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Taverna CG, Arias BA, Firacative C, Vivot ME, Szusz W, Vivot W, Mazza M, Córdoba SB, Canteros CE. Genotypic Diversity and Antifungal Susceptibility of Clinical Isolates of Cryptococcus Gattii Species Complex from Argentina. Mycopathologia 2023; 188:51-61. [PMID: 36609823 DOI: 10.1007/s11046-022-00705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/24/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study was to determine the genotypic diversity of 22 Cryptococcus gattii species complex clinical isolates from Argentina and to place these genotypes within the diversity of clinical, veterinary and environmental isolates from Latin America. Mating type and antifungal susceptibility of the isolates were also determined. By URA5-RFLP, nine isolates were identified as molecular type VGI, 10 as VGII, one as VGIII and two as VGIV. Multilocus sequence typing (MSLT), following the International Society for Human and Animal Mycology (ISHAM) consensus MLST scheme, was used to determine the genotypic diversity. Our results suggest that, in Argentina, VGI isolates have low genetic diversity, while VGII isolates have high genetic diversity. Both isolates identified as VGIV by URA5-RFLP were genotyped by MLST as belonging to the currently named VGVI clade. From all isolates, eight sequence types (STs) were unique for Argentina, while five STs have been reported already in other countries, being of high interest the genotypes ST20 and ST7 since they belong to the subtypes VGIIa and VGIIb, respectively, which are associated with hypervirulent strains responsible for outbreaks in North America. To note, geographical analysis showed that some genotypes may be associated with some regions in Argentina. Most isolates were MATα, but we are reporting one isolate MATa for the first time in the country. Antifungal susceptibility tests showed that itraconazole, voriconazole and posaconazole had high activity against all isolates, while amphotericin B, fluconazole and 5-fluorocytosine were the least active drugs against all studied isolates.
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Affiliation(s)
- Constanza Giselle Taverna
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Barbara Abigail Arias
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá, Colombia
| | - Matías Ezequiel Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Wanda Szusz
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Walter Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Mazza
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Susana Beatriz Córdoba
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Cristina Elena Canteros
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
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Chidebelu PE, Nweze EI, Meis JF, Cogliati M, Hagen F. Multi-locus sequence typing reveals genotypic similarity in Nigerian Cryptococcus neoformans AFLP1/VNI of environmental and clinical origin. J Med Microbiol 2021; 70. [PMID: 34665109 DOI: 10.1099/jmm.0.001440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IntroductionPigeon droppings are among the major environmental sources of Cryptococcus neoformans AFLP1/VNI, from where the organism infects susceptible humans and animals resulting in cryptococcosis. Until now, C. neoformans AFLP1B/VNII was the only molecular type reported in Nigeria. Effective clinical treatment of this infection has occasionally been stymied by the emergence of antifungal non-susceptible, and resistant strains of C. neoformans AFLP1/VNI.Hypothesis/Gap StatementPigeon droppings harbour C. neoformans and HIV/AIDS patients are among the susceptible population to develop cryptococcal infection. Epidemiological data on cryptococcal prevalence is limited in Nigeria.AimTo investigate the environmental prevalence of C. neoformans in South-eastern Nigeria and compare the isolates with other lineages by using molecular and microbiological tools.MethodologyA total of 500 pigeon droppings and 300 blood samples of HIV/AIDS patients were collected, respectively, from five market squares and three tertiary healthcare centres within the Nsukka area of South-eastern Nigeria. The antifungal susceptibility of the C. neoformans isolates to amphotericin B, fluconazole, 5-fluorocytosine, itraconazole, voriconazole, posaconazole, and isavuconazole was investigated based on the CLSI M27-A3 protocol. Yeasts were identified by MALDI-TOF MS, thereafter Cryptococcus MLST was performed according to the International Society for Human and Animal Mycology (ISHAM) consensus scheme.Results C. neoformans was recovered from 6 (1.2 %) pigeon droppings and 6 (2 %) blood cultures of HIV/AIDS patients. Molecular analyses indicated that all cryptococcal isolates belong to serotype A and the AFLP1/VNI molecular type with sequence type (ST)32. Infection with C. neoformans was independent of sex and age of the patients investigated. All C. neoformans isolates were susceptible to the seven antifungal agents.ConclusionThis is the first report on the prevalence of C. neoformans AFLP1/VNI (ST32) in environmental and clinical samples from Nigeria. The antifungal susceptibility indicates that antifungal resistance by C. neoformans is yet a rare occurrence in Nigeria.
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Affiliation(s)
- Paul E Chidebelu
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emeka I Nweze
- Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
- Cleveland State University, Cleveland, Ohio, USA
| | - Jacques F Meis
- Department of Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Centre of Expertise in Mycology RadboudUMC/CWZ, Nijmegen, The Netherlands
| | - Massimo Cogliati
- Laboratorio di Micologia Medica, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Hong N, Chen M, Xu J. Molecular Markers Reveal Epidemiological Patterns and Evolutionary Histories of the Human Pathogenic Cryptococcus. Front Cell Infect Microbiol 2021; 11:683670. [PMID: 34026667 PMCID: PMC8134695 DOI: 10.3389/fcimb.2021.683670] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023] Open
Abstract
The human pathogenic Cryptococcus species are the main agents of fungal meningitis in humans and the causes of other diseases collectively called cryptococcosis. There are at least eight evolutionary divergent lineages among these agents, with different lineages showing different geographic and/or ecological distributions. In this review, we describe the main strain typing methods that have been used to analyze the human pathogenic Cryptococcus and discuss how molecular markers derived from the various strain typing methods have impacted our understanding of not only cryptococcal epidemiology but also its evolutionary histories. These methods include serotyping, multilocus enzyme electrophoresis, electrophoretic karyotyping, random amplified polymorphic DNA, restriction fragment length polymorphism, PCR-fingerprinting, amplified fragment length polymorphism, multilocus microsatellite typing, single locus and multilocus sequence typing, matrix-assisted laser desorption/ionization time of flight mass spectrometry, and whole genome sequencing. The major findings and the advantages and disadvantages of each method are discussed. Together, while controversies remain, these strain typing methods have helped reveal (i) the broad phylogenetic pattern among these agents, (ii) the centers of origins for several lineages and their dispersal patterns, (iii) the distributions of genetic variation among geographic regions and ecological niches, (iv) recent hybridization among several lineages, and (v) specific mutations during infections within individual patients. However, significant challenges remain. Multilocus sequence typing and whole genome sequencing are emerging as the gold standards for continued strain typing and epidemiological investigations of cryptococcosis.
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Affiliation(s)
- Nan Hong
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China.,Department of Burn and Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Min Chen
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON, Canada
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Firacative C, Meyer W, Castañeda E. Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group. J Fungi (Basel) 2021; 7:jof7040282. [PMID: 33918572 PMCID: PMC8069395 DOI: 10.3390/jof7040282] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023] Open
Abstract
Cryptococcosis, a potentially fatal mycosis, is caused by members of the Cryptococcus neoformans and Cryptococcus gattii species complexes. In Latin America, cryptococcal meningitis is still an important health threat with a significant clinical burden. Analysis of publicly available molecular data from 5686 clinical, environmental, and veterinary cryptococcal isolates from member countries of the Latin American Cryptococcal Study Group showed that, as worldwide, C. neoformans molecular type VNI is the most common cause of cryptococcosis (76.01%) in HIV-infected people, followed by C. gattii molecular type VGII (12.37%), affecting mostly otherwise healthy hosts. These two molecular types also predominate in the environment (68.60% for VNI and 20.70% for VGII). Among the scarce number of veterinary cases, VGII is the predominant molecular type (73.68%). Multilocus sequence typing analysis showed that, in Latin America, the C. neoformans population is less diverse than the C. gattii population (D of 0.7104 vs. 0.9755). Analysis of antifungal susceptibility data showed the presence of non-wild-type VNI, VGI, VGII, and VGIII isolates in the region. Overall, the data presented herein summarize the progress that has been made towards the molecular epidemiology of cryptococcal isolates in Latin America, contributing to the characterization of the genetic diversity and antifungal susceptibility of these globally spreading pathogenic yeasts.
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Affiliation(s)
- Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
- Correspondence: ; Tel.: +57-1-297-0200 (ext. 3404)
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Research and Education Network Westmead Hospital, Faculty of Medicine and Health, Sydney Medical School-Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, The University of Sydney, Sydney 2145, Australia;
| | - Elizabeth Castañeda
- Grupo de Microbiología, Instituto Nacional de Salud, Bogota 111321, Colombia;
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A Short-Tandem-Repeat Assay ( MmySTR) for Studying Genetic Variation in Madurella mycetomatis. J Clin Microbiol 2021; 59:JCM.02331-20. [PMID: 33298608 DOI: 10.1128/jcm.02331-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/01/2020] [Indexed: 12/27/2022] Open
Abstract
Madurella mycetomatis is the major causative agent of eumycetoma, a neglected tropical infection characterized by painless subcutaneous lesions, inflammation, and grains draining from multiple sinuses. To study the epidemiology of mycetoma, a robust discriminatory typing technique is needed. We describe the use of a short-tandem-repeat assay (MmySTR) for genotyping of M. mycetomatis isolates predominantly from Sudan. Eleven microsatellite markers (3 dinucleotides, 4 trinucleotide repeats, and 4 tetranucleotide repeats) were selected from the M. mycetomatis MM55 genome using the Tandem Repeats Finder software. PCR amplification primers were designed for each microsatellite marker using primer3 software and amplified in a multicolor multiplex PCR approach. To establish the extent of genetic variation within the population, a collection of 120 clinical isolates from different regions was genotyped with this assay. The 11 selected MmySTR markers showed a large genotypic heterogeneity. From a collection of 120 isolates, 108 different genotypes were obtained. Simpson's diversity index (D) value for individual markers ranged from 0.081 to 0.881, and the combined panel displayed an overall D value of 0.997. The MmySTR assay demonstrated high stability, reproducibility, and specificity. The MmySTR assay is a promising new typing technique that can be used to genotype isolates of M. mycetomatis Apart from the possible contribution of host factors, the genetic diversity observed among this group of isolates might contribute to the different clinical manifestations of mycetoma. We recommend that the MmySTR assay be used to establish a global reference database for future study of M. mycetomatis isolates.
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Danesi P, Falcaro C, Schmertmann LJ, de Miranda LHM, Krockenberger M, Malik R. Cryptococcus in Wildlife and Free-Living Mammals. J Fungi (Basel) 2021; 7:jof7010029. [PMID: 33419125 PMCID: PMC7825559 DOI: 10.3390/jof7010029] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 12/21/2022] Open
Abstract
Cryptococcosis is typically a sporadic disease that affects a broad range of animal species globally. Disease is a consequence of infection with members of the Cryptococcus neoformans or Cryptococcus gattii species complexes. Although cryptococcosis in many domestic animals has been relatively well-characterized, free-living wildlife animal species are often neglected in the literature outside of occasional case reports. This review summarizes the clinical presentation, pathological findings and potential underlying causes of cryptococcosis in various other animals, including terrestrial wildlife species and marine mammals. The evaluation of the available literature supports the hypothesis that anatomy (particularly of the respiratory tract), behavior and environmental exposures of animals play vital roles in the outcome of host–pathogen–environment interactions resulting in different clinical scenarios. Key examples range from koalas, which exhibit primarily C. gattii species complex disease presumably due to their behavior and environmental exposure to eucalypts, to cetaceans, which show predominantly pulmonary lesions due to their unique respiratory anatomy. Understanding the factors at play in each clinical scenario is a powerful investigative tool, as wildlife species may act as disease sentinels.
