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Eisenman HC. A Galleria Model of Cryptococcus neoformans Infection. Methods Mol Biol 2024; 2775:3-11. [PMID: 38758307 DOI: 10.1007/978-1-0716-3722-7_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Galleria mellonella larvae are a popular and simple model organism for infectious disease research. Last instar larvae can be purchased inexpensively from commercial suppliers and infected with Cryptococcus. Injection into the proleg of larvae results in systemic infections. Larvae may then be monitored for survival or homogenized to determine fungal burden. Fixation of infected larvae produces samples suitable for histological staining and analysis.
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Affiliation(s)
- Helene C Eisenman
- Department of Natural Sciences, Baruch College, The City University of New York, New York, NY, USA.
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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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Florek M, Nawrot U, Korzeniowska-Kowal A, Włodarczyk K, Wzorek A, Woźniak-Biel A, Brzozowska M, Galli J, Bogucka A, Król J. An analysis of the population of Cryptococcus neoformans strains isolated from animals in Poland, in the years 2015-2019. Sci Rep 2021; 11:6639. [PMID: 33758319 PMCID: PMC7987961 DOI: 10.1038/s41598-021-86169-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/11/2021] [Indexed: 02/07/2023] Open
Abstract
Fungi belonging to the Cryptococcus neoformans/C. gattii species complex (CNGSC) are pathogens causing severe infections in humans and animals, that for humans may result in a mortality rate ranging up to 70%. The CNGSC is divided into eight major molecular types, that may differ in their virulence and susceptibility. In order to fully understand the epidemiology of cryptococcosis, it is important to study the world distribution and population structure of these pathogens. The present study is the first presenting a population of strains isolated in Poland and one of the few using a multi-species animal group as a source of the specimen. The pathogen was present in 2.375% of the tested animals. The URA5-RFLP and MALDI-TOF MS analyses have revealed that the population consisted exclusively of C. neoformans strains, with a predominance of major molecular type VNIV (C. neoformans var. neoformans). The MALDI-TOF MS was used to perform the CNGSC strains identification on both the species and sub-species level. Despite the fact that the animals providing the specimens were not treated with 5-fluorocytosine, around 10% of the tested population presented MIC values exceeding 64 mg/L, indicating the existence of the 5-fluorocytosine-resistant strains in the environment.
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Affiliation(s)
- Magdalena Florek
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland.
| | - Urszula Nawrot
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211a, 50-556, Wrocław, Poland
| | - Agnieszka Korzeniowska-Kowal
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Katarzyna Włodarczyk
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211a, 50-556, Wrocław, Poland
| | - Anna Wzorek
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Anna Woźniak-Biel
- Department of Epizootiology and Clinic of Birds and Exotic Animals, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, pl. Grunwaldzki 45, 50-366, Wrocław, Poland
| | - Magdalena Brzozowska
- Referral Animal Hospital Strömsholm, Djursjukhusvägen 11, 73494, Strömsholm, Sweden
| | - Józef Galli
- Veterinary Laboratory Vetlab, Wodzisławska 6, 52-017, Wrocław, Poland
| | - Anna Bogucka
- Veterinary Laboratory Vetlab, Wodzisławska 6, 52-017, Wrocław, Poland
| | - Jarosław Król
- Department of Pathology, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland
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Predominance of Cryptococcus neoformans Var. grubii in Ahvaz, Molecular Identification and Evaluation of Virulence Factors. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.112408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Cryptococcus neoformans is an encapsulated yeast pathogen with worldwide distribution, and the highest incidence of cryptococcosis was attributed to C. neoformans (var. grubii. The pathogenicity of Cryptococcus species is associated with several factors, including capsule and melanin production, growth at 37 ºC, and secretion of extracellular enzymes. Objectives: The present study aimed to isolate and identify Cryptococcus species from pigeon guano in Ahvaz, Iran and investigate important virulence factors in the isolates. Methods: Seventy-three isolates of C. neoformans var. grubii were identified based on classical and molecular microbiology methods. Capsule size was measured by the grow yeasts in the presence of 5% CO2. Specific media demonstrated the activity of extracellular enzymes (phospholipase, hemolysin, proteinase, esterase, urease, catalase, and gelatinase). Besides, melanin production was evaluated by the niger seed agar medium. Results: Two hundred and seventeen samples were examined for the presence of Cryptococcus over 165 days in Ahvaz. All tested isolates were contained capsules with variable sizes under 5% CO2 concentration. Moreover, 100% of isolates were produced extracellular enzymes (urease, hemolysin, and catalase), whereas no proteinase and gelatinase activities were observed among isolates. Furthermore, most isolates had phospholipase (93.1%) and esterase activities (86.3%). Also, melanin was produced by all of the isolates. Conclusions: Although two methods were used for recovery of Cryptococcus, only Cryptococcus was isolated from pigeon guano, and swabs from the cage walls were negative. Cryptococcus neoformans var. grubii was the only species from pigeon droppings from Ahvaz with more pathogenic factors. Owing to the high pathogenicity of the isolates, the frequency of the disease is expected to be higher.
