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Taha M, Tartor YH, Elaziz RMA, Elsohaby I. Genetic diversity and antifungal susceptibilities of environmental Cryptococcus neoformans and Cryptococcus gattii species complexes. IMA Fungus 2024; 15:21. [PMID: 39060926 PMCID: PMC11282759 DOI: 10.1186/s43008-024-00153-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Cryptococcosis is an opportunistic systemic mycosis caused by Cryptococcus neoformans and C. gattii species complexes and is of increasing global importance. Maintaining continued surveillance of the antifungal susceptibility of environmental C. neoformans and C. gattii isolates is desirable for better managing cryptococcosis by identifying resistant isolates and revealing the emergence of intrinsically resistant species. Relevant research data from Egypt are scarce. Thus, this study aimed to report the genetic diversity of C. neoformans and C. gattii species complexes originating from different environmental sources in Egypt, antifungal susceptibility profiles, antifungal combinations, and correlations of susceptibility with genotypes. A total of 400 environmental samples were collected, 220 from birds and 180 from trees. Cryptococcus spp. were found in 58 (14.5%) of the samples, 44 (75.9%) of the isolates were recovered from birds and 14 (24.1%) from trees. These isolates were genotyped using M13 polymerase chain reaction-fingerprinting and URA5 gene restriction fragment length polymorphism analysis. Of the 31 C. neoformans isolates, 24 (77.4%), 6 (19.4%) and one (4.4%) belonged to VNI, VNII, and VNIII genotypes, respectively. The 27 C. gattii isolates belonged to VGI (70.4%), VGII (18.5%), and VGIII (11.1%) genotypes. Non-wild type C. neoformans and C. gattii isolates that may have acquired resistance to azoles, amphotericin B (AMB), and terbinafine (TRB) were observed. C. gattii VGIII was less susceptible to fluconazole (FCZ) and itraconazole (ITZ) than VGI and VGII. C. neoformans isolates showed higher minimum inhibitory concentrations (MICs) to FCZ, ITZ, and voriconazole (VRZ) than those of C. gattii VGI and VGII. Significant (P < 0.001) correlations were found between the MICs of VRZ and ITZ (r = 0.64) in both C. neoformans and C. gattii isolates, FCZ and TRB in C. neoformans isolates, and FCZ and TRB (r = 0.52) in C. gattii isolates.There is no significant differences in the MICs of TRB in combination with FCZ (P = 0.064) or in combination with AMB (P = 0.543) and that of TRB alone against C. gattii genotypes. By calculating the fractional inhibitory concentration (FIC) index, the combination of FCZ + AMB was synergistic against all tested genotypes. These findings expand our knowledge of ecological niches, genetic diversity, and resistance traits of C. neoformans and C. gattii genotypes in Egypt. Further investigations into how they are related to clinical isolates in the region are warranted.
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Affiliation(s)
- Mohamed Taha
- Department of Microbiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, 44511, Egypt
| | - Yasmine H Tartor
- Department of Microbiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, 44511, Egypt.
| | - Rana M Abd Elaziz
- Cairo International Airport Veterinary Quarantine, General Organization for Veterinary Services, Ministry of Agriculture, Cairo, Egypt
| | - Ibrahim Elsohaby
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
- Centre for Applied One Health Research and Policy Advice (OHRP), City University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig, 44511, Egypt
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Omura M, Satoh K, Tamura T, Komori A, Makimura K. Molecular epidemiological investigation of Cryptococcus spp. carried by captive koalas ( Phascolarctos cinereus) in Japan. Microbiol Spectr 2024; 12:e0290323. [PMID: 38411053 PMCID: PMC11210188 DOI: 10.1128/spectrum.02903-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii cause cryptococcosis, a systemic mycosis that infects a wide range of species. Recent molecular biological investigations have allowed for the genotyping of these species, providing more detailed information on their pathogenicity and infection routes. Koalas (Phascolarctos cinereus) are frequently colonized by Cryptococcus spp., but molecular epidemiological studies have yet to be conducted in Japan. Here, we conducted multi-locus sequence typing (MLST) analysis on Cryptococcus spp. colonization isolates obtained from all koalas kept in seven parks across Japan. Out of 46 koalas examined, 10 (22%) were positive for C. gattii and 3 (6.5%) were positive for C. neoformans. All C. gattii isolates belonged to molecular type VGI and were either sequence type (ST) 51 or a novel ST, and all C. neoformans isolates belonged to molecular type VNI and ST23. Despite the frequent movement of koalas between parks, the STs were relatively park-specific, suggesting that the floor of the rearing barns is a source of infection and may act as a reservoir. MLST analysis confirmed that C. gattii was transported, established, and spread by koalas in areas where C. gattii was not originally present. MLST analysis is considered useful in assessing the pathogenicity and tracing the transmission routes of Cryptococcus spp. carried by koalas.IMPORTANCEThis is the first study to conduct a multi-locus sequence typing analysis on Cryptococcus spp. carried by captive koalas in Japan. Cryptococcosis remains a globally high-fatality fungal infection in humans, and captive koalas are known to carry a high percentage of Cryptococcus spp. Through this research, the molecular types and transmission routes of Cryptococcus spp. carried by koalas have been elucidated, revealing the potential role of enclosure flooring as a reservoir. It has been confirmed that Cryptococcus gattii, which is not endemic in Japan, has become established through koalas and is spreading to new individuals in Japan. This study is believed to provide valuable insights into koala conservation and contribute to the One Health approach for Cryptococcosis, a zoonotic infection.
