mo of itraconazole therapy, but the ferret was eventually euthanized because of splenic hemangiosarcoma. At postmortem, microscopic foci of persistent cryptococcosis were detected. The diagnosis raised concerns that the owners and other ferrets were exposed to a common environmental source of infection, thus prompting an investigation. Soil samples, swabs of a hollow eucalypt log (used for behavioral enrichment), and nasal swabs from 8 asymptomatic ferrets were collected. Nasal exudate (obtained at diagnosis) and tissues (collected at postmortem) were available from the clinical case. Bird seed agar culture resulted in a heavy growth of Cryptococcus spp. from one environmental site (the log), one nasal swab, and nasal exudate and tissues from the clinical case. All other samples were culture-negative. Sub-cultured isolates from the log were a mixture of C. gattii molecular type VGI and C. neoformans molecular type VNI. Ferret isolates were a similar mixture of C. gattii VGI (all disease isolates) and C. neoformans VNI (nasal-colonizing isolate). Multilocus sequence typing further revealed the ferret isolates as identical to environmental isolates collected from the log, confirming the log as the source of clinical disease and nasal colonization. The log was removed to prevent further exposure to a high environmental load of Cryptococcus spp.
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Affiliation(s)
- Laura J Schmertmann
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alison Wardman
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Laura Setyo
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Alex Kan
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Wieland Meyer
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Richard Malik
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
| | - Mark B Krockenberger
- Sydney School of Veterinary Science (Schmertmann, Setyo, Krockenberger), Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Faculty of Medicine and Health (Schmertmann, Kan, Meyer), Veterinary Pathology Diagnostic Services (Setyo, Krockenberger), Marie Bashir Institute for Infectious Diseases and Biosecurity (Meyer, Krockenberger) and Centre for Veterinary Education (Malik), The University of Sydney, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Westmead, New South Wales, Australia (Schmertmann, Kan, Meyer)
- Richmond Veterinary Hospital, Richmond, New South Wales, Australia (Wardman)
- Westmead Hospital (Research and Education Network), Westmead, New South Wales, Australia (Meyer)
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12
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Schmertmann LJ, Irinyi L, Malik R, Powell JR, Meyer W, Krockenberger MB. The mycobiome of Australian tree hollows in relation to the Cryptococcus gattii and C. neoformans species complexes. Ecol Evol 2019; 9:9684-9700. [PMID: 31534685 PMCID: PMC6745847 DOI: 10.1002/ece3.5498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/26/2022] Open
Abstract
Cryptococcosis is a fungal infection caused by members of the Cryptococcus gattii and C. neoformans species complexes. The C. gattii species complex has a strong environmental association with eucalypt hollows (particularly Eucalyptus camaldulensis), which may present a source of infection. It remains unclear whether a specific mycobiome is required to support its environmental survival and growth. Conventional detection of environmental Cryptococcus spp. involves culture on differential media, such as Guizotia abyssinica seed agar. Next-generation sequencing (NGS)-based culture-independent identification aids in contextualising these species in the environmental mycobiome. Samples from 23 Australian tree hollows were subjected to both culture- and amplicon-based metagenomic analysis to characterize the mycobiome and assess relationships between Cryptococcus spp. and other fungal taxa. The most abundant genera detected were Coniochaeta, Aspergillus, and Penicillium, all being commonly isolated from decaying wood. There was no correlation between the presence of Cryptococcus spp. in a tree hollow and the presence of any other fungal genus. Some differences in the abundance of numerous taxa were noted in a differential heat tree comparing samples with or without Cryptococcus-NGS reads. The study expanded the known environmental niche of the C. gattii and C. neoformans species complexes in Australia with detections from a further five tree species. Discrepancies between the detection of Cryptococcus spp. using culture or NGS suggest that neither is superior per se and that, rather, these methodologies are complementary. The inherent biases of amplicon-based metagenomics require cautious interpretation of data through consideration of its biological relevance.