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Taverna CG, Bosco-Borgeat ME, Mazza M, Vivot ME, Davel G, Canteros CE. Frequency and geographical distribution of genotypes and mating types of Cryptococcus neoformans and Cryptococcus gattii species complexes in Argentina. Rev Argent Microbiol 2020; 52:183-188. [PMID: 31948732 DOI: 10.1016/j.ram.2019.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/15/2019] [Accepted: 07/16/2019] [Indexed: 12/27/2022] Open
Abstract
The aim of this work was to know the frequency and geographical distribution of genotypes and mating types of Cryptococcus neoformans and Cryptococcus gattii species complexes isolated from human infections in Argentina during the period from April 2009 to April 2011. A multicenter study was conducted, in which 372 isolates were obtained from 61 laboratories throughout the country. Of those, 98.8% of the isolates belonged to the C. neoformans species complex and 1.1% to the C. gattii species complex. Genotype VNI (MATα) was the most frequently isolated (n=326, 87.6%), followed by VNII (MATα) (n=22, 5.9%), the recently described VNII-VNIV (aADα) hybrid (n=14, 3.8%), VNIV (MATα) (n=4, 1.1%), VNIII (αADa) hybrid (n=1, 0.3%), and VNIII (αADα) hybrid (n=1, 0.3%). The Argentine Central region showed the greatest number of cases and genotype diversity. Interestingly, a relative high frequency was observed in genotype VNII (MATα) in the Cuyo, Northeast and Northwest regions and, also in VNII-VNIV (aADα) hybrids in the Northwest region. C. gattii species complex was isolated at a low rate; 3 VGI (MATα) and 1 VGII (MATα) isolates were obtained from the Northwest and Central regions. In conclusion, this study shows that genotype frequencies seem to vary among regions in Argentina and reveals a relatively high frequency of rare hybrids in the Northwest region. Further regional clinical and environmental studies may help to elucidate if those variations in frequencies are associated with the existence of regional ecological niches or any other regional factors.