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Affiliation(s)
- Patrizia Danesi
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Padua, Italy;
- Correspondence:
| | - Christian Falcaro
- Laboratory of Parasitology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Padua, Italy;
| | - Laura J. Schmertmann
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Luisa Helena Monteiro de Miranda
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Mark Krockenberger
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, The University of Sydney, Sydney 2006, Australia; (L.J.S.); (L.H.M.d.M.); (M.K.)
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, Sydney 2006, Australia;
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Chen M, Wang Y, Li Y, Hong N, Zhu X, Pan W, Liao W, Xu J, Du J, Chen J. Genotypic diversity and antifungal susceptibility of environmental isolates of Cryptococcus neoformans from the Yangtze River Delta region of East China. Med Mycol 2020; 59:653-663. [PMID: 33269400 DOI: 10.1093/mmy/myaa096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/03/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Although cryptococcosis is widely recognized as infection by Cryptococcus neoformans sensu lato from environmental sources, information concerning the characteristics of environmental isolates of C. neoformans s. l. and how they are related to clinical isolates is very limited, especially in East China. In this study, 61 environmental isolates of C. neoformans were recovered from pigeon (Columba livia) droppings from the Yangtze River Delta region of East China. These isolates were genotyped using the ISHAM-MLST consensus scheme and their antifungal drug susceptibilities were determined following the CLSI M27-A3 guidelines. The 61 isolates were found belonging to 13 sequence types (STs), including several novel STs such as ST254 and ST194. The dominant ST in this environmental sample was ST31, different from that of clinical strains (ST5) in this region. Azole-resistance, such as fluconazole (FLU)-resistance, was observed among our environmental C. neoformans isolates. The findings of this study expand our understanding of ecological niches, population genetic diversity, and azole-resistance characteristics of the yeast in East China. Our research lays the foundation for further comparative analysis the potential mechanisms for the observed differences between environmental and clinical populations of C. neoformans in China. LAY SUMMARY Cryptococcosis is widely recognized as infection by Cryptococcus neoformans sensu lato from environmental sources. However, there is currently limited information about the genetic diversity and antifungal susceptibility of environmental C. neoformans s. l. isolates, including how they may differ from clinical samples. In this study, we collected 61 environmental C. neoformans isolates from domestic pigeon droppings from the Yangtze River Delta region of East China. These isolates were genotyped using multi-locus sequencing. We found a high genotypic diversity in this population of C. neoformans, with several novel genotypes and a distribution of genotypes different from that of clinical strains in this region. Azole-resistance, such as fluconazole (FLU)-resistance, was observed among our environmental C. neoformans isolates. The findings of this study expand our understanding of ecological niches, genetic diversity, and azole-resistance characteristics of the yeast in East China. Our research lays the foundation for phylogenomic analysis investigating why and how disparate population structures of C. neoformans isolates formed between environmental and clinical sources in the region.
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Affiliation(s)
- Min Chen
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yan Wang
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yingfang Li
- Department of Skin & Cosmetic Research, Shanghai Skin Diseases Hospital, Shanghai, China
| | - Nan Hong
- Department of Dermatology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Xinlin Zhu
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Wanqing Liao
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, Canada
| | - Jingxia Du
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jianghan Chen
- Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai, China
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Prakash A, Sundar G, Sharma B, Hagen F, Meis JF, Chowdhary A. Genotypic diversity in clinical and environmental isolates of Cryptococcus neoformans from India using multilocus microsatellite and multilocus sequence typing. Mycoses 2020; 63:284-293. [PMID: 31820495 DOI: 10.1111/myc.13041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cryptococcus neoformans is the leading cause of cryptococcal meningitis in HIV/AIDS patients. As infections in humans are predominantly caused by the inhalation of basidiospores from environmental sources, therefore, analysing the population structure of both clinical and environmental populations of C neoformans can increase our understanding of the molecular epidemiology of cryptococcosis. OBJECTIVE To investigate the genotypic diversity and antifungal susceptibility profile of a large collection of C neoformans isolates (n = 523) from clinical and environmental sources in India between 2001 and 2014. MATERIALS AND METHODS Cryptococcus neoformans isolates were genotyped by AFLP, microsatellite typing (MLMT) and MLST. In vitro antifungal susceptibility for standard antifungals was undertaken using CLSI M27-A3. RESULTS All isolates were C neoformans, AFLP1/VNI and exhibited mating-type MATα. MLMT revealed that the majority of isolates belonged to microsatellite cluster (MC) MC3 (49%), followed by MC1 (35%), and the remaining isolates fell in 11 other MC types. Interestingly, two-thirds of clinical isolates were genotype MC3 and only 17% of them were MC1, whereas majority of environmental strains were MC1 (54%) followed by MC3 (16%). Overall, MLST assigned 5 sequence types (STs) among all isolates and ST93 was the most common (n = 76.7%), which was equally distributed in both HIV-positive and HIV-negative patients. Geometric mean MICs revealed that isolates in MC1 were significantly less (P < .05) susceptible to amphotericin B, 5-flucytosine, itraconazole, posaconazole and isavuconazole than isolates in MC3. CONCLUSIONS The study shows a good correlation between MLMT and MLST genotyping methods. Further, environmental isolates were genetically more diverse than clinical isolates.
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Affiliation(s)
- Anupam Prakash
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Gandhi Sundar
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Brijesh Sharma
- Department of Medicine, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Jacques F Meis
- Center of Expertise in Mycology, Radboud University Medical Centre/Canisius Wilhelmina Hospital and Excellence Center for Medical Mycology of the European Confederation of Medical Mycology (ECMM), Nijmegen, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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Dou H, Wang H, Xie S, Chen X, Xu Z, Xu Y. Molecular characterization of Cryptococcus neoformans isolated from the environment in Beijing, China. Med Mycol 2018; 55:737-747. [PMID: 28431114 DOI: 10.1093/mmy/myx026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
The molecular type of environmental Cryptococcus neoformans in Beijing was not clear. Our study aims to reveal the molecular characterization of C. neoformans complex from environment in Beijing, China. A total of 435 samples of pigeon droppings from 11 different homes in Beijing were collected from August to November in 2015. Pigeon droppings were inoculated onto caffeic acid cornmeal agar (CACA) to screen C. neoformans complex. Bruker Biotyper matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed for species identification. Serotype and mating type was determined by specific primers. Restriction fragment length polymorphisms of URA5 (URA5-RFLP) were applied to genotype. Multi-locus sequence typing (MLST) was done for further identification and sequence type (ST) determination. Altogether, 81 isolates of C. neoformans AFLP1/VNI were recognized from 435 pigeon droppings in this study. The positive rate for C. neoformans AFLP1/VNI from pigeon droppings in different homes varied from 5.0% to 52.6%, the average was 20.2%. All of these cryptococcal strains were serotype A, MATα. They were genotyped as VNI by URA5-RFLP and were confirmed by MLST. No other molecular types of C. neoformans and Cryptococcus gattii isolates were isolated. Their STs were identified as ST 31 (n = 54, 66.7%), followed by ST 53 (n = 10), ST 191 (n = 8), ST 5 (n = 5), ST 57 (n = 3), and ST 38 (n = 1). We concluded that not only clinical but also environmental isolates of C. neoformans need to be investigated more deeply and more extensively. The virulence difference between ST 5 and ST 31 need to be explored in the future.
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Affiliation(s)
- Hongtao Dou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huizhu Wang
- Department of Clinical Laboratory, Beijing Di-Tan Hospital, Capital Medical University, Beijing, China
| | - Shaowei Xie
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinxin Chen
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhipeng Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingchun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Firacative C, Lizarazo J, Illnait-Zaragozí MT, Castañeda E. The status of cryptococcosis in Latin America. Mem Inst Oswaldo Cruz 2018; 113:e170554. [PMID: 29641639 PMCID: PMC5888000 DOI: 10.1590/0074-02760170554] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/06/2018] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis is a life-threatening fungal infection caused by the encapsulated
yeasts Cryptococcus neoformans and C. gattii,
acquired from the environment. In Latin America, as occurring
worldwide, C. neoformans causes more than 90% of the cases of
cryptococcosis, affecting predominantly patients with HIV, while C.
gattii generally affects otherwise healthy individuals. In this
region, cryptococcal meningitis is the most common presentation, with
amphotericin B and fluconazole being the antifungal drugs of choice. Avian
droppings are the predominant environmental reservoir of C.
neoformans, while C. gattii is associated with
several arboreal species. Importantly, C. gattii has a high
prevalence in Latin America and has been proposed to be the likely origin of
some C. gattii populations in North America. Thus, in the
recent years, significant progress has been made with the study of the basic
biology and laboratory identification of cryptococcal strains, in understanding
their ecology, population genetics, host-pathogen interactions, and the clinical
epidemiology of this important mycosis in Latin America.
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Affiliation(s)
- Carolina Firacative
- Westmead Hospital, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jairo Lizarazo
- Internal Medicine Department, Hospital Universitario Erasmo Meoz, Universidad de Pamplona, Cúcuta, Colombia
| | - María Teresa Illnait-Zaragozí
- Diagnosis and Reference Centre, Bacteriology-Mycology Department Research, Tropical Medicine Institute Pedro Kourí, Havana, Cuba
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Herkert PF, Meis JF, Lucca de Oliveira Salvador G, Rodrigues Gomes R, Aparecida Vicente V, Dominguez Muro M, Lameira Pinheiro R, Lopes Colombo A, Vargas Schwarzbold A, Sakuma de Oliveira C, Simão Ferreira M, Queiroz-Telles F, Hagen F. Molecular characterization and antifungal susceptibility testing of Cryptococcus neoformans sensu stricto from southern Brazil. J Med Microbiol 2018; 67:560-569. [PMID: 29461182 DOI: 10.1099/jmm.0.000698] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Cryptococcosis is acquired from the environment by the inhalation of Cryptococcus cells and may establish from an asymptomatic latent infection into pneumonia or meningoencephalitis. The genetic diversity of a Cryptococcus neoformans species complex has been investigated by several molecular tools, such as multi-locus sequence typing, amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism and microsatellite analysis. This study aimed to investigate the genotype distributions and antifungal susceptibility profiles of C. neoformans sensu lato isolates from southern Brazil. METHODOLOGY We studied 219 C. neoformans sensu lato isolates with mating- and serotyping, AFLP fingerprinting, microsatellite typing and antifungal susceptibility testing.Results/Key findings. Among the isolates, 136 (69 %) were from HIV-positive patients. Only C. neoformans mating-type α and serotype A were observed. AFLP fingerprinting analysis divided the isolates into AFLP1/VNI (n=172; 78.5 %), AFLP1A/VNII (n=19; 8.7 %), AFLP1B/VNII (n=4; 1.8 %) and a new AFLP pattern AFLP1C (n=23; 10.5 %). All isolates were susceptible to tested antifungals and no correlation between antifungal susceptibility and genotypes was observed. Through microsatellite analysis, most isolates clustered in a major microsatellite complex and Simpson's diversity index of this population was D=0.9856. CONCLUSION The majority of C. neoformans sensu stricto infections occurred in HIV-positive patients. C. neoformans AFLP1/VNI was the most frequent genotype and all antifungal drugs had high in vitro activity against this species. Microsatellite analyses showed a high genetic diversity within the regional C. neoformans sensu stricto population, and correlation between environmental and clinical isolates, as well as a temporal and geographic relationship.
