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Machiavello Roman FJ, Pischel L, Azar MM. Lung infections due to emerging fungal pathogens. Curr Opin Pulm Med 2024; 30:258-265. [PMID: 38411158 DOI: 10.1097/mcp.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW This review highlights the epidemiology, pathogenesis and clinical management of pulmonary infections caused by emerging fungal organisms. RECENT FINDINGS Emerging fungal infections have arisen as a result of population and environmental changes. An enlarging pool of immunocompromised hosts on triazole antifungal prophylaxis has led to an increased incidence of non- Aspergillus molds, such as Fusarium , Scedosporium and Lomentospora spp. Advances in diagnostic capabilities led to the identification of the Emergomyces genus and non- dermatitidis Blastomyces species, which have a significant disease burden in Africa and the Middle East. Climate change has contributed to changing the distribution of previously confined endemic mycoses, like coccidioidomycosis and talaromycosis. These emerging organisms pose important diagnostic and therapeutic challenges. SUMMARY Newly recognized pathogenic fungi and established endemic mycoses with expanding geographic boundaries have become important agents of pulmonary disease. There is a dearth of clinical evidence on the appropriate management of these infections.
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Affiliation(s)
| | | | - Marwan M Azar
- Department of Medicine, Section of Infectious Diseases and Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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2
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Jean SS, Liu CY, Huang YT, Ko WC, Ho MW, Liu IM, Hsieh PC, Hsueh PR. Minimum inhibitory concentrations of antifungals against invasive isolates of Cryptococcus species worldwide: Global antifungal antimicrobial testing leadership and surveillance program, 2010-2020. Int J Antimicrob Agents 2024; 63:107090. [PMID: 38242250 DOI: 10.1016/j.ijantimicag.2024.107090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/15/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
This study examined the geographic distribution of minimum inhibitory concentrations (MICs) of antifungals against Cryptococcus isolates. Data were collected on the MICs of specific antifungals (amphotericin B, 5-flucytosine, fluconazole, voriconazole, posaconazole, and isavuconazole) against various Cryptococcus species for the period 2010 to 2020 from the Antimicrobial Testing Leadership and Surveillance database. Cryptococcus isolates were collected from samples of blood and cerebrospinal fluid (CSF) from patients hospitalized in different regions worldwide. We applied the epidemiological cutoff values (ECVs) of antifungals against various Cryptococcus species to distinguish wild-type (WT) from non-WT Cryptococcus isolates. A total of 395 isolates of Cryptococcus species cultured from blood (n = 201) or CSF (n = 194) were analyzed. C. grubii (n = 270), C. neoformans (n = 111), and C. gattii (n = 11) were the three predominant species causing bloodstream infections (BSI) or meningitis/meningoencephalitis (MME). The proportion of MICs above the ECV (1 mg/L) for amphotericin B among C. neoformans isolates was significantly lower than that among C. gattii isolates (MICs >0.5 mg/L; P < 0.001), as evaluated using the chi-square test. For most isolates of the three predominant Cryptococcus species, the MICs of new triazoles were ≤0.25 mg/L. The MICs of fluconazole and amphotericin B in the BSI/MME-causing Cryptococcus isolates collected from patients hospitalized in the Asia-Western Pacific region and Europe were significantly lower (i.e., the distributions were more leftward) than those in North America and Latin America. Ongoing monitoring of MIC data for important antifungals against cryptococcosis is crucial.
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Affiliation(s)
- Shio-Shin Jean
- Departments of Internal Medicine and Critical Care Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan; Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan
| | - Chia-Ying Liu
- Departments of Infectious Diseases and Hospitalist, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Tsung Huang
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mao-Wang Ho
- Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - I-Min Liu
- Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan
| | - Po-Chuen Hsieh
- Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Laboratory Diagnosis, College of Medicine, China Medical University, Taichung, Taiwan; Ph.D Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan.