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Affiliation(s)
- Constanza Giselle Taverna
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Eugenia Bosco-Borgeat
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Mazza
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
| | - Matías Ezequiel Vivot
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela Davel
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
| | - Cristina Elena Canteros
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
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- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán," ANLIS (Administración Nacional de Laboratorios e Institutos de Salud) Ciudad Autónoma de Buenos Aires, Argentina
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Rakotoarivelo RA, Raberahona M, Rasamoelina T, Rabezanahary A, Rakotomalala FA, Razafinambinintsoa T, Bénet T, Vanhems P, Randria MJDD, Romanò L, Cogliati M, Cornet M, Rakoto Andrianarivelo M. Epidemiological characteristics of cryptococcal meningoencephalitis associated with Cryptococcus neoformans var. grubii from HIV-infected patients in Madagascar: A cross-sectional study. PLoS Negl Trop Dis 2020; 14:e0007984. [PMID: 31929533 PMCID: PMC6980680 DOI: 10.1371/journal.pntd.0007984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/24/2020] [Accepted: 12/10/2019] [Indexed: 12/21/2022] Open
Abstract
Cryptococcal meningoencephalitis (CM) remains the most prevalent invasive fungal infection worldwide. The main objective of this study was to describe the prevalence of CM and cryptococcal infection in HIV-infected patients in Madagascar. The secondary objectives were to assess the adjusted prevalence of CM according to clinical presentation and patient characteristics, to determine crude 90-day survival according to cryptococcal antigen (CrAg) status and CM, and to identify the genotypes of Cryptococcus clinical isolates. This cross-sectional study was carried out at two urban hospitals in Antananarivo (central highlands) and Toamasina (east coast) between November 2014 and December 2016. Consecutive HIV-infected adults presenting with CD4 cell counts ≤200/μl were enrolled. Lateral flow immunoassays of CrAg were performed on serum for all patients, and on cerebrospinal fluid for patients with CM symptoms. MALDI-ToF MS, ITS sequencing, and determinations of the molecular and mating types of the isolates were performed. Fluconazole is the only drug for CM treatment available in Madagascar. Patients were treated orally, with high doses (1200 mg/day) for 10–12 weeks and then with 200 mg/day. Minimum inhibitory concentrations were determined for amphotericin B, flucytosine, voriconazole and fluconazole in E-tests. Overall prevalence was 13.2% (95% CI 7.9–20.3) for cryptococcal infection and 10.9% (95% CI 6.1–17.5) for CM, among the 129 HIV-infected patients studied. The 90-day mortality rate was 58.8% (10/17) in CrAg-positive patients and 17.9% (20/112) in CrAg-negative patients (p<0.001). The 13 Cryptococcus strains obtained at baseline were all Cryptococcus neoformans var. grubii, genotypes VNI-αA (3 isolates), VNII-αA (4 isolates) or hybrid VNI/VNII-αAAα (6 isolates), suggesting high diversity. Two strains acquired fluconazole resistance after four and five months of exposure, respectively. The prevalence of cryptococcosis is high in Madagascar and this serious condition is life-threatening in HIV-infected patients. These findings will be used to raise the awareness of national authorities to strengthen the national HIV/AIDS control program. Cryptococcal meningoencephalitis (CM) remains the most prevalent invasive fungal infection worldwide, with an estimated mortality of 70% in sub-Saharan Africa. In this cross-sectional study, we investigated the prevalence, clinical features, case-management and outcome of CM in HIV-infected patients. We also molecularly characterized the Cryptococcus isolates from these patients. The study was conducted in the main hospitals of two geographically distant cities, one located at Antananarivo in the central highlands and the other at Toamasina on the east coast. The prevalence of cryptococcal infection was higher than previously reported global prevalence values, and most of the patients developed CM. Classical signs of meningoencephalitis, including headache, fever and neck pain, were observed, as reported in previous studies. Ninety-day mortality (58.8%) was higher in patients with Cryptococcus infections than in non-infected patients (17.9%). All patients diagnosed with infection were treated with high-dose fluconazole, the only treatment available in Madagascar, in accordance with WHO recommendations. Molecular analyses of isolates from both regions revealed high levels of genome diversity and suggested that further environmental and larger clinical studies would be worthwhile. In conclusion, the prevalence of cryptococcal diseases is high in Madagascar, which is currently faced with the challenges of prioritizing various diseases of public health concern, providing health centers with rapid diagnostic tools and facilitating access to more reliable molecules.