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Affiliation(s)
- Patricia Fernanda Herkert
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | | | - Renata Rodrigues Gomes
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil.,Department of Biological Science, State University of Parana/Campus Paranaguá, Paranaguá, PR, Brazil
| | - Vania Aparecida Vicente
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil
| | - Marisol Dominguez Muro
- Laboratory of Mycology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | | | | | | | - Carla Sakuma de Oliveira
- Hospital Universitário do Oeste do Paraná, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | | | - Flávio Queiroz-Telles
- Comunnitarian Health Department, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Ferry Hagen
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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12
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Kassi FK, Bellet V, Drakulovski P, Krasteva D, Roger F, Valérie BTA, Aboubakar T, Doumbia A, Kouakou GA, Delaporte E, Reynes J, Yavo W, Menan HIE, Bertout S. Comparative typing analyses of clinical and environmental strains of the Cryptococcus neoformans/Cryptococcus gattii species complex from Ivory Coast. J Med Microbiol 2017; 67:87-96. [PMID: 29214970 DOI: 10.1099/jmm.0.000654] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The aim of this study was to assess the biotope of the Cryptococcus neoformans/Cryptococcus gattii species complex from Ivory Coast, and clarify the possible epidemiological relationship between environmental and clinical strains. METHODOLOGY Samples from Eucalyptus camaldulensis (n=136), Mangifera indica (n=13) and pigeon droppings (n=518) were collected from different sites close to the living environment of Ivorian HIV patients with cryptococcosis (n=10, 50 clinical strains). Clinical and environmental strains were characterized by molecular serotyping and genotyping [RFLP analysis of the URA5 gene, (GACA)4, (GTG)5 and M13 PCR fingerprinting] and compared.Results/Key findings. Environmental strains were recovered only from the pigeon droppings. In vitro susceptibility profiles showed that all strains were susceptible to fluconazole, flucytosine and amphotericin B. All environmental strains consisted of C. neoformans (A, AFLP1/VNI), whereas clinical strains included C. neoformans (A, AFLP1/VNI), C. neoformans x Cryptococcus deneoformans hybrids (AD, AFLP3/VNIII) and Cryptococcus deuterogattii (B, AFLP6/VGII). Two patients were co-infected with both C. neoformans and C. neoformans x C. deneoformans hybrids. We noticed a low genetic diversity among the environmental samples compared to the high diversity of the clinical samples. Some clinical strains were genetically more similar to environmental strains than to other clinical strains, including those from the same patient. CONCLUSION These results provide new information on the ecology and epidemiology of the C. neoformans/C. gattii species complex in Ivory Coast.
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Affiliation(s)
- Fulgence K Kassi
- Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les Autres Maladies Infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Ivory Coast
| | - Virginie Bellet
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Groupe Infections Fongique et Parasitaire Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier Cedex 5, France
| | - Pascal Drakulovski
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Groupe Infections Fongique et Parasitaire Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier Cedex 5, France
| | - Donika Krasteva
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Groupe Infections Fongique et Parasitaire Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier Cedex 5, France
| | - Frédéric Roger
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Groupe Infections Fongique et Parasitaire Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier Cedex 5, France
| | - Bedia-Tanoh A Valérie
- Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les Autres Maladies Infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Ivory Coast
| | - Touré Aboubakar
- Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les Autres Maladies Infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Ivory Coast
| | - Adama Doumbia
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Ivory Coast
| | - Gisèle A Kouakou
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Ivory Coast
| | - Eric Delaporte
- UMI 233 Service des Maladies Infectieuses et Tropicales, CHU Gui de Chauliac, Montpellier, France
| | - Jacques Reynes
- UMI 233 Service des Maladies Infectieuses et Tropicales, CHU Gui de Chauliac, Montpellier, France
| | - William Yavo
- Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les Autres Maladies Infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Ivory Coast
| | - Hervé I E Menan
- Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les Autres Maladies Infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Ivory Coast
| | - Sebastien Bertout
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Groupe Infections Fongique et Parasitaire Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier Cedex 5, France
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13
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Investigating Clinical Issues by Genotyping of Medically Important Fungi: Why and How? Clin Microbiol Rev 2017; 30:671-707. [PMID: 28490578 DOI: 10.1128/cmr.00043-16] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Genotyping studies of medically important fungi have addressed elucidation of outbreaks, nosocomial transmissions, infection routes, and genotype-phenotype correlations, of which secondary resistance has been most intensively investigated. Two methods have emerged because of their high discriminatory power and reproducibility: multilocus sequence typing (MLST) and microsatellite length polymorphism (MLP) using short tandem repeat (STR) markers. MLST relies on single-nucleotide polymorphisms within the coding regions of housekeeping genes. STR polymorphisms are based on the number of repeats of short DNA fragments, mostly outside coding regions, and thus are expected to be more polymorphic and more rapidly evolving than MLST markers. There is no consensus on a universal typing system. Either one or both of these approaches are now available for Candida spp., Aspergillus spp., Fusarium spp., Scedosporium spp., Cryptococcus neoformans, Pneumocystis jirovecii, and endemic mycoses. The choice of the method and the number of loci to be tested depend on the clinical question being addressed. Next-generation sequencing is becoming the most appropriate method for fungi with no MLP or MLST typing available. Whatever the molecular tool used, collection of clinical data (e.g., time of hospitalization and sharing of similar rooms) is mandatory for investigating outbreaks and nosocomial transmission.
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14
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Molecular Characterization and Antifungal Susceptibility Testing of Sequentially Obtained Clinical Cryptococcus deneoformans and Cryptococcus neoformans Isolates from Ljubljana, Slovenia. Mycopathologia 2017; 183:371-380. [PMID: 29064061 DOI: 10.1007/s11046-017-0214-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 10/15/2017] [Indexed: 12/22/2022]
Abstract
AIM To retrospectively investigate the epidemiology of cryptococcosis in Ljubljana, Slovenia. METHODOLOGY Forty-six sequentially obtained isolates from 19 patients were subjected to amplified fragment length polymorphism (AFLP) genotyping, microsatellite typing, mating- and serotype PCRs and antifungal susceptibility testing. RESULTS Majority of the isolates were Cryptococcus deneoformans (n = 29/46; 63%) followed by Cryptococcus neoformans (n = 16/46; 34.8%) and their interspecies hybrid (n = 1/46; 2.2%). Mating-type α was predominant, two mating-type a C. deneoformans isolates and one mating-type a/α isolate were observed. Several mixed infections were found by microsatellite typing; one patient had a persisting C. deneoformans infection for > 2.5 years. For C. deneoformans, the in vitro antifungal MIC90 and susceptibility ranges were for amphotericin B 0.25 µg/ml (0.031-0.25 µg/ml), 5-fluorocytosine 0.25 µg/ml (0.063-4 µg/ml), fluconazole 8 µg/ml (0.5-16 µg/ml), voriconazole 0.063 µg/ml (0.008-0.125 µg/ml), posaconazole 0.063 µg/ml (0.008-0.063 µg/ml) and itraconazole 0.063 µg/ml (0.031-0.125 µg/ml). For C. neoformans, these values were for amphotericin B 0.25 µg/ml (0.063-0.5 µg/ml), 5-fluorocytosine 1 µg/ml (0.063-1 µg/ml), fluconazole 16 µg/ml (0.5-64 µg/ml), voriconazole 0.125 µg/ml (0.008-0.25 µg/ml), posaconazole 0.063 µg/ml (0.008-0.063 µg/ml) and itraconazole 0.063 µg/ml (0.031-0.125 µg/ml). CONCLUSIONS Majority of the cases were caused by C. deneoformans; mating-type α was predominant. Several mixed infections were identified by AFLP genotyping and microsatellite typing. Despite antifungal therapy, a cryptococcal isolate could persist for years. Voriconazole, itraconazole and posaconazole were the most potent antifungal drugs.
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15
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Hagen F, Lumbsch HT, Arsic Arsenijevic V, Badali H, Bertout S, Billmyre RB, Bragulat MR, Cabañes FJ, Carbia M, Chakrabarti A, Chaturvedi S, Chaturvedi V, Chen M, Chowdhary A, Colom MF, Cornely OA, Crous PW, Cuétara MS, Diaz MR, Espinel-Ingroff A, Fakhim H, Falk R, Fang W, Herkert PF, Ferrer Rodríguez C, Fraser JA, Gené J, Guarro J, Idnurm A, Illnait-Zaragozi MT, Khan Z, Khayhan K, Kolecka A, Kurtzman CP, Lagrou K, Liao W, Linares C, Meis JF, Nielsen K, Nyazika TK, Pan W, Pekmezovic M, Polacheck I, Posteraro B, de Queiroz Telles F, Romeo O, Sánchez M, Sampaio A, Sanguinetti M, Sriburee P, Sugita T, Taj-Aldeen SJ, Takashima M, Taylor JW, Theelen B, Tomazin R, Verweij PE, Wahyuningsih R, Wang P, Boekhout T. Importance of Resolving Fungal Nomenclature: the Case of Multiple Pathogenic Species in the Cryptococcus Genus. mSphere 2017; 2:e00238-17. [PMID: 28875175 PMCID: PMC5577652 DOI: 10.1128/msphere.00238-17] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Cryptococcosis is a major fungal disease caused by members of the Cryptococcus gattii and Cryptococcus neoformans species complexes. After more than 15 years of molecular genetic and phenotypic studies and much debate, a proposal for a taxonomic revision was made. The two varieties within C. neoformans were raised to species level, and the same was done for five genotypes within C. gattii. In a recent perspective (K. J. Kwon-Chung et al., mSphere 2:e00357-16, 2017, https://doi.org/10.1128/mSphere.00357-16), it was argued that this taxonomic proposal was premature and without consensus in the community. Although the authors of the perspective recognized the existence of genetic diversity, they preferred the use of the informal nomenclature "C. neoformans species complex" and "C. gattii species complex." Here we highlight the advantage of recognizing these seven species, as ignoring these species will impede deciphering further biologically and clinically relevant differences between them, which may in turn delay future clinical advances.