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3
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Hauser N, Conlon KC, Desai A, Kobziar LN. Climate Change and Infections on the Move in North America. Infect Drug Resist 2022; 14:5711-5723. [PMID: 35002262 PMCID: PMC8722568 DOI: 10.2147/idr.s305077] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/12/2021] [Indexed: 12/18/2022] Open
Abstract
Climate change is increasingly recognized for its impacts on human health, including how biotic and abiotic factors are driving shifts in infectious disease. Changes in ecological conditions and processes due to temperature and precipitation fluctuations and intensified disturbance regimes are affecting infectious pathogen transmission, habitat, hosts, and the characteristics of pathogens themselves. Understanding the relationships between climate change and infectious diseases can help clinicians broaden the scope of differential diagnoses when interviewing, diagnosing, and treating patients presenting with infections lacking obvious agents or transmission pathways. Here, we highlight key examples of how the mechanisms of climate change affect infectious diseases associated with water, fire, land, insects, and human transmission pathways in the hope of expanding the analytical framework for infectious disease diagnoses. Increased awareness of these relationships can help prepare both clinical physicians and epidemiologists for continued impacts of climate change on infectious disease in the future.
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Affiliation(s)
- Naomi Hauser
- Department of Medicine, Division of Infectious Disease, University of California Davis Health, Sacramento, CA, USA.,Climate Adaptation Research Center, University of California, Davis, CA, USA
| | - Kathryn C Conlon
- Climate Adaptation Research Center, University of California, Davis, CA, USA.,Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA.,Department of Veterinary Medicine & Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Angel Desai
- Department of Medicine, Division of Infectious Disease, University of California Davis Health, Sacramento, CA, USA
| | - Leda N Kobziar
- Department of Natural Resources and Society, University of Idaho, Coeur d'Alene, ID, USA
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4
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Fairhead LJ, Smith S, Sim BZ, Stewart AGA, Stewart JD, Binotto E, Law M, Hanson J. The seasonality of infections in tropical Far North Queensland, Australia: A 21-year retrospective evaluation of the seasonal patterns of six endemic pathogens. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000506. [PMID: 36962353 PMCID: PMC10021965 DOI: 10.1371/journal.pgph.0000506] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/17/2023]
Abstract
An understanding of the seasonality of infections informs public health strategies and assists clinicians in their management of patients with undifferentiated illness. The seasonality of infections is driven by a variety of environmental and human factors; however, the role of individual climatic factors has garnered much attention. This study utilises Poisson regression models to assess the seasonality of six important infections in tropical Australia and their association with climatic factors and severe weather events over a 21-year period. Melioidosis and leptospirosis showed marked wet season predominance, while more cases of rickettsial disease and cryptococcosis were seen in cooler, drier months. Staphylococcus aureus infections were not seasonal, while influenza demonstrated inter-seasonality. The climate did not significantly change during the 21 years of the study period, but the incidence of melioidosis and rickettsial disease increased considerably, highlighting the primacy of other factors-including societal inequality, and the impact of urban expansion-in the incidence of these infections. While anthropogenic climate change poses a threat to the region-and may influence the burden of these infections in the future-this study highlights the fact that, even for seasonal diseases, other factors presently have a greater effect on disease incidence. Public health strategies must also target these broader drivers of infection if they are to be effective.
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Affiliation(s)
- Lee J Fairhead
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Beatrice Z Sim
- Infectious Diseases Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - James D Stewart
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Enzo Binotto
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Matthew Law
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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5
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Gnat S, Łagowski D, Nowakiewicz A, Dyląg M. A global view on fungal infections in humans and animals: opportunistic infections and microsporidioses. J Appl Microbiol 2021; 131:2095-2113. [PMID: 33556223 DOI: 10.1111/jam.15032] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
After cardiovascular diseases, infectious diseases are the second most common cause of death worldwide. Although these infections are caused mainly by viruses or bacteria, a systematically growing prevalence of human and animal opportunistic fungal infections is noticeable worldwide. More attention is being paid to this problem, especially due to the growing frequency of recalcitrant and recurrent mycoses. The latter are classically divided into superficial, which are the most common type, subcutaneous, and systemic. This work discusses opportunistic fungal pathogens without proven horizontal transmission between different animal species including humans and microsporidia as spore-forming unicellular parasites related to fungi; however, with a yet undetermined taxonomic position. The review also mentions aetiological agents, risk factors, epidemiology, geographical distribution, and finally symptoms characteristic for individual disease entities. This paper provides insight into fungal infections from a global perspective and simultaneously draws attention to emerging pathogens, whose prevalence is continuously increasing. Finally, this work also takes into consideration the correct nomenclature of fungal disease entities and the importance of secondary metabolites in the pathogenesis of fungal infections.