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Affiliation(s)
- Rivonirina Andry Rakotoarivelo
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Tambohobe, Faculté de Médecine, Université de Fianarantsoa, Fianarantsoa, Madagascar
| | - Mihaja Raberahona
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
- * E-mail:
| | | | | | | | - Tiana Razafinambinintsoa
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
| | - Thomas Bénet
- Service d’Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Philippe Vanhems
- Service d’Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, Lyon, France
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Mamy Jean de Dieu Randria
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
| | - Luisa Romanò
- Laboratorio di Micologia Medica, Dipartimento di Scienze Biomediche per la Salute, Universita degli Studi di Milano, Milano, Italy
| | - Massimo Cogliati
- Laboratorio di Micologia Medica, Dipartimento di Scienze Biomediche per la Salute, Universita degli Studi di Milano, Milano, Italy
| | - Muriel Cornet
- Université Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble I NP, TIMC-IMAG, Grenoble, France
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Samarasinghe H, Vogan A, Pum N, Xu J. Patterns of allele distribution in a hybrid population of the Cryptococcus neoformans species complex. Mycoses 2019; 63:275-283. [PMID: 31774582 DOI: 10.1111/myc.13040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The sister yeast species Cryptococcus neoformans (serotype A) and Cryptococcus deneoformans (serotype D) are causative agents of deadly cryptococcosis and fungal meningoencephalitis. These haploid yeasts can hybridise in nature, giving rise to AD hybrids that are predominantly diploid or aneuploid. Despite their increasing prevalence in clinical settings, much remains unknown about the allelic distribution patterns in AD hybrid strains. OBJECTIVES This study aims to characterise allele distributions in AD hybrids derived from the same basidium as well as from multiple basidia in a laboratory-derived C neoformans × C deneoformans hybrid cross. METHODS We dissected a total of 1625 basidiospores from 31 basidia. The 297 basidiospores that successfully germinated were genotyped by molecular characterisation of 33 markers using PCR-RFLP, with at least two markers on each of the 14 chromosomes in the genome. RESULTS Of the 297 strains, 294 contained at least one heterozygous locus, with a mean heterozygosity of ~30% per strain. Most hybrid genomes and chromosomes displayed significantly distorted allele distributions, with offspring originating from the same basidium tended to have alleles at different loci from the same parent. More basidia were skewed in favour of C deneoformans alleles, the mitochondria-donor parent, than the C neoformans alleles. CONCLUSIONS The divergence between C neoformans and C deneoformans genomes has likely created co-adapted allelic combinations, with their co-segregation in hybrid offspring imparting a significant fitness benefit. However, the diversity of genotypes recovered here in a single hybridisation event indicates the enormous capacity of AD hybrids for adaptation and diversification.
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Affiliation(s)
| | - Aaron Vogan
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Nicole Pum
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON, Canada
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Anacona C, González C FE, Vásquez-A LR, Escandón P. First isolation and molecular characterization of Cryptococcus neoformans var. grubii in excreta of birds in the urban perimeter of the Municipality of Popayán, Colombia. Rev Iberoam Micol 2018; 35:123-129. [PMID: 30274952 DOI: 10.1016/j.riam.2018.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Cryptococcosis is a systemic opportunistic mycosis, caused by Cryptococcus neoformans and Cryptococcus gattii, which affects mainly the central nervous system of immunocompromised patients; no reports have been made on the isolation of the fungus from the environment of Popayán, Colombia. AIMS The main objective of this investigation was to determinate the incidence of C. neoformans in the urban perimeter in the City of Popayán, Colombia. METHODS A total of 303 samples from droppings of Columba livia and Bubulcus ibis were collected between September 2012 and June 2013. The samples were processed by conventional techniques; identification of colonies was performed by biochemical tests, and molecular patterns were determined by PCR fingerprinting with the primer (GTG)5 and restriction fragment length polymorphism (RFLP) of the gene URA5. RESULTS A total of 118 (38.94%) samples were positive for Cryptococcus in excreta of C. livia, and 361 strains belonging to Cryptococcus neoformans var. grubii were isolated. From the latter, 99.2% corresponded to the molecular pattern VNI and 0.8% to VNII, with an increased occurrence (24.4%) at a temperature of 22.5°C and a humidity of 60.8%. The excreta of B. ibis did not show the presence of the fungus. CONCLUSIONS C. livia excreta is a key environmental niche for C. neoformans var. grubii, type VNI, supporting growth and reproduction, and serving as a major source of infection for susceptible populations in Popayán. This represents the first report on the isolation of the agent of cryptococcosis from the environment in this region, with a significant prevalence in bird excreta.