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Affiliation(s)
- Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | | | | | - Hamid Badali
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
| | - Sebastien Bertout
- Unité Mixte Internationale Recherches Translationnelles sur l’Infection à VIH et les Maladies Infectieuses, Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université Montpellier, Montpellier, France
| | - R. Blake Billmyre
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, USA
| | - M. Rosa Bragulat
- Veterinary Mycology Group, Department of Animal Health and Anatomy, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - F. Javier Cabañes
- Veterinary Mycology Group, Department of Animal Health and Anatomy, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Mauricio Carbia
- Departamento de Parasitología y Micología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sudha Chaturvedi
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Vishnu Chaturvedi
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Min Chen
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Second Military Medical University, Shanghai, China
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | | | - Oliver A. Cornely
- CECAD Cluster of Excellence, University of Cologne, Cologne, Germany
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Center for Clinical Trials, University Hospital Cologne, Cologne, Germany
| | - Pedro W. Crous
- Phytopathology Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Department of Entomology and Plant Pathology, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
- Department of Microbiology and Plant Pathology, Forestry and Agricultural Biotechnology Institute (FABI), University of Pretoria, Pretoria, South Africa
| | - Maria S. Cuétara
- Department of Microbiology, Hospital Severo Ochoa, Madrid, Spain
| | - Mara R. Diaz
- University of Miami, NSF NIEHS Oceans and Human Health Center, Miami, Florida, USA
- Rosentiel School of Marine and Atmospheric Science, Division of Marine Biology and Fisheries, University of Miami, Miami, Florida, USA
| | | | - Hamed Fakhim
- Department of Medical Parasitology and Mycology/Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rama Falk
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
- Department of Fisheries and Aquaculture, Ministry of Agriculture and Rural Development, Nir-David, Israel
| | - Wenjie Fang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Second Military Medical University, Shanghai, China
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Patricia F. Herkert
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil
| | | | - James A. Fraser
- Australian Infectious Diseases Research Centre, School of Chemistry & Molecular Biosciences, University of Queensland, Brisbane, Australia
| | - Josepa Gené
- Unitat de Micologia, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Guarro
- Unitat de Micologia, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Alexander Idnurm
- School of BioSciences, BioSciences 2, University of Melbourne, Melbourne, Australia
| | | | - Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Kantarawee Khayhan
- Department of Microbiology and Parasitology, Faculty of Medical Sciences, University of Phayao, Phayao, Thailand
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Anna Kolecka
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Cletus P. Kurtzman
- Mycotoxin Prevention and Applied Microbiology Research Unit, National Center for Agricultural Utilization Research, USDA-ARS, Peoria, Illinois, USA
| | - Katrien Lagrou
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Wanqing Liao
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Second Military Medical University, Shanghai, China
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Carlos Linares
- Medical School, Universidad Miguel Hernández, Alicante, Spain
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Kirsten Nielsen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tinashe K. Nyazika
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Malawi-Liverpool-Wellcome Trust, College of Medicine, University of Malawi, Blantyre, Malawi
- School of Tropical Medicine, Liverpool, United Kingdom
| | - Weihua Pan
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Second Military Medical University, Shanghai, China
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | | | - Itzhack Polacheck
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Brunella Posteraro
- Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Flavio de Queiroz Telles
- Department of Communitarian Health, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Orazio Romeo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - Manuel Sánchez
- Medical School, Universidad Miguel Hernández, Alicante, Spain
| | - Ana Sampaio
- Centro de Investigação e de Tecnologias Agro-ambientais e Biológicas (CITAB), Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta dos Prados, Vila Real, Portugal
| | - Maurizio Sanguinetti
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Pojana Sriburee
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Takashi Sugita
- Department of Microbiology, Meiji Pharmaceutical University, Noshio, Kiyose, Tokyo, Japan
| | - Saad J. Taj-Aldeen
- Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Masako Takashima
- Japan Collection of Microorganisms, RIKEN BioResource Center, Koyadai, Tsukuba, Ibaraki, Japan
| | - John W. Taylor
- Department of Plant and Microbial Biology, University of California Berkeley, Berkeley, California, USA
| | - Bart Theelen
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paul E. Verweij
- Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Retno Wahyuningsih
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Parasitology, School of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia
| | - Ping Wang
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Teun Boekhout
- Institute of Biodiversity and Ecosystems Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
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16
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Lian DS, Zhao SJ. Capillary electrophoresis based on nucleic acid detection for diagnosing human infectious disease. Clin Chem Lab Med 2017; 54:707-38. [PMID: 26352354 DOI: 10.1515/cclm-2015-0096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/17/2015] [Indexed: 01/22/2023]
Abstract
Rapid transmission, high morbidity, and mortality are the features of human infectious diseases caused by microorganisms, such as bacteria, fungi, and viruses. These diseases may lead within a short period of time to great personal and property losses, especially in regions where sanitation is poor. Thus, rapid diagnoses are vital for the prevention and therapeutic intervention of human infectious diseases. Several conventional methods are often used to diagnose infectious diseases, e.g. methods based on cultures or morphology, or biochemical tests based on metabonomics. Although traditional methods are considered gold standards and are used most frequently, they are laborious, time consuming, and tedious and cannot meet the demand for rapid diagnoses. Disease diagnosis using capillary electrophoresis methods has the advantages of high efficiency, high throughput, and high speed, and coupled with the different nucleic acid detection strategies overcomes the drawbacks of traditional identification methods, precluding many types of false positive and negative results. Therefore, this review focuses on the application of capillary electrophoresis based on nucleic detection to the diagnosis of human infectious diseases, and offers an introduction to the limitations, advantages, and future developments of this approach.
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17
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Gerstein AC, Nielsen K. It's not all about us: evolution and maintenance of Cryptococcus virulence requires selection outside the human host. Yeast 2017; 34:143-154. [PMID: 27862271 DOI: 10.1002/yea.3222] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 12/11/2022] Open
Abstract
Cryptococcus is predominantly an AIDS-related pathogen that causes significant morbidity and mortality in immunocompromised patients. Research studies have historically focused on understanding how the organism causes human disease through the use of in vivo and in vitro model systems to identify virulence factors. Cryptococcus is not an obligate pathogen, however, as human-human transmission is either absent or rare. Selection in the environment must thus be invoked to shape the evolution of this taxa, and directly influences genotypic and trait diversity. Importantly, the evolution and maintenance of pathogenicity must also stem directly from environmental selection. To that end, here we examine abiotic and biotic stresses in the environment, and discuss how they could shape the factors that are commonly identified as important virulence traits. We identify a number of important unanswered questions about Cryptococcus diversity and evolution that are critical for understanding this deadly pathogen, and discuss how implementation of modern sampling and genomic tools could be utilized to answer these questions. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Aleeza C Gerstein
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kirsten Nielsen
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, Minnesota, USA
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Gago S, Serrano C, Alastruey-Izquierdo A, Cuesta I, Martín-Mazuelos E, Aller AI, Gómez-López A, Mellado E. Molecular identification, antifungal resistance and virulence ofCryptococcus neoformansandCryptococcus deneoformansisolated in Seville, Spain. Mycoses 2016; 60:40-50. [DOI: 10.1111/myc.12543] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/09/2016] [Accepted: 07/11/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Sara Gago
- Mycology Reference Laboratory; Centro Nacional de Microbiología; Instituto de Salud Carlos III; Madrid Spain
- Manchester Fungal Infection Group; Institute of Inflammation and Repair; University of Manchester; Manchester UK
| | - Carmen Serrano
- Sección Micología; Hospital San Juan de Dios del Aljarafe; Sevilla Spain
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory; Centro Nacional de Microbiología; Instituto de Salud Carlos III; Madrid Spain
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015); Instituto de Salud Carlos III; Madrid Spain
| | - Isabel Cuesta
- Mycology Reference Laboratory; Centro Nacional de Microbiología; Instituto de Salud Carlos III; Madrid Spain
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015); Instituto de Salud Carlos III; Madrid Spain
| | | | - Ana Isabel Aller
- Unidad de Gestión de Enfermedades Infecciosas y Microbiología; Hospital de Valme; Sevilla Spain
| | - Alicia Gómez-López
- Mycology Reference Laboratory; Centro Nacional de Microbiología; Instituto de Salud Carlos III; Madrid Spain
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015); Instituto de Salud Carlos III; Madrid Spain
| | - Emilia Mellado
- Mycology Reference Laboratory; Centro Nacional de Microbiología; Instituto de Salud Carlos III; Madrid Spain
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015); Instituto de Salud Carlos III; Madrid Spain
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19
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Nyazika TK, Hagen F, Machiridza T, Kutepa M, Masanganise F, Hendrickx M, Boekhout T, Magombei-Majinjiwa T, Siziba N, Chin'ombe N, Mateveke K, Meis JF, Robertson VJ. Cryptococcus neoformans population diversity and clinical outcomes of HIV-associated cryptococcal meningitis patients in Zimbabwe. J Med Microbiol 2016; 65:1281-1288. [PMID: 27638836 DOI: 10.1099/jmm.0.000354] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
HIV and cryptococcal meningitis co-infection is a major public health problem in most developing countries. Cryptococcus neoformans sensu stricto is responsible for the majority of HIV-associated cryptococcosis cases in sub-Saharan Africa. Despite the available information, little is known about cryptococcal population diversity and its association with clinical outcomes in patients with HIV-associated cryptococcal meningitis in sub-Saharan Africa. In a prospective cohort, we investigated the prevalence and clinical outcome of Cryptococcusneoformans sensu stricto meningitis among HIV-infected patients in Harare, Zimbabwe, and compared the genotypic diversity of the isolates with those collected from other parts of Africa. Molecular typing was done using amplified fragment length polymorphism genotyping and microsatellite typing. The majority of patients with HIV-associated Cryptococcusneoformans sensu stricto meningitis in this cohort were males (n=33/55; 60.0 %). The predominant Cryptococcus neoformans sensu stricto genotype among the Zimbabwean isolates was genotype AFLP1/VNI (n=40; 72.7 %), followed by AFLP1A/VNB/VNII (n=8; 14.6 %), and AFLP1B/VNII was the least isolated (n=7; 12.7 %). Most of the isolates were mating-type α (n=51; 92.7 %), and only four (7.3 %) were mating-type a. Overall in-hospital mortality was 55.6 % (n=30), and no difference between infecting genotype and clinical outcome of patient (P=0.73) or CD4+ counts (P=0.79) was observed. Zimbabwean Cryptococcusneoformans sensu stricto genotypes demonstrated a high level of genetic diversity by microsatellite typing, and 51 genotypes within the main molecular types AFLP1/VNI, AFLP1A/VNB/VNII and AFLP1B/VNII were identified. This study demonstrates that Cryptococcusneoformans sensu stricto in Zimbabwe has a high level of genetic diversity when compared to other regional isolates.