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Affiliation(s)
- S Gnat
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, University of Life Sciences, Lublin, Poland
| | - D Łagowski
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, University of Life Sciences, Lublin, Poland
| | - A Nowakiewicz
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Preclinical Veterinary Sciences, University of Life Sciences, Lublin, Poland
| | - M Dyląg
- Department of Mycology and Genetics, Faculty of Biological Sciences, Institute of Genetics and Microbiology, University of Wroclaw, Wroclaw, Poland
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6
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Cogliati M, Patrizia P, Vincenzo C, Esposto MC, Prigitano A, Romanò L, Puccianti E. Cryptococcus neoformans species complex isolates living in a tree micro-ecosystem. FUNGAL ECOL 2020. [DOI: 10.1016/j.funeco.2019.100889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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7
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Alaniz AJ, Carvajal JG, Carvajal MA, Cogliati M, Vergara PM. Spatial Quantification of the Population Exposed to Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Europe: Estimating the Immunocompetent and HIV/AIDS Patients Under Risk. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:524-533. [PMID: 31578757 DOI: 10.1111/risa.13410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/24/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Cryptococcus is an important fungal pathogen worldwide, causing serious clinical manifestations that can affect immunocompetent patients and can be particularly severe for immunocompromised patients. The Cryptococcus gattii s.s. (AFLP4/VGI), Cryptococcus tetragattii (AFLP/VGIV), Cryptococcus neoformans, and Cryptococcus deneoformans have been isolated from both clinical and environmental sources in Europe. We aim to quantify the people in Europe and the entire Mediterranean area who are under risk associated with each of the three fungal pathogens in a spatially explicit way, generating a series of maps and population statistics per country. Niche modeling was applied to estimate the potential distribution of each fungal pathogen, then these models were overlapped with a map of population density to estimate risk levels. The potential number of people per risk level and per country was quantified using a map of population count per pixel. Prevalence of HIV per country was also included in the analysis to quantify the HIV-infected population under potential risk. People under risk associated with exposure to C. gattii species (C. gattii s.s. and C. tetragattii) reached 137.65 million, whereas those exposed to C. neoformans and C. deneoformans were 268.58 and 360.78 million people, respectively. More than a half million HIV-infected patients are exposed to each of the two species of the C. neoformans species complex, and more than 200,000 to the C. gattii species complex. The present results can be useful for public health planning by European governments, focusing on the provision of inputs for a "screen-and-treat" approach, availability of medical resources, and continuous monitoring programs in risk zones.
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Affiliation(s)
- Alberto J Alaniz
- Centro de Estudios en Ecología Espacial y Medio Ambiente, Ecogeografía, Santiago, Chile
- Departamento de Gestión Agraria, Facultad Tecnológica, Universidad de Santiago de Chile, Santiago, Chile
| | - Jorge G Carvajal
- Centro de Estudios en Ecología Espacial y Medio Ambiente, Ecogeografía, Santiago, Chile
| | - Mario A Carvajal
- Centro de Estudios en Ecología Espacial y Medio Ambiente, Ecogeografía, Santiago, Chile
| | - Massimo Cogliati
- Dipartimento Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Pablo M Vergara
- Departamento de Gestión Agraria, Facultad Tecnológica, Universidad de Santiago de Chile, Santiago, Chile
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8
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Klumph M, Hoeynck B, Baumgardner DJ. Cryptococcal Antigen Testing in an Integrated Medical System: Eastern Wisconsin. J Patient Cent Res Rev 2020; 7:57-62. [PMID: 32002448 PMCID: PMC6988710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) - previously shown to be >90% sensitive and >90% specific - within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of 23 were immunocompromised. Positive patients were disproportionately male (82.6%) and nonwhite (3.8% of those tested vs 1.2% of whites tested); P<0.01 for both. These associations remained in multivariable models. Positive patients were not significantly older (59.1 vs 53.6 years; P=0.07). Overall, 17 separate zip codes had at least one positive case. Positive patients were more prevalent in the zip codes that included the city of Milwaukee (11 of 377 [2.9% of those tested] vs 12 of 834 [1.4% of all those tested in the remaining area of the state]), but this difference was not statistically significant. No other case clustering or close proximity to waterways was observed (41% were <162 m from green space, similar to historical controls). Overall, male sex, nonwhite race/ethnicity, and immunocompromised status, not zip code, were statistically associated with positive CrAg.