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Affiliation(s)
- Laura J. Schmertmann
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Richard Malik
- Centre for Veterinary Education, Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
| | - Jeff R. Powell
- Hawkesbury Institute for the EnvironmentWestern Sydney UniversityPenrithNSWAustralia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNSWAustralia
- The Westmead Institute for Medical ResearchWestmeadNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
| | - Mark B. Krockenberger
- Sydney School of Veterinary ScienceThe University of SydneySydneyNSWAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNSWAustralia
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13
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Reagan KL, McHardy I, Thompson GR, Sykes JE. Evaluation of the clinical performance of 2 point-of-care cryptococcal antigen tests in dogs and cats. J Vet Intern Med 2019; 33:2082-2089. [PMID: 31468619 PMCID: PMC6766525 DOI: 10.1111/jvim.15599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/08/2019] [Indexed: 01/09/2023] Open
Abstract
Background Point‐of‐care (POC) Cryptococcus antigen assays may provide veterinarians with a more rapid, patient‐side diagnosis when compared with traditional laboratory‐based latex agglutination tests. Objective To determine the sensitivity and specificity of 2 POC lateral flow cryptococcal serum antigen tests, CrAg LFA (Immy, Norman, OK) and the CryptoPS (Biosynex, Strasbourg, France) for diagnosis of cryptococcosis in dogs and cats, using the cryptococcal antigen latex agglutination system (CALAS) as the reference standard. Animals 102 serum samples from 51 dogs and 40 cats. Methods Specimens were classified as CALAS‐positive (n = 25) or CALAS‐negative (n = 77). The sensitivity and specificity of each POC assay was calculated by comparing the results to the serologic reference standard results. Results The CrAg LFA assay correctly classified 23/25 CALAS‐positive specimens and 69/74 CALAS‐negative specimens resulting in a sensitivity of 92.0% (confidence interval [CI], 75.0%‐98.6%) and specificity of 93.2% (CI, 85.1%‐97.1%). The CryptoPS assay correctly classified 8/10 tested CALAS‐positive specimens and 56/59 tested CALAS‐negative specimens resulting in a sensitivity of 80.0% (CI, 49.0%‐96.5%) and specificity of 94.9% (CI, 86.1%‐98.6%). Conclusion and Clinical Importance The POC assays appear to be a sensitive and specific alternative to the traditional CALAS assay with more rapid turnaround times, which may result in earlier diagnosis and treatment.
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Affiliation(s)
- Krystle L Reagan
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Ian McHardy
- Department of Medical Microbiology and Immunology, University of California-Davis, Davis, California
| | - George R Thompson
- Department of Internal Medicine, Division of Infectious Diseases, University of California-Davis Medical Center, Sacramento, California
| | - Jane E Sykes
- Department of Medicine & Epidemiology, University of California-Davis, Davis, California
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14
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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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15
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Abstract
Cryptococcus gattii molecular type VGII is one of the etiologic agents of cryptococcosis, a systemic mycosis affecting a wide range of host species. Koalas (Phascolarctos cinereus) exhibit a comparatively high prevalence of cryptococcosis (clinical and subclinical) and nasal colonization, particularly in captivity. In Australia, disease associated with C. gattii VGII is typically confined to Western Australia and the Northern Territory (with sporadic cases reported in eastern Australia), occupying an enigmatic ecologic niche. A cluster of cryptococcosis in captive koalas in eastern Australia (five confirmed cases, a further two suspected), caused predominantly by C. gattii VGII, was investigated by surveying for subclinical disease, culturing koala nasal swabs and environmental samples, and genotyping cryptococcal isolates. URA5 restriction fragment length polymorphism analysis, multilocus sequence typing (MLST), and whole-genome sequencing (WGS) provided supportive evidence that the transfer of koalas from Western Australia and subsequently between several facilities in Queensland spread VGII into uncontaminated environments and environments in which C. gattii VGI was endemic. MLST identified VGII isolates as predominantly sequence type 7, while WGS further confirmed a limited genomic diversity and revealed a basal relationship with isolates from Western Australia. We hypothesize that this represents a founder effect following the introduction of a koala from Western Australia. Our findings suggest a possible competitive advantage for C. gattii VGII over VGI in the context of this captive koala environment. The ability of koalas to seed C. gattii VGII into new environments has implications for the management of captive populations and movements of koalas between zoos.IMPORTANCE Cryptococcus gattii molecular type VGII is one of the causes of cryptococcosis, a severe fungal disease that is acquired from the environment and affects many host species (including humans and koalas). In Australia, disease caused by C. gattii VGII is largely confined to western and central northern parts of the country, with sporadic cases reported in eastern Australia. We investigated an unusual case cluster of cryptococcosis, caused predominantly by C. gattii VGII, in a group of captive koalas in eastern Australia. This research identified that the movements of koalas between wildlife parks, including an initial transfer of a koala from Western Australia, introduced and subsequently spread C. gattii VGII in this captive environment. The spread of this pathogen by koalas could also impact other species, and these findings are significant in the implications they have for the management of koala transfers and captive environments.
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