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Affiliation(s)
- Miki Omura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
| | - Kazuo Satoh
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Takashi Tamura
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Aya Komori
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Koichi Makimura
- Laboratory of Medical Mycology, Graduate School of Medicine, Teikyo University, Tokyo, Japan
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
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Firacative C, Zuluaga-Puerto N, Guevara J. Cryptococcus neoformans Causing Meningoencephalitis in Adults and a Child from Lima, Peru: Genotypic Diversity and Antifungal Susceptibility. J Fungi (Basel) 2022; 8:jof8121306. [PMID: 36547639 PMCID: PMC9781953 DOI: 10.3390/jof8121306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis, caused predominantly by Cryptococcus neoformans, is a potentially fatal, opportunistic infection that commonly affects the central nervous system of immunocompromised patients. Globally, this mycosis is responsible for almost 20% of AIDS-related deaths, and in countries like Peru, its incidence remains high, mostly due to the annual increase in new cases of HIV infection. This study aimed to establish the genotypic diversity and antifungal susceptibility of C. neoformans isolates causing meningoencephalitis in 25 adults and a 9-year-old girl with HIV and other risk factors from Lima, Peru. To identify the genotype of the isolates, multilocus sequence typing was applied, and to establish the susceptibility of the isolates to six antifungals, a YeastOne® broth microdilution was used. From the isolates, 19 were identified as molecular type VNI, and seven as VNII, grouped in eight and three sequence types, respectively, which shows that the studied population was highly diverse. Most isolates were susceptible to all antifungals tested. However, VNI isolates were less susceptible to fluconazole, itraconazole and voriconazole than VNII isolates (p < 0.05). This study contributes data on the molecular epidemiology and the antifungal susceptibility profile of the most common etiological agent of cryptococcosis, highlighting a pediatric case, something which is rare among cryptococcal infection.
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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 de Rosario, Bogota 111221, Colombia
- Correspondence:
| | | | - José Guevara
- Facultad de Medicina “San Fernando”, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
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Associations between Cryptococcus Genotypes, Phenotypes, and Clinical Parameters of Human Disease: A Review. J Fungi (Basel) 2021; 7:jof7040260. [PMID: 33808500 PMCID: PMC8067209 DOI: 10.3390/jof7040260] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 12/11/2022] Open
Abstract
The genus Cryptococcus contains two primary species complexes that are significant opportunistic human fungal pathogens: C. neoformans and C. gattii. In humans, cryptococcosis can manifest in many ways, but most often results in either pulmonary or central nervous system disease. Patients with cryptococcosis can display a variety of symptoms on a spectrum of severity because of the interaction between yeast and host. The bulk of our knowledge regarding Cryptococcus and the mechanisms of disease stem from in vitro experiments and in vivo animal models that make a fair attempt, but do not recapitulate the conditions inside the human host. To better understand the dynamics of initiation and progression in cryptococcal disease, it is important to study the genetic and phenotypic differences in the context of human infection to identify the human and fungal risk factors that contribute to pathogenesis and poor clinical outcomes. In this review, we summarize the current understanding of the different clinical presentations and health outcomes that are associated with pathogenicity and virulence of cryptococcal strains with respect to specific genotypes and phenotypes.
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Wu SY, Kang M, Liu Y, Chen ZX, Xiao YL, He C, Ma Y. Molecular epidemiology and antifungal susceptibilities of Cryptococcus species isolates from HIV and non-HIV patients in Southwest China. Eur J Clin Microbiol Infect Dis 2021; 40:287-295. [PMID: 32895755 DOI: 10.1007/s10096-020-04013-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
To investigated the molecular epidemiology and in vitro antifungal susceptibility of Cryptococcus isolates from West China Hospital from HIV and non-HIV patients between 2009 and 2015. A total of 132 C. neoformans and C. gattii were subjected to antifungal susceptibility testing by E-test method. Among the 132 isolates, 42 C. neoformans and C. gattii were analyzed by mating type and URA5-RFLP. A total of 113 C. neoformans and C. gattii were subjected to multi-locus sequence typing (MLST). MLST results revealed that ST5 was the major molecular type. The wild-type (WT) phenotype was seen in 91.5-100% of C. neoformans isolates for amphotericin B, 5-flucytosine, fluconazole, and voriconazole. However, 72.3% (94/130) of C. neoformans isolates were non-wild-type (non-WT) to itraconazole by E-test method. In the sixth study year, the geometric mean, MIC50 and MIC90 of fluconazole were the highest (P < 0.001). Among 132 patients. 52 were coinfected with HIV and 80 were HIV-negative. Isolates from HIV and non-HIV patients showed no differences in susceptibility to amphotericin B (P = 0.544), 5-flucytosine (P = 0.063), fluconazole (P = 0.570), voriconazole (P = 0.542), and itraconazole (P = 0.787). Our study showed that Cryptococcus in southwest China showed a low degree of genetic diversity. The increased MIC values of fluconazole are noted. Cryptococcus isolates from HIV and non-HIV patients have shown no differences in susceptibility to five antifungal agents.