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Affiliation(s)
- Marianne Klumph
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Brian Hoeynck
- Aurora Research Institute, Aurora Health Care, Milwaukee, WI
| | - Dennis J. Baumgardner
- Department of Family Medicine, Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
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9
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Ergin Ç, Şengül M, Aksoy L, Döğen A, Sun S, Averette AF, Cuomo CA, Seyedmousavi S, Heitman J, Ilkit M. Cryptococcus neoformans Recovered From Olive Trees ( Olea europaea) in Turkey Reveal Allopatry With African and South American Lineages. Front Cell Infect Microbiol 2019; 9:384. [PMID: 31788454 PMCID: PMC6856141 DOI: 10.3389/fcimb.2019.00384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/25/2019] [Indexed: 11/13/2022] Open
Abstract
Cryptococcus species are life-threatening human fungal pathogens that cause cryptococcal meningoencephalitis in both immunocompromised and healthy hosts. The natural environmental niches of Cryptococcus include pigeon (Columba livia) guano, soil, and a variety of tree species such as Eucalyptus camaldulensis, Ceratonia siliqua, Platanus orientalis, and Pinus spp. Genetic and genomic studies of extensive sample collections have provided insights into the population distribution and composition of different Cryptococcus species in geographic regions around the world. However, few such studies examined Cryptococcus in Turkey. We sampled 388 Olea europaea (olive) and 132 E. camaldulensis trees from seven locations in coastal and inland areas of the Aegean region of Anatolian Turkey in September 2016 to investigate the distribution and genetic diversity present in the natural Cryptococcus population. We isolated 84 Cryptococcus neoformans strains (83 MATα and 1 MAT a) and 3 Cryptococcus deneoformans strains (all MATα) from 87 (22.4% of surveyed) O. europaea trees; a total of 32 C. neoformans strains were isolated from 32 (24.2%) of the E. camaldulensis trees, all of which were MATα. A statistically significant difference was observed in the frequency of C. neoformans isolation between coastal and inland areas (P < 0.05). Interestingly, the MAT a C. neoformans isolate was fertile in laboratory crosses with VNI and VNB MATα tester strains and produced robust hyphae, basidia, and basidiospores, thus suggesting potential sexual reproduction in the natural population. Sequencing analyses of the URA5 gene identified at least five different genotypes among the isolates. Population genetics and genomic analyses revealed that most of the isolates in Turkey belong to the VNBII lineage of C. neoformans, which is predominantly found in southern Africa; these isolates are part of a distinct minor clade within VNBII that includes several isolates from Zambia and Brazil. Our study provides insights into the geographic distribution of different C. neoformans lineages in the Mediterranean region and highlights the need for wider geographic sampling to gain a better understanding of the natural habitats, migration, epidemiology, and evolution of this important human fungal pathogen.
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Affiliation(s)
- Çağri Ergin
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Mustafa Şengül
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Levent Aksoy
- Department of Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Aylin Döğen
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Mersin, Mersin, Turkey
| | - Sheng Sun
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Anna F Averette
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Seyedmojtaba Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey
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10
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Carignan A, Valiquette L, Laupland KB. Impact of climate change on emerging infectious diseases: Implications for Canada. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2019; 4:55-59. [PMID: 36337740 PMCID: PMC9602962 DOI: 10.3138/jammi.2018-12-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 06/16/2023]
Affiliation(s)
- Alex Carignan
- Department of Microbiology and Infectious Diseases, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Kevin B Laupland
- Department of Intensive Care Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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11
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Silva FB, Santos JRN, da Silva LC, Gomes WC, Villis PCM, Gomes EDS, Pinheiro EDAD, Azevedo CDMPESD, Dias RDS, Monteiro CDA, Santos JRA. Climate drivers of hospitalizations for mycoses in Brazil. Sci Rep 2019; 9:6902. [PMID: 31061460 PMCID: PMC6502841 DOI: 10.1038/s41598-019-43353-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 04/18/2019] [Indexed: 01/26/2023] Open
Abstract
Climate can modulate human health at large spatial scales, but the influence of global, regional, and local environments remains poorly understood, especially for neglected diseases, such as mycoses. In this work, we present the correlation between climatic variables and hospitalizations for mycoses in Brazilian state capitals, evaluating the period of 2008 to 2016 at different time scales. The results indicate that climate modulates the hospitalizations for mycoses differently at annual and monthly time scales, with minimum temperature as a key climatic variable during periods of high prevalence in the 10 Brazilian capitals with the highest hospitalizations for mycoses rates. The greatest number of hospitalizations coincided with La Niña events, while a reduction was observed during El Niño events, thereby demonstrating the influence of the Pacific Interdecadal Climate Oscillation on the prevalence of mycoses in Brazil. At a regional scale, the mycoses burden in Brazil appears to respond differently to local and global climatic drivers.