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Affiliation(s)
- Cristian Anacona
- Centro de Estudios en Microbiología y Parasitología CEMPA, Universidad del Cauca, Popayán, Colombia
| | - Fabiola E González C
- Centro de Estudios en Microbiología y Parasitología CEMPA, Universidad del Cauca, Popayán, Colombia
| | - Luis Reinel Vásquez-A
- Centro de Estudios en Microbiología y Parasitología CEMPA, Universidad del Cauca, Popayán, Colombia
| | - Patricia Escandón
- Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, Colombia.
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Firacative C, Lizarazo J, Illnait-Zaragozí MT, Castañeda E. The status of cryptococcosis in Latin America. Mem Inst Oswaldo Cruz 2018; 113:e170554. [PMID: 29641639 PMCID: PMC5888000 DOI: 10.1590/0074-02760170554] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/06/2018] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis is a life-threatening fungal infection caused by the encapsulated
yeasts Cryptococcus neoformans and C. gattii,
acquired from the environment. In Latin America, as occurring
worldwide, C. neoformans causes more than 90% of the cases of
cryptococcosis, affecting predominantly patients with HIV, while C.
gattii generally affects otherwise healthy individuals. In this
region, cryptococcal meningitis is the most common presentation, with
amphotericin B and fluconazole being the antifungal drugs of choice. Avian
droppings are the predominant environmental reservoir of C.
neoformans, while C. gattii is associated with
several arboreal species. Importantly, C. gattii has a high
prevalence in Latin America and has been proposed to be the likely origin of
some C. gattii populations in North America. Thus, in the
recent years, significant progress has been made with the study of the basic
biology and laboratory identification of cryptococcal strains, in understanding
their ecology, population genetics, host-pathogen interactions, and the clinical
epidemiology of this important mycosis in Latin America.
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Affiliation(s)
- Carolina Firacative
- Westmead Hospital, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jairo Lizarazo
- Internal Medicine Department, Hospital Universitario Erasmo Meoz, Universidad de Pamplona, Cúcuta, Colombia
| | - María Teresa Illnait-Zaragozí
- Diagnosis and Reference Centre, Bacteriology-Mycology Department Research, Tropical Medicine Institute Pedro Kourí, Havana, Cuba
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Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance. J Fungi (Basel) 2018; 4:jof4010032. [PMID: 29494502 PMCID: PMC5872335 DOI: 10.3390/jof4010032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/16/2018] [Accepted: 02/27/2018] [Indexed: 12/26/2022] Open
Abstract
The passive and voluntary surveillance of cryptococcosis in Colombia since 1997 has seen an increasing participating rate, revealing its importance to both in immunosuppressed and immunocompetent people. The present work details the national data gathered in 1997-2016, through a retrospective analysis of the information collected in the survey. From a total of 1974 cases reported, an overall incidence of 0.23 cases per 100,000 people was found. This incidence rose to 1.1 cases per 1000 people in the Acquired Immunodeficiency Syndrome (AIDS) population. Cryptococcosis was most common in male young adults (26-40 years), with a male:female ratio of 3.9:1 in the general population and 5.4:1 in Human Immunodeficiency Virus (HIV) patients. Culture was the most common form of diagnosis in 96.3% of cases, recovering C. neoformans species in 87.5% and C. gattii in 3.1% of samples. VNI was the most prevalent (96.1%) molecular type, while VGII predominated in C. gattii isolates (54.3%). Early mortality was reported as the outcome in 47.5% of patients. Cryptococcosis remains an important opportunistic disease in Colombia and is gaining status as a primary pathogen in apparently immunocompetent patients. Our findings show the importance of including cryptococcosis as a notifiable disease, which will allow for improving opportune diagnosis and treatment, resulting in better patient outcomes.
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Mazza M, Davel GO, Taverna CG, Refojo N, Canteros CE, Bueno NS, Isla G, Abrantes RA, Hevia AI, Toranzo AI. Contribution of the National Mycology Laboratory Network to Surveillance of Cryptococcosis in Argentina. CURRENT FUNGAL INFECTION REPORTS 2017. [DOI: 10.1007/s12281-017-0301-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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