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Affiliation(s)
- Tinashe K Nyazika
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Tendai Machiridza
- Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Melody Kutepa
- Parirenyatwa Group of Hospitals, Causeway, Harare, Zimbabwe
| | | | - Marijke Hendrickx
- Section Mycology and Aerobiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Teun Boekhout
- Department of Basidiomycetous & Yeast Research, CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Tricia Magombei-Majinjiwa
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nonthokozo Siziba
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nyasha Chin'ombe
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kudzanai Mateveke
- Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Radboudumc/CWZ Centre of Expertise in Mycology, Nijmegen, The Netherlands
| | - Valerie J Robertson
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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20
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Sweet MJ, Scriven LA, Singleton I. Microsatellites for microbiologists. ADVANCES IN APPLIED MICROBIOLOGY 2016; 81:169-207. [PMID: 22958530 DOI: 10.1016/b978-0-12-394382-8.00005-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Microsatellites are repeating sequences of 2-6base pairs of DNA. Currently, they are used as molecular markers in many organisms, specifically in genetic studies analyzing kinship and population structure. In addition, they can be used to study gene duplication and/or deletion. Although they are used in studies on microorganisms including fungi, bacteria, protists, and archaea, it appears that these genetic markers are not being utilized to their full microbiological potential. Microsatellites have many advantages over other genetic markers currently in use as they are in general species specific, and therefore, cross-contamination by nontarget organisms is rare. Furthermore, microsatellites are suitable for use with fast and cheap DNA extraction methods, with ancient DNA or DNA from hair and fecal samples used in noninvasive sampling, making them widely available as a genetic marker. Microsatellites have already proven to be a useful tool for evolutionary studies of pathogenic microorganisms such as Candida albicans and Helicobacter pylori, and the onset of new sequencing techniques (such as 454, PACBIO, and mini-ion sequencing) means the ability to detect such markers will become less time consuming and cheaper, thus further expanding their potential to answer important microbial ecology questions.
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Affiliation(s)
- Michael J Sweet
- School of Biology, Institute for Research on Sustainability, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
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21
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Kammalac Ngouana T, Drakulovski P, Krasteva D, Kouanfack C, Reynes J, Delaporte E, Boyom FF, Mallié M, Bertout S. Cryptococcus neoformans isolates from Yaoundé human immunodeficiency virus-infected patients exhibited intra-individual genetic diversity and variation in antifungal susceptibility profiles between isolates from the same patient. J Med Microbiol 2016; 65:579-589. [PMID: 27100672 DOI: 10.1099/jmm.0.000265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cryptococcal meningitis is a dreadful opportunistic fungal infection amongst human immunodeficiency virus (HIV)-infected patients. One complication in the management of the disease is the possible infection of a patient by two or more different strains of Cryptococcus neoformans. This study investigated the intra-individual genetic diversity and antifungal susceptibility of C. neoformans isolates from Yaoundé (Cameroon) HIV-infected patients with cryptococcal meningitis. Twenty-five clinical isolates were obtained during a prospective study. Five colonies were randomly collected from each initial sample. The 150 isolates obtained (125 colonies and 25 initial samples) were submitted to serotyping by multiplex PCR. Genotyping analyses were achieved using RFLP, and minisatellite- and microsatellite-length polymorphism. The antifungal susceptibility testing was carried out using a Sensititre YeastOne kit. Seven antifungals were tested: itraconazole, fluconazole, amphotericin B, ketoconazole, 5-fluorocytosine, posaconazole and voriconazole. The 150 isolates were identified as C. neoformans serotype A and genotype VNI. The microsatellite and minisatellite sequence analyses generated 15 genotypes. Six out of 25 (24 %) patients were found to be infected by two different genotypes. Antifungal susceptibility showed several profiles: posaconazole (0.015-0.25 µg ml-1), amphotericin B (0.06-1 µg ml-1), fluconazole (0.5-16 µg ml-1), itraconazole (0.008-0.12 µg ml-1), ketoconazole (0.008-0.12 µg ml-1), 5-fluorocytosine (0.25-16 µg ml-1) and voriconazole (0.008-0.12 µg ml-1). It was noted that isolates from the same patient might present different susceptibility profiles to an antifungal drug with differences of more than four dilutions. The results achieved highlighted the possible presence of isolates with different genotypes in a patient with dissimilar antifungal susceptibility profiles during a single episode of cryptococcal meningitis.
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Affiliation(s)
- Thierry Kammalac Ngouana
- Clinical Biology Laboratory, Yaoundé Central Hospital, Yaoundé, Cameroon
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
- Antimicrobial and Biocontrol Agents Unit (AMBAU), Laboratory for Phytobiochemistry and Medicinal Plants Studies, Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Pascal Drakulovski
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
| | - Donika Krasteva
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
| | - Charles Kouanfack
- Clinical Biology Laboratory, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Jacques Reynes
- Service des Maladies Infectieuses et Tropicales, Hôpital Gui de Chauliac, IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI', Montpellier, France
| | - Eric Delaporte
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
| | - Fabrice Fekam Boyom
- Antimicrobial and Biocontrol Agents Unit (AMBAU), Laboratory for Phytobiochemistry and Medicinal Plants Studies, Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Michèle Mallié
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
| | - Sebastien Bertout
- IRD UMI 233 TransVIHMI - UM INSERM U1175 'TransVIHMI' Laboratoire de Parasitologie et Mycologie Médicale, UFR Pharmacie, Université de Montpellier, Montpellier, France
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22
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Lackner M, Coassin S, Haun M, Binder U, Kronenberg F, Haas H, Jank M, Maurer E, Meis JF, Hagen F, Lass-Flörl C. Geographically predominant genotypes of Aspergillus terreus species complex in Austria: s microsatellite typing study. Clin Microbiol Infect 2015; 22:270-6. [PMID: 26577144 DOI: 10.1016/j.cmi.2015.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/19/2022]
Abstract
Aspergillus terreus species complex is recognized as a frequent agent of invasive aspergillosis in Tyrol. The reason for this specific epidemiological situation is unclear. Aspergillus terreus strains isolated from environmental and clinical sources were genotyped using a novel panel of short tandem repeats and were evaluated for virulence. Three major endemic genotypes collected from the Inn region and its side valleys were found to cause the majority of invasive A. terreus infections. All of these genotypes were of the same mating type, which suggests that a mating barrier is present between these geographically well-adapted strains which is found to persist for at least 11 years. The three major genotypes were prevalent in both human infections and the environment. No major differences in virulence were observed using Galleria mellonella as model. Our data suggest a specific environmental exposure being responsible for the high incidence of A. terreus infections in Innsbruck, the Inn valley and side valleys (Tyrol, Austria).
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Affiliation(s)
- M Lackner
- Division of Hygiene and Medical Microbiology, Austria.
| | - S Coassin
- Division of Genetic Epidemiology, Austria
| | - M Haun
- Division of Genetic Epidemiology, Austria
| | - U Binder
- Division of Hygiene and Medical Microbiology, Austria
| | | | - H Haas
- Division of Molecular Biology, Medical University of Innsbruck, Austria
| | - M Jank
- Division of Hygiene and Medical Microbiology, Austria
| | - E Maurer
- Division of Hygiene and Medical Microbiology, Austria
| | - J F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
| | - F Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - C Lass-Flörl
- Division of Hygiene and Medical Microbiology, Austria
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23
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Park SH, Choi SC, Lee KW, Kim MN, Hwang SM. Genotypes of Clinical and Environmental Isolates of Cryptococcus neoformans and Cryptococcus gattii in Korea. MYCOBIOLOGY 2015; 43:360-365. [PMID: 26539057 PMCID: PMC4630447 DOI: 10.5941/myco.2015.43.3.360] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 06/05/2023]
Abstract
Multilocus sequence typing analysis was applied to determine the genotypes of 147 (137 clinical and 10 environmental) Cryptococcus neoformans and three clinical Cryptococcus gattii isolates from 1993 to 2014 in Korea. Among the 137 clinical isolates of C. neoformans, the most prevalent genotype was ST5 (n = 131), followed by ST31 (n = 5) and ST127 (n = 1). Three C. gattii strains were identified as ST57, ST7, and ST113. All environmental isolates were identified as C. neoformans with two genotypes, ST5 (n = 7) and ST31 (n = 3). Our results show that C. neoformans isolates in Korea are genetically homogeneous, and represent a close genetic relationship between clinical and environmental isolates.
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Affiliation(s)
- So Hae Park
- Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 46252, Korea
| | - Seok Cheol Choi
- Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 46252, Korea
| | - Kyung Won Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul 03080, Korea
| | - Soo Myung Hwang
- Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 46252, Korea
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24
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Abstract
Cryptococcus neoformans is a human opportunistic fungal pathogen causing severe disseminated meningoencephalitis, mostly in patients with cellular immune defects. This species is divided into three serotypes: A, D, and the AD hybrid. Our objectives were to compare population structures of serotype A and D clinical isolates and to assess whether infections with AD hybrids differ from infections with the other serotypes. For this purpose, we analyzed 483 isolates and the corresponding clinical data from 234 patients enrolled during the CryptoA/D study or the nationwide survey on cryptococcosis in France. Isolates were characterized in terms of ploidy, serotype, mating type, and genotype, utilizing flow cytometry, serotype- and mating type-specific PCR amplifications, and multilocus sequence typing (MLST) methods. Our results suggest that C. neoformans serotypes A and D have different routes of multiplication (primarily clonal expansion versus recombination events for serotype A and serotype D, respectively) and important genomic differences. Cryptococcosis includes a high proportion of proven or probable infections (21.5%) due to a mixture of genotypes, serotypes, and/or ploidies. Multivariate analysis showed that parameters independently associated with failure to achieve cerebrospinal fluid (CSF) sterilization by week 2 were a high serum antigen titer, the lack of flucytosine during induction therapy, and the occurrence of mixed infection, while infections caused by AD hybrids were more likely to be associated with CSF sterilization. Our study provides additional evidence for the possible speciation of C. neoformans var. neoformans and grubii and highlights the importance of careful characterization of causative isolates. Cryptococcus neoformans is an environmental fungus causing severe disease, estimated to be responsible for 600,000 deaths per year worldwide. This species is divided into serotypes A and D and an AD hybrid, and these could be considered two different species and an interspecies hybrid. The objectives of our study were to compare population structures of serotype A and serotype D and to assess whether infections with AD hybrids differ from infections with serotype A or D isolates in terms of clinical presentation and outcome. For this purpose, we used clinical data and strains from patients diagnosed with cryptococcosis in France. Our results suggest that, according to the serotype, isolates have different routes of multiplication and high genomic differences, confirming the possible speciation of serotypes A and D. Furthermore, we observed a better prognosis for infections caused by AD hybrid than those caused by serotype A or D, at least for those diagnosed in France.