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Affiliation(s)
- Fabrício Brito Silva
- Mestrado em Meio Ambiente - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil
| | | | | | - Wolia Costa Gomes
- Mestrado em Meio Ambiente - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil
| | | | - Eliane Dos Santos Gomes
- Discente do Curso de Engenharia Ambiental - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil
| | - Edilene de Araújo Diniz Pinheiro
- Mestrado em Meio Ambiente - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil.,Discente do Curso de Biomedicina - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil
| | | | - Rosane da Silva Dias
- Mestrado em Gestão de Programas e Serviços de Saúde - Universidade CEUMA (UNICEUMA), São Luís, Maranhão, Brazil
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12
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Phenotypic characteristics and transcriptome profile of Cryptococcus gattii biofilm. Sci Rep 2019; 9:6438. [PMID: 31015652 PMCID: PMC6478838 DOI: 10.1038/s41598-019-42896-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/08/2019] [Indexed: 12/23/2022] Open
Abstract
In this study, we characterized Cryptococcus gattii biofilm formation in vitro. There was an increase in the density of metabolically active sessile cells up to 72 h of biofilm formation on polystyrene and glass surfaces. Scanning electron microscopy and confocal laser scanning microscopy analysis revealed that in the early stage of biofilm formation, yeast cells adhered to the abiotic surface as a monolayer. After 12 h, extracellular fibrils were observed projecting from C. gattii cells, connecting the yeast cells to each other and to the abiotic surface; mature biofilm consisted of a dense network of cells deeply encased in an extracellular polymeric matrix. These features were also observed in biofilms formed on polyvinyl chloride and silicone catheter surfaces. We used RNA-Seq-based transcriptome analysis to identify changes in gene expression associated with C. gattii biofilm at 48 h compared to the free-floating planktonic cells. Differential expression analysis showed that 97 and 224 transcripts were up-regulated and down-regulated in biofilm, respectively. Among the biological processes, the highest enriched term showed that the transcripts were associated with cellular metabolic processes, macromolecule biosynthetic processes and translation.
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13
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Acheson ES, Galanis E, Bartlett K, Mak S, Klinkenberg B. Searching for clues for eighteen years: Deciphering the ecological determinants of Cryptococcus gattii on Vancouver Island, British Columbia. Med Mycol 2018; 56:129-144. [PMID: 28525610 DOI: 10.1093/mmy/myx037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 04/06/2017] [Indexed: 12/19/2022] Open
Abstract
Cryptococcus gattii emerged on Vancouver Island in 1999 for unknown reasons, causing human and animal fatalities and illness. The apparent emergence of this fungus in another temperate area, this time in the Pacific Northwest, suggests the fungus may have expanded its ecological niche. Yet studies that directly examine the potential roles of climatic and land use changes on C. gattii are still lacking. We aim to summarize the existing global literature on the ecology of C. gattii, with particular focus on the gap in knowledge surrounding the potential effects of climatic and land use changes. We systematically reviewed English peer-reviewed literature on the ecological determinants of C. gattii. We included studies published from January 1970 through June 2016 and identified 56 relevant studies for our review. We identified environmental isolations of C. gattii from 18 countries, spanning 72 separate regions across six continents. Fifty-three tree species were associated with C. gattii, spanning 10 climate classifications and 36 terrestrial ecoregions. No studies directly tested the potential effects of climatic changes (including climatic oscillations and global climate change) on C. gattii, while only one study directly assessed those of land use change. To improve model predictions of current and future distributions of C. gattii, more focus is needed on the potential effects of climatic and land use changes to help decrease the public health risk. The apparent emergence of C. gattii in British Columbia is also an opportunity to explore the factors behind emerging infectious diseases in Canada and elsewhere.