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25
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MacEwen CR, Ryan A, Winearls CG. Donor transmission of Cryptococcus neoformans presenting late after renal transplantation. Clin Kidney J 2015; 6:224-7. [PMID: 26019853 PMCID: PMC4432446 DOI: 10.1093/ckj/sft006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/09/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- Clare R MacEwen
- The Oxford Kidney Unit , Oxford University Hospitals NHS Trust , Oxford OX3 7LE , UK
| | - Aidan Ryan
- The Oxford Kidney Unit , Oxford University Hospitals NHS Trust , Oxford OX3 7LE , UK
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26
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Gits-Muselli M, Peraldi MN, de Castro N, Delcey V, Menotti J, Guigue N, Hamane S, Raffoux E, Bergeron A, Valade S, Molina JM, Bretagne S, Alanio A. New Short Tandem Repeat-Based Molecular Typing Method for Pneumocystis jirovecii Reveals Intrahospital Transmission between Patients from Different Wards. PLoS One 2015; 10:e0125763. [PMID: 25933203 PMCID: PMC4416908 DOI: 10.1371/journal.pone.0125763] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/26/2015] [Indexed: 12/26/2022] Open
Abstract
Pneumocystis pneumonia is a severe opportunistic infection in immunocompromised patients caused by the unusual fungus Pneumocystis jirovecii. Transmission is airborne, with both immunocompromised and immunocompetent individuals acting as a reservoir for the fungus. Numerous reports of outbreaks in renal transplant units demonstrate the need for valid genotyping methods to detect transmission of a given genotype. Here, we developed a short tandem repeat (STR)-based molecular typing method for P. jirovecii. We analyzed the P. jirovecii genome and selected six genomic STR markers located on different contigs of the genome. We then tested these markers in 106 P. jirovecii PCR-positive respiratory samples collected between October 2010 and November 2013 from 91 patients with various underlying medical conditions. Unique (one allele per marker) and multiple (more than one allele per marker) genotypes were observed in 34 (32%) and 72 (68%) samples, respectively. A genotype could be assigned to 55 samples (54 patients) and 61 different genotypes were identified in total with a discriminatory power of 0.992. Analysis of the allelic distribution of the six markers and minimum spanning tree analysis of the 61 genotypes identified a specific genotype (Gt21) in our hospital, which may have been transmitted between 10 patients including six renal transplant recipients. Our STR-based molecular typing method is a quick, cheap and reliable approach to genotype Pneumocystis jirovecii in hospital settings and is sensitive enough to detect minor genotypes, thus enabling the study of the transmission and pathophysiology of Pneumocystis pneumonia.
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Affiliation(s)
- Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Marie-Noelle Peraldi
- Service de transplantation rénale, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
| | - Nathalie de Castro
- Service de Maladie Infectieuses et tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Véronique Delcey
- Service de Médecine interne, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Hôpital Lariboisière, Paris, France
| | - Jean Menotti
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Emmanuel Raffoux
- Service d’Hématologie adulte, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Anne Bergeron
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Service de Pneumologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Sandrine Valade
- Service de Réanimation, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Jean-Michel Molina
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Service de Maladie Infectieuses et tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
- * E-mail:
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27
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Hagen F, Khayhan K, Theelen B, Kolecka A, Polacheck I, Sionov E, Falk R, Parnmen S, Lumbsch HT, Boekhout T. Recognition of seven species in the Cryptococcus gattii/Cryptococcus neoformans species complex. Fungal Genet Biol 2015; 78:16-48. [PMID: 25721988 DOI: 10.1016/j.fgb.2015.02.009] [Citation(s) in RCA: 472] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/12/2015] [Accepted: 02/15/2015] [Indexed: 02/08/2023]
Abstract
Phylogenetic analysis of 11 genetic loci and results from many genotyping studies revealed significant genetic diversity with the pathogenic Cryptococcus gattii/Cryptococcus neoformans species complex. Genealogical concordance, coalescence-based, and species tree approaches supported the presence of distinct and concordant lineages within the complex. Consequently, we propose to recognize the current C. neoformans var. grubii and C. neoformans var. neoformans as separate species, and five species within C. gattii. The type strain of C. neoformans CBS132 represents a serotype AD hybrid and is replaced. The newly delimited species differ in aspects of pathogenicity, prevalence for patient groups, as well as biochemical and physiological aspects, such as susceptibility to antifungals. MALDI-TOF mass spectrometry readily distinguishes the newly recognized species.
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Affiliation(s)
- Ferry Hagen
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Kantarawee Khayhan
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Department of Microbiology and Parasitology, Faculty of Medical Sciences, University of Phayao, Phayao, Thailand
| | - Bart Theelen
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands
| | - Anna Kolecka
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands
| | - Itzhack Polacheck
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Edward Sionov
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel; Department of Food Quality & Safety, Institute for Postharvest and Food Sciences, Agricultural Research Organization, The Volcani Center, Bet Dagan, Israel
| | - Rama Falk
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel; Department of Fisheries and Aquaculture, Ministry of Agriculture and Rural Development, Nir-David, Israel
| | - Sittiporn Parnmen
- Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Teun Boekhout
- CBS-KNAW Fungal Biodiversity Centre, Basidiomycete and Yeast Research, Utrecht, The Netherlands; Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
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Dou H, Xu Y, Li T. Application of the DiversiLab system for tracing the source of the mixed infections caused byCryptococcus neoformansvar.grubiifrom a patient with systemic lupus erythematosus. Mycoses 2015; 58:149-59. [PMID: 25591136 DOI: 10.1111/myc.12291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 11/25/2014] [Accepted: 12/15/2014] [Indexed: 01/15/2023]
Affiliation(s)
- Hongtao Dou
- Department of Clinical Laboratory; Peking Union Medical College Hospital; Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Yingchun Xu
- Department of Clinical Laboratory; Peking Union Medical College Hospital; Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Taisheng Li
- Department of Infectious Diseases; Peking Union Medical College Hospital; Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
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Illnait-Zaragozi MT, Martínez-Machín GF, Fernández-Andreu CM, Perurena-Lancha MR, Hagen F, Meis JF. Cryptococcus and Cryptococcosis in Cuba. A minireview. Mycoses 2014; 57:707-17. [DOI: 10.1111/myc.12275] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | | | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases; Canisius-Wilhelmina Hospital; Nijmegen The Netherlands
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases; Canisius-Wilhelmina Hospital; Nijmegen The Netherlands
- Department of Medical Microbiology; Radboud University Medical Center; Nijmegen The Netherlands
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Fang W, Fa Z, Liao W. Epidemiology of Cryptococcus and cryptococcosis in China. Fungal Genet Biol 2014; 78:7-15. [PMID: 25445309 DOI: 10.1016/j.fgb.2014.10.017] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/27/2014] [Accepted: 10/29/2014] [Indexed: 11/17/2022]
Abstract
Cryptococcosis is a significant invasive fungal infection with noteworthy morbidity and mortality, primarily caused by Cryptococcus neoformans and Cryptococcus gattii. In China, C. neoformans var. grubii (especially molecular type VNI) is the most common variety in the environment and responsible for the majority of cryptococcal infections. C. gattii infections are quite rare in China and the primary molecular type is VGI, which is closely related to C. gattii isolates in Australia. Interestingly, the majority of cryptococcosis in China were reported in the HIV-uninfected patients (especially immunocompetent hosts). This unique phenomenon may be attributed to multiple polymorphisms in the genes encoding mannose-binding lectin (MBL) and Fc-gamma receptor 2B (FCGR2B) in the Han population, the major ethnic group in China. Compared to immunocompromised patients, immunocompetent patients with cryptococcal meningitis often presented with more intense inflammatory responses and more severe neurological complications, but less fungal burdens and disseminated infection. The overall prognosis, which is independently associated with amphotericin B-based initial therapy, is similar between immunocompetent and immunocompromised patients. In addition, intrathecal administration of amphotericin B has been proved to be an effective adjunctive treatment for cryptococcosis in China.
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Affiliation(s)
- Wei Fang
- Department of Dermatology and Venereology, Changzheng Hospital, Shanghai, China
| | - Zhenzong Fa
- Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, China
| | - Wanqing Liao
- Department of Dermatology and Venereology, Changzheng Hospital, Shanghai, China; Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Shanghai, China.
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Insights on the genotype distribution among Cryptococcus neoformans and C. gattii Portuguese clinical isolates. Curr Microbiol 2014; 68:199-203. [PMID: 24077953 DOI: 10.1007/s00284-013-0452-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
This study provides a comprehensive picture of the C. neoformans/C. gattii molecular types most often associated with human cryptococcosis in Portugal and assesses the impact of C. gattii in these infections. One hundred and twenty-two clinical isolates, from distinct patients, were identified as C. neoformans and genotyped by URA5-RFLP, with the molecular types VNI (45.5 %) and VNIII (30.9 %) being the most commonly found ones. The molecular types VNII (11.4 %) and VNIV (11.4 %) were less abundant. One patient was found to be infected with a VGII isolate. This patient exhibited unusual clinical symptoms of cryptococcosis, reinforcing the suspicion for the presence of a different genotypic pattern, as determined afterwards. This case was detected in 2007 and is the first report of a potential autochthonous C. gattii infection case in Portugal, as the patient revealed no historical record of travelling outside the country.
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Park SH, Kim M, Joo SI, Hwang SM. Molecular Epidemiology of Clinical Cryptococcus neoformans Isolates in Seoul, Korea. MYCOBIOLOGY 2014; 42:73-78. [PMID: 24808738 PMCID: PMC4004952 DOI: 10.5941/myco.2014.42.1.73] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 02/16/2014] [Accepted: 02/23/2014] [Indexed: 06/03/2023]
Abstract
Cryptococcal infection is primarily caused by two species, Cryptococcus neoformans and C. gattii. Between the two species, C. neoformans var. grubii is the major causative agent of cryptococcosis in Asia. We investigated the molecular characteristics of 46 isolates of C. neoformans from patients with cryptococcosis between 2008 and 2012 in Seoul, Korea. All the isolates were determined to be C. neoformans var. grubii (serotype A), mating type MATα, and molecular type VNI by PCR-restriction fragment length polymorphism of the URA5 gene. Multilocus sequencing type (MLST) analysis using the International Society of Human and Animal Mycoses (ISHAM) consensus MLST scheme identified two sequence types (ST). Out of the 46 strains, 44 (95.7%) were identified as ST5, and remaining 2 were identified as ST31. Our study revealed that the clinical strains of C. neoformans in Korea are genetically homogeneous with the VNI/ST5 genotypes, and new appearance of VNI/ST31 genotype may serve as an important indicator of global genetic analysis.
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Affiliation(s)
- So Hae Park
- Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 609-757, Korea
| | - Mina Kim
- Department of Laboratory Medicine, Ulsan University School of Medicine, Seoul 138-736, Korea
| | - Sei Ick Joo
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul 110-744, Korea
| | - Soo Myung Hwang
- Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 609-757, Korea
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Khayhan K, Hagen F, Pan W, Simwami S, Fisher MC, Wahyuningsih R, Chakrabarti A, Chowdhary A, Ikeda R, Taj-Aldeen SJ, Khan Z, Ip M, Imran D, Sjam R, Sriburee P, Liao W, Chaicumpar K, Vuddhakul V, Meyer W, Trilles L, van Iersel LJJ, Meis JF, Klaassen CHW, Boekhout T. Geographically structured populations of Cryptococcus neoformans Variety grubii in Asia correlate with HIV status and show a clonal population structure. PLoS One 2013; 8:e72222. [PMID: 24019866 PMCID: PMC3760895 DOI: 10.1371/journal.pone.0072222] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 07/08/2013] [Indexed: 12/29/2022] Open
Abstract
Cryptococcosis is an important fungal disease in Asia with an estimated 140,000 new infections annually the majority of which occurs in patients suffering from HIV/AIDS. Cryptococcus neoformans variety grubii (serotype A) is the major causative agent of this disease. In the present study, multilocus sequence typing (MLST) using the ISHAM MLST consensus scheme for the C. neoformans/C. gattii species complex was used to analyse nucleotide polymorphisms among 476 isolates of this pathogen obtained from 8 Asian countries. Population genetic analysis showed that the Asian C. neoformans var. grubii population shows limited genetic diversity and demonstrates a largely clonal mode of reproduction when compared with the global MLST dataset. HIV-status, sequence types and geography were found to be confounded. However, a correlation between sequence types and isolates from HIV-negative patients was observed among the Asian isolates. Observations of high gene flow between the Middle Eastern and the Southeastern Asian populations suggest that immigrant workers in the Middle East were originally infected in Southeastern Asia.