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Affiliation(s)
- Emily Sohanna Acheson
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
| | - Eleni Galanis
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Karen Bartlett
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada, V6T 1Z3
| | - Sunny Mak
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Brian Klinkenberg
- Department of Geography, University of British Columbia, 1984 West Mall, Vancouver, British Columbia, Canada, V6T 1Z2
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14
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Vélez N, Escandón P. Report on novel environmental niches for Cryptococcus neoformans and Cryptococcus gattii in Colombia: Tabebuia guayacan and Roystonea regia. Med Mycol 2018; 55:794-797. [PMID: 28115408 DOI: 10.1093/mmy/myw138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/01/2016] [Indexed: 12/31/2022] Open
Abstract
Knowledge of the environmental distribution of C. neoformans/C. gattii is important in the epidemiology and ecology of the etiological agent, which causes cryptococcosis, a deadly disease worldwide. The aim of this report is to describe the presence of C. neoformans/C. gattii in new environmental niches in Colombia. A total of 837 environmental samples were collected from six different species of trees across four cities; molecular type was determined by PCR fingerprinting and RFLP. Molecular type VNI and VGIII were isolated from different species of trees, resulting in two novel niches for this pathogen: Tabebuia guayacan and Roystonea regia.
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Affiliation(s)
- Norida Vélez
- Grupo de Microbiología, Instituto Nacional de Salud
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15
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Abstract
Cryptococcus is among the most common invasive fungal pathogens globally and is one of the leading causes of acquired immunodeficiency virus-related deaths. Cryptococcus neoformans and Cryptococcus gattii are the most clinically relevant species and account for most cryptococcal disease. Pulmonary manifestations can range from mild symptoms to life-threatening infection. Treatment is tailored based on the severity of pulmonary infection, the presence of disseminated or central nervous system disease, and patient immune status. Amphotericin B and flucytosine followed by fluconazole remain the standard agents for the treatment of severe cryptococcal infection.
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Affiliation(s)
- Kate Skolnik
- Division of Respirology, Department of Internal Medicine, Rockyview General Hospital, University of Calgary, Respirology Offices, 7007 14th Street Southwest, Calgary, Alberta T2V 1P9, Canada
| | - Shaunna Huston
- Department of Physiology and Pharmacology, Health Research Innovation Centre, University of Calgary, Room 4AA08, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1, Canada
| | - Christopher H Mody
- Department of Microbiology and Infectious Diseases, Health Research Innovation Centre, University of Calgary, Room 4AA14, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1, Canada; Department of Internal Medicine, Health Research Innovation Centre, University of Calgary, Room 4AA14, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1, Canada.
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16
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Ballou ER, Johnston SA. The cause and effect of Cryptococcus interactions with the host. Curr Opin Microbiol 2017; 40:88-94. [PMID: 29154043 DOI: 10.1016/j.mib.2017.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 10/18/2017] [Indexed: 12/12/2022]
Abstract
Upon Cryptococcus neoformans infection of the host lung, the fungus enters a nutrient poor environment and must adapt to a variety of host-specific stress conditions (temperature, nutrient limitation, pH, CO2). Fungal spores enter this milieu with limited nutritional reserves, germinate, and begin proliferating by budding as yeast. Although relatively little is known about the initial stages of infection, recent work has characterized changes that occur upon germination. This program and subsequent yeast-phase proliferation progress in a dynamic environment as host nutrient immunity responds to the infection via toxic accumulation or sequestration of essential micronutrients and innate immune cells are recruited to the site of infection. Adaptation to the host environment and evasion of the immune response through pathogenicity factor expression allows proliferation and dissemination to multiple sites throughout the body, including, most significantly for human disease, the central nervous system. Here we will discuss recent insights into mechanisms underlying C. neoformans interactions with the host during infection.
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Affiliation(s)
- Elizabeth R Ballou
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Simon A Johnston
- Department of Infection, Immunity and Cardiovascular disease, Medical School, University of Sheffield, UK; Bateson Centre, University of Sheffield, Sheffield, UK.
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17
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GUO C, DU Y, SHEN SQ, LAO XQ, QIAN J, OU CQ. Spatiotemporal analysis of tuberculosis incidence and its associated factors in mainland China. Epidemiol Infect 2017; 145:2510-2519. [PMID: 28595668 PMCID: PMC9148796 DOI: 10.1017/s0950268817001133] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/09/2017] [Accepted: 05/09/2017] [Indexed: 11/06/2022] Open
Abstract
Spatiotemporal analysis is an important tool to monitor changes of tuberculosis (TB) epidemiology, identify high-risk regions and guide resource allocation. However, there are limited data on the contributing factors of TB incidence. This study aimed to investigate the spatiotemporal pattern of TB incidence and its associated factors in mainland China during 2005-2013. Global Moran's I test, Getis-Ord Gi index and heat maps were used to examine the spatial clustering and seasonal patterns. Generalized Linear Mixed Model was applied to identify factors associated with TB incidence. TB incidence presented high geographical variations with two main hot spots, while a generally consistent seasonal pattern was observed with a peak in late winter. Furthermore, we found province-level TB incidence increased with the proportion of the elderly but decreased with Gross Demographic Product per capita and the male:female ratio. Meteorological factors also influenced TB incidence. TB showed obvious spatial clustering in mainland China and both the demographic and socio-economic factors and meteorological measures were associated with TB incidence. These results provide the related information to identify the high-risk districts and the evidence for the government to develop corresponding control measures.
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Affiliation(s)
- C. GUO
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Y. DU
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - S. Q. SHEN
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - X. Q. LAO
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - J. QIAN
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - C. Q. OU
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
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18
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Spina-Tensini T, Muro MD, Queiroz-Telles F, Strozzi I, Moraes ST, Petterle RR, Vettorello M, Staudacher C, Miguez LAL, de Almeida SM. Geographic distribution of patients affected by Cryptococcus neoformans/Cryptococcus gattii species complexes meningitis, pigeon and tree populations in Southern Brazil. Mycoses 2016; 60:51-58. [PMID: 27561904 DOI: 10.1111/myc.12550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 12/29/2022]
Abstract
Cryptococcal meningitis is mainly caused by members of the C. neoformans/C. gattii species complexes. The ecological niches of Cryptococcus species have extensively been studied, but its epidemiological relationship with meningitis cases is still unknown. In this study, we estimate the relationship between cryptococcal meningitis cases and tree and pigeon populations, the classical niches of members of C. neoformans/C. gattii sensu lato. We analysed the records of every patient whose cerebrospinal fluid culture yielded Cryptococcus spp. during the last 30 years at Clinical Hospital of Curitiba. Data about Curitiba's pigeon and tree distribution were obtained from Curitiba's Secretaries of Zoonosis and Environment archives. We used ArcGis9 software to plot the distribution of the pigeon and tree populations in this city as well as cryptococcal meningitis cases, distinguishing them according to the causal agent in C. neoformans or C. gattii s.l. In total, 489 cryptococcal cultures were documented, with 140 corresponding to patients eligible for this study (134 affected by C. neoformans s.l. and 6 by C. gattii s.l.). The map showed a relationship between C. neoformans s.l. patients and pigeon population. C. gattii s.l. patients were associated with neither tree nor pigeon populations, but lived close to large unbuilt, unforested areas.
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Affiliation(s)
- Tallulah Spina-Tensini
- Department of Neurology, Clinical Hospital of Universidade Federal do Paraná, Curitiba, Brazil
| | - Marisol Dominguez Muro
- Laboratory of Mycology, Clinical Hospital of Universidade Federal do Paraná, Curitiba, Brazil
| | - Flávio Queiroz-Telles
- Infectious diseases Ambulatory, Clinical Hospital of Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | | | | | | | - Sérgio Monteiro de Almeida
- Department of Neuroinfections, Clinical Hospital of Universidade Federal do Paraná, Curitiba, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba-PR. Faculdades Pequeno Príncipe, Curitiba, Brazil
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