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Affiliation(s)
- Kantarawee Khayhan
- Department of Microbiology and Parasitology, Faculty of Medical Sciences, University of Phayao, Phayao, Thailand
- CBS-KNAW Fungal Biodiversity Centre, Department of Yeast and Basidiomycete Research, Utrecht, The Netherlands
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ferry Hagen
- CBS-KNAW Fungal Biodiversity Centre, Department of Yeast and Basidiomycete Research, Utrecht, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Weihua Pan
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Institute of Dermatology and Medical Mycology, Changzheng Hospital, Secondary Military Medical University, Shanghai, People's Republic of China
| | - Sitali Simwami
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Matthew C. Fisher
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Retno Wahyuningsih
- Division of Mycology, Department of Parasitology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Parasitology, Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Reiko Ikeda
- Department of Microbiology, Meiji Pharmaceutical University, Tokyo, Japan
| | - Saad J. Taj-Aldeen
- Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Health Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Margaret Ip
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong
| | - Darma Imran
- Department of Neurology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Neurology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ridhawati Sjam
- Division of Mycology, Department of Parasitology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Pojana Sriburee
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanqing Liao
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Institute of Dermatology and Medical Mycology, Changzheng Hospital, Secondary Military Medical University, Shanghai, People's Republic of China
| | - Kunyaluk Chaicumpar
- Research and Diagnostic Center for Emerging Infectious Disease, and Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Varaporn Vuddhakul
- Department of Microbiology, Faculty of Science, Prince of Songkla University, Hat Yai , Thailand
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, Sydney Medical School–Westmead, The University of Sydney, Westmead Hospital, Sydney, Australia
| | - Luciana Trilles
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, Sydney Medical School–Westmead, The University of Sydney, Westmead Hospital, Sydney, Australia
- Laboratório de Micologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Corné H. W. Klaassen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Teun Boekhout
- CBS-KNAW Fungal Biodiversity Centre, Department of Yeast and Basidiomycete Research, Utrecht, The Netherlands
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Institute of Dermatology and Medical Mycology, Changzheng Hospital, Secondary Military Medical University, Shanghai, People's Republic of China
- * E-mail:
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Ferreira AS, Sampaio A, Maduro AP, Silva I, Teles F, Martins MDL, Inácio J. Genotypic diversity of environmentalCryptococcus neoformansisolates from Northern Portugal. Mycoses 2013; 57:98-104. [DOI: 10.1111/myc.12106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 05/27/2013] [Accepted: 06/11/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Ana Sofia Ferreira
- Laboratório Nacional de Investigação Veterinária; Instituto Nacional de Investigação Agrária e Veterinária; Lisbon Portugal
- Microbiology Unit; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
| | - Ana Sampaio
- Departamento de Biologia e Ambiente; Centro de Investigação e de Tecnologias Agroambientais e Biológicas (CITAB); Universidade de Trás-os-Montes e Alto Douro (UTAD); Vila Real Portugal
| | - Ana Paula Maduro
- Microbiology Unit; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
| | - Inês Silva
- Microbiology Unit; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
| | - Fernando Teles
- Microbiology Unit; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
- Centre for Malaria and Tropical Diseases; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
| | - Maria da Luz Martins
- Microbiology Unit; Instituto de Higiene e Medicina Tropical; Universidade Nova de Lisboa; Lisbon Portugal
- Faculdade de Ciências e Tecnologia; Departamento de Ciências da Vida; Centro de Recursos Microbiológicos; Universidade Nova de Lisboa; Lisbon Portugal
| | - João Inácio
- Laboratório Nacional de Investigação Veterinária; Instituto Nacional de Investigação Agrária e Veterinária; Lisbon Portugal
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Illnait-Zaragozí MT, Ortega-Gonzalez LM, Hagen F, Martínez-Machin GF, Meis JF. Fatal Cryptococcus gattii genotype AFLP5 infection in an immunocompetent Cuban patient. Med Mycol Case Rep 2013; 2:48-51. [PMID: 24432215 PMCID: PMC3885943 DOI: 10.1016/j.mmcr.2013.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 12/21/2022] Open
Abstract
We describe the first clinical case of cryptococcosis due C. gattii in a Cuban immunocompetent patient who had a traveling history two years before to Central America. Molecular characterization of the isolate showed it to be genotype AFLP5 of which MLST sequences clustered with clinical and environmental strains from Colombia. The patient died one year after the diagnosis despite a prolonged treatment with (liposomal) amphotericin B, fluconazole, voriconazole and gamma interferon.
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Affiliation(s)
| | | | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, PO Box 9015, Nijmegen 6500 GS, The Netherlands
| | | | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, PO Box 9015, Nijmegen 6500 GS, The Netherlands
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen 6500 HB, The Netherlands
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Schoffelen T, Illnait-Zaragozi MT, Joosten LAB, Netea MG, Boekhout T, Meis JF, Sprong T. Cryptococcus gattii induces a cytokine pattern that is distinct from other cryptococcal species. PLoS One 2013; 8:e55579. [PMID: 23383232 PMCID: PMC3561320 DOI: 10.1371/journal.pone.0055579] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/03/2013] [Indexed: 12/23/2022] Open
Abstract
Understanding more about the host's immune response to different Cryptococcus spp. will provide additional insight into the pathogenesis of cryptocococcis. We hypothesized that the ability of C. gattii to cause disease in immunocompetent humans depends on a distinct innate cytokine response of the host to this emerging pathogen. In the current study we assessed the cytokine profile of human peripheral blood mononuclear cells (PBMCs) of healthy individuals, after in vitro stimulation with 40 different well-defined heat-killed isolates of C. gattii, C. neoformans and several hybrid strains. In addition, we investigated the involvement of TLR2, TLR4 and TLR9 in the pro-inflammatory cytokine response to C. gattii. Isolates of C. gattii induced higher concentrations of the pro-inflammatory cytokines IL-1β, TNF-α and IL-6 and the Th17/22 cytokine IL-17 and IL-22 compared to C. neoformans var neoformans and C. neoformans var grubii. In addition, clinical C. gattii isolates induced higher amounts of cytokines than environmental isolates. This difference was not observed in C. neoformans var. grubii isolates. Furthermore, we demonstrated a likely contribution of TLR4 and TLR9, but no role for TLR2, in the host's cytokine response to C. gattii. In conclusion, clinical heat-killed C. gattii isolates induced a more pronounced inflammatory response compared to other Cryptococcus species and non-clinical C. gattii. This is dependent on TLR4 and TLR9 as cellular receptors.
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Affiliation(s)
- Teske Schoffelen
- Department of Medicine and Nijmegen Institute for Infection, Inflammation & Immunity (N4i), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Leo A. B. Joosten
- Department of Medicine and Nijmegen Institute for Infection, Inflammation & Immunity (N4i), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mihai G. Netea
- Department of Medicine and Nijmegen Institute for Infection, Inflammation & Immunity (N4i), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Teun Boekhout
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
- Shanghai Key Laboratory for Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Tom Sprong
- Department of Medicine and Nijmegen Institute for Infection, Inflammation & Immunity (N4i), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Department of Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- * E-mail:
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Cogliati M. Global Molecular Epidemiology of Cryptococcus neoformans and Cryptococcus gattii: An Atlas of the Molecular Types. SCIENTIFICA 2013; 2013:675213. [PMID: 24278784 PMCID: PMC3820360 DOI: 10.1155/2013/675213] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/11/2012] [Indexed: 05/08/2023]
Abstract
Cryptococcosis is a fungal disease affecting more than one million people per year worldwide. The main etiological agents of cryptococcosis are the two sibling species Cryptococcus neoformans and Cryptococcus gattii that present numerous differences in geographical distribution, ecological niches, epidemiology, pathobiology, clinical presentation and molecular characters. Genotyping of the two Cryptococcus species at subspecies level supplies relevant information to understand how this fungus has spread worldwide, the nature of its population structure, and how it evolved to be a deadly pathogen. At present, nine major molecular types have been recognized: VNI, VNII, VNB, VNIII, and VNIV among C. neoformans isolates, and VGI, VGII, VGIII, and VGIV among C. gattii isolates. In this paper all the information available in the literature concerning the isolation of the two Cryptococcus species has been collected and analyzed on the basis of their geographical origin, source of isolation, level of identification, species, and molecular type. A detailed analysis of the geographical distribution of the major molecular types in each continent has been described and represented on thematic maps. This study represents a useful tool to start new epidemiological surveys on the basis of the present knowledge.
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Affiliation(s)
- Massimo Cogliati
- Lab. Micologia Medica, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
- *Massimo Cogliati:
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Azole preexposure affects the Aspergillus fumigatus population in patients. Antimicrob Agents Chemother 2012; 56:4948-50. [PMID: 22710122 DOI: 10.1128/aac.05990-11] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The relationship between the azole preexposure of 86 patients and the genotype, azole susceptibility, and cyp51A polymorphisms of 110 corresponding Aspergillus fumigatus isolates was explored. Isolates carrying serial polymorphisms (F46Y and M172V with or without N248T with or without D255E with or without E427K) had higher itraconazole MICs (P = 0.04), although <2 μg/ml using the EUCAST methodology, were associated with two genetic clusters (P < 0.001) and with voriconazole preexposure of patients (P = 0.016). Voriconazole preexposure influences the distribution of A. fumigatus isolates with selection of isolates carrying cyp51A polymorphisms and higher itraconazole MICs.
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Extensive genetic diversity within the Dutch clinical Cryptococcus neoformans population. J Clin Microbiol 2012; 50:1918-26. [PMID: 22442325 DOI: 10.1128/jcm.06750-11] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A set of 300 Dutch Cryptococcus neoformans isolates, obtained from 237 patients during 1977 to 2007, was investigated by determining the mating type, serotype, and AFLP and microsatellite genotype and susceptibility to seven antifungal compounds. Almost half of the studied cases were from HIV-infected patients, followed by a patient group of individuals with other underlying diseases and immunocompetent individuals. The majority of the isolates were mating type α and serotype A, followed by αD isolates and other minor categories. The most frequently observed genotype was AFLP1, distantly followed by AFLP2 and AFLP3. Microsatellite typing revealed a high genetic diversity among serotype A isolates but a lower diversity within the serotype D set of isolates. One patient was infected by multiple AFLP genotypes. Fluconazole and flucytosine had the highest geometric mean MICs of 2.9 and 3.5 μg/ml, respectively, while amphotericin B (0.24 μg/ml), itraconazole (0.08 μg/ml), voriconazole (0.07 μg/ml), posaconazole (0.06 μg/ml), and isavuconazole (0.03 μg/ml) had much lower geometric mean MICs. One isolate had a high flucytosine MIC (>64 μg/ml), while decreased susceptibility (≥16 μg/ml) for flucytosine and fluconazole was found in 9 and 10 C. neoformans isolates, respectively.
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40
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Resistance of Asian Cryptococcus neoformans serotype A is confined to few microsatellite genotypes. PLoS One 2012; 7:e32868. [PMID: 22427900 PMCID: PMC3302784 DOI: 10.1371/journal.pone.0032868] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 02/01/2012] [Indexed: 01/03/2023] Open
Abstract
Background Cryptococcus neoformans is a pathogenic yeast that causes cryptococcosis, a life threatening disease. The prevalence of cryptococcosis in Asia has been rising after the onset of the AIDS epidemic and estimates indicate more than 120 cases per 1,000 HIV-infected individuals per year. Almost all cryptococcal disease cases in both immunocompromised and immunocompetent patients in Asia are caused by C. neoformans var. grubii. Epidemiological studies on C. neoformans in pan-Asia have not been reported. The present work studies the genetic diversity of the fungus by microsatellite typing and susceptibility analysis of approximately 500 isolates from seven Asian countries. Methodology/Principal Findings Genetic diversity of Asian isolates of C. neoformans was determined using microsatellite analysis with nine microsatellite markers. The analysis revealed eight microsatellite complexes (MCs) which showed different distributions among geographically defined populations. A correlation between MCs and HIV-status was observed. Microsatellite complex 2 was mainly associated with isolates from HIV-negative patients, whereas MC8 was associated with those from HIV-positive patients. Most isolates were susceptible to amphotericin B, itraconazole, voriconazole, posaconazole, and isavuconazole, but 17 (3.4%) and 10 (2%) were found to be resistant to 5-flucytosine and fluconazole, respectively. Importantly, five Indonesian isolates (approximately 12.5% from all Indonesian isolates investigated and 1% from the total studied isolates) were resistant to both antifungals. The majority of 5-flucytosine resistant isolates belonged to MC17. Conclusions The findings showed a different distribution of genotypes of C. neoformans var. grubii isolates from various countries in Asia, as well as a correlation of the microsatellite genotypes with the original source of the strains and resistance to 5-flucytosine.
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Illnait-Zaragozí MT, Martínez-Machín GF, Fernández-Andreu CM, Perurena-Lancha MR, Theelen B, Boekhout T, Meis JF, Klaassen CH. Environmental isolation and characterisation of Cryptococcus species from living trees in Havana city, Cuba. Mycoses 2012; 55:e138-44. [DOI: 10.1111/j.1439-0507.2012.02168.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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42
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Litvintseva AP, Mitchell TG. Population genetic analyses reveal the African origin and strain variation of Cryptococcus neoformans var. grubii. PLoS Pathog 2012; 8:e1002495. [PMID: 22383873 PMCID: PMC3285590 DOI: 10.1371/journal.ppat.1002495] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Anastasia P Litvintseva
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, USA.
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Chowdhary A, Rhandhawa HS, Prakash A, Meis JF. Environmental prevalence of Cryptococcus neoformans and Cryptococcus gattii in India: an update. Crit Rev Microbiol 2011; 38:1-16. [PMID: 22133016 DOI: 10.3109/1040841x.2011.606426] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An overview of work done to-date in India on environmental prevalence, population structure, seasonal variations and antifungal susceptibility of Cryptococcus neoformans and Cryptococcus gattii is presented. The primary ecologic niche of both pathogens is decayed wood in trunk hollows of a wide spectrum of host trees, representing 18 species. Overall, C. neoformans showed a higher environmental prevalence than that of C. gattii which was not found in the avian habitats. Apart from their arboreal habitat, both species were demonstrated in soil and air in close vicinity of their tree hosts. In addition, C. neoformans showed a strong association with desiccated avian excreta. An overwhelming number of C. neoformans strains belonged to genotype AFLP1/VNI, var. grubii (serotype A), whereas C. gattii strains were genotype AFLP4/VGI, serotype B. All of the environmental strains of C. neoformans and C. gattii were mating type α (MATα). Contrary to the Australian experience, Eucalyptus trees were among the epidemiologically least important and, therefore, the hypothesis of global spread of C. gattii through Australian export of infected Eucalyptus seeds is rebutted. Reference is made to long-term colonization of an abandoned, old timber beam of sal wood (Shorea robusta) by a melanin positive (Mel(+)) variant of Cryptococcus laurentii that was pathogenic to laboratory mice.
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Affiliation(s)
- Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, India
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Simwami SP, Khayhan K, Henk DA, Aanensen DM, Boekhout T, Hagen F, Brouwer AE, Harrison TS, Donnelly CA, Fisher MC. Low diversity Cryptococcus neoformans variety grubii multilocus sequence types from Thailand are consistent with an ancestral African origin. PLoS Pathog 2011; 7:e1001343. [PMID: 21573144 PMCID: PMC3089418 DOI: 10.1371/journal.ppat.1001343] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 04/15/2011] [Indexed: 12/19/2022] Open
Abstract
The global burden of HIV-associated cryptococcal meningitis is estimated at nearly one million cases per year, causing up to a third of all AIDS-related deaths. Molecular epidemiology constitutes the main methodology for understanding the factors underpinning the emergence of this understudied, yet increasingly important, group of pathogenic fungi. Cryptococcus species are notable in the degree that virulence differs amongst lineages, and highly-virulent emerging lineages are changing patterns of human disease both temporally and spatially. Cryptococcus neoformans variety grubii (Cng, serotype A) constitutes the most ubiquitous cause of cryptococcal meningitis worldwide, however patterns of molecular diversity are understudied across some regions experiencing significant burdens of disease. We compared 183 clinical and environmental isolates of Cng from one such region, Thailand, Southeast Asia, against a global MLST database of 77 Cng isolates. Population genetic analyses showed that Thailand isolates from 11 provinces were highly homogenous, consisting of the same genetic background (globally known as VNI) and exhibiting only ten nearly identical sequence types (STs), with three (STs 44, 45 and 46) dominating our sample. This population contains significantly less diversity when compared against the global population of Cng, specifically Africa. Genetic diversity in Cng was significantly subdivided at the continental level with nearly half (47%) of the global STs unique to a genetically diverse and recombining population in Botswana. These patterns of diversity, when combined with evidence from haplotypic networks and coalescent analyses of global populations, are highly suggestive of an expansion of the Cng VNI clade out of Africa, leading to a limited number of genotypes founding the Asian populations. Divergence time testing estimates the time to the most common ancestor between the African and Asian populations to be 6,920 years ago (95% HPD 122.96 - 27,177.76). Further high-density sampling of global Cng STs is now necessary to resolve the temporal sequence underlying the global emergence of this human pathogen.
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Affiliation(s)
- Sitali P. Simwami
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Kantarawee Khayhan
- CBS Fungal Biodiversity Centre, Utrecht, The Netherlands
- Department of Microbiology and Parasitology, School of Medical Science, Naresuan University Phayao, Phayao, Thailand
| | - Daniel A. Henk
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David M. Aanensen
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Teun Boekhout
- CBS Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Ferry Hagen
- CBS Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Annemarie E. Brouwer
- Department of General Internal Medicine and Nijmegen University Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
- St. Elisabeth Hospital, Tilburg, The Netherlands
| | - Thomas S. Harrison
- Department of Infectious Diseases, St George's Hospital Medical School, London, United Kingdom
| | - Christl A. Donnelly
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Matthew C. Fisher
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
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Most cases of cryptococcal meningitis in HIV-uninfected patients in Vietnam are due to a distinct amplified fragment length polymorphism-defined cluster of Cryptococcus neoformans var. grubii VN1. J Clin Microbiol 2010; 49:658-64. [PMID: 21159929 DOI: 10.1128/jcm.01985-10] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Cryptococcal disease most commonly occurs in patients with an underlying immune deficit, most commonly HIV infection, and is due to Cryptococcus neoformans var. grubii. Occasionally disease due to this variety occurs in apparently immunocompetent patients. The relationship between strains infecting immunosuppressed and immunocompetent patients is not clear. Amplified fragment length polymorphism (AFLP) analysis was used to characterize the relationship between strains infecting HIV-infected and uninfected patients. Isolates from 51 HIV-uninfected patients and 100 HIV-infected patients with cryptococcal meningitis were compared. C. neoformans var. grubii VNI was responsible for infections in 73% of HIV-uninfected and 100% of HIV-infected patients. AFLP analysis defined two distinct clusters, VNIγ and VNIδ. The majority (84%) of isolates from HIV-uninfected patients were VNIγ, compared with only 38% of isolates from HIV-infected patients (odds ratio, 8.30; 95% confidence interval [CI], 3.04 to 26.6; P < 0.0001). In HIV-uninfected patients, underlying disease was less frequent in those with VNIγ infections. Two clusters of C. neoformans var. grubii VN1 are responsible for the majority of cases of cryptococcal meningitis in Vietnam. The distribution of these clusters differs according to the immune status of the host.
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Illnait-Zaragozí MT, Martínez-Machín GF, Fernández-Andreu CM, Hagen F, Boekhout T, Klaassen CHW, Meis JF. Microsatellite typing and susceptibilities of serial Cryptococcus neoformans isolates from Cuban patients with recurrent cryptococcal meningitis. BMC Infect Dis 2010; 10:289. [PMID: 20920321 PMCID: PMC2959061 DOI: 10.1186/1471-2334-10-289] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Accepted: 10/04/2010] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cryptococcus neoformans is commonly associated with meningoencephalitis in immunocompromised patients and occasionally in apparently healthy individuals. Recurrence of infection after initial treatment is not uncommon. We studied C. neoformans isolates from 7 Cuban patients with recurrent cryptococcal meningitis. Antifungal susceptibility and genotyping with microsatellite molecular typing were carried out. METHODS Isolates (n = 19) were recovered from cerebrospinal fluid, blood, urine and semen. Antifungal susceptibilities for amphotericin B, fluconazole, flucytosine, itraconazole, voriconazole, posaconazole and isavuconazole were tested by CLSI M27A3 broth microdilution method. Genotyping was done using a panel of 9 microsatellite (STR) markers: (CT)n, (TG)n, (TA)n, (CTA)n, (TCT)n, (CCA)n, (TTAT)n, (ATCC)n and (TATT)n. RESULTS The average number of isolates/patient was 2.71. The mean time interval between the collection of any two isolates was 52.5 days. All strains were identified as C. neoformans var. grubii (serotype Aα). Although none of the strains were resistant to the studied drugs, in serial isolates from two patients, MICs values of triazoles increased 4-5 log2 dilutions over time. STR patterns showed 14 distinctive profiles. In three patients the recurrent infection was associated with genotypically identical isolates. The four other patients had relapse isolates which were genotypically different from the initial infecting strain. CONCLUSION Recurrences of cryptococcal meningitis in our series of patients was not associated with development of drug resistance of the original strain but by an initial infection with different strains or a reinfection with a new strain.
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Hagen F, Boekhout T. The Search for the Natural Habitat of Cryptococcus gattii. Mycopathologia 2010; 170:209-11. [DOI: 10.1007/s11046-010-9313-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 04/02/2010] [Indexed: 11/25/2022]
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