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Affiliation(s)
- Si-Ying Wu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mei Kang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
| | - Ya Liu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi-Xing Chen
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yu-Ling Xiao
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chao He
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Ma
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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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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Lin KH, Lin YP, Ho MW, Chen YC, Chung WH. Molecular epidemiology and phylogenetic analyses of environmental and clinical isolates of Cryptococcus gattii sensu lato in Taiwan. Mycoses 2020; 64:324-335. [PMID: 33037734 DOI: 10.1111/myc.13195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The rare occurrence of cryptococcosis caused by Cryptococcus gattii sensu lato (C. gattii s.l.) leads to the difficulties in studying the molecular epidemiology of this globally emerging disease. OBJECTIVES To establish the molecular epidemiological profile of C. gattii s.l. in Taiwan, and understand the genetic relationship between locally endemic and global isolates. METHODS A nationwide survey on environmental C. gattii s.l. in Taiwan was conducted from 2017 to 2019. The geographic distribution and molecular epidemiology based on multilocus sequence typing (MLST) data of the environmental isolates were compared with 18 previously collected clinical isolates. Phylogenetic analysis was performed to elucidate the genetic relationship between the global isolates and the isolates endemic to Taiwan. RESULTS From a total of 622 environmental samples, 104 (16.7%) were positive for C. gattii s.l.. Seven sequence types were identified among the environmental isolates. The genetic population structure showed that the environmental and clinical isolates were closely linked by sequence types and geographical locations. Phylogenetic analysis revealed the association between the C. gattii s.l. isolates in Taiwan and those from South America and South Asia. The recombination test suggested that, in Taiwan, the C. gattii sensu stricto (C. gattii s.s). isolates undergo clonal reproduction and sexual recombination, whereas C. deuterogattii isolates were clonal. CONCLUSIONS The molecular epidemiology of environmental C. gattii s.l. isolates is closely linked to the clinical isolates. Phylogenetic analysis of the environmental isolates provides an insight into the mechanisms underlying reproduction and dispersal of C. gattii s.l. in Taiwan.
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Affiliation(s)
- Kuo-Hsi Lin
- Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.,Department of Plant Pathology, National Chung Hsing University, Taichung, Taiwan
| | - Yi-Pei Lin
- Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Mao-Wang Ho
- China Medical University Hospital, Taichung, Taiwan
| | | | - Wen-Hsin Chung
- Department of Plant Pathology, National Chung Hsing University, Taichung, Taiwan.,Innovation and Development Center of Sustainable Agriculture (IDCSA), Taichung, Taiwan
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Samarasinghe H, Aljohani R, Jimenez C, Xu J. Fantastic yeasts and where to find them: the discovery of a predominantly clonal Cryptococcus deneoformans population in Saudi Arabian soils. FEMS Microbiol Ecol 2020; 95:5538757. [PMID: 31344232 DOI: 10.1093/femsec/fiz122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/20/2019] [Indexed: 12/15/2022] Open
Abstract
Cryptococcus deneoformans is an opportunist yeast pathogen and causative agent of meningoencephalitis in humans. It is known to be mainly distributed in temperate climates. Most of our current understanding of this species has come from clinical isolates, leaving environmental populations largely unexplored. The Middle East remains one such underexplored area with no published study to date investigating cryptococcal diversity in soil. In this study, we identified 76 C. deneoformans isolates from a survey of 562 soil samples collected from six cities in Saudi Arabia. Multilocus sequence typing revealed the presence of two major sequence types (STs), ST160 (n = 63) and ST294 (n = 9), along with four singleton STs, three of which were novel. One novel ST, ST613, was likely a recombinant product between ST160 and ST294. Among the 76 isolates, 75 belonged to mating type (MAT)α while one isolate was MATa. Our analyses suggest that the Saudi Arabian C. deneoformans population likely reproduces both asexually and sexually in nature. Our study is the first to report the occurrence of C. deneoformans in a desert climate, representing a novel expansion to this species' currently known ecological niche.
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Affiliation(s)
| | - Renad Aljohani
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Carlene Jimenez
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON, Canada
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Kassi FK, Drakulovski P, Bellet V, Roger F, Chabrol A, Krasteva D, Doumbia A, Landman R, Kakou A, Reynes J, Delaporte E, Menan HEI, Bertout S. Cryptococcus genetic diversity and mixed infections in Ivorian HIV patients: A follow up study. PLoS Negl Trop Dis 2019; 13:e0007812. [PMID: 31738768 PMCID: PMC6886875 DOI: 10.1371/journal.pntd.0007812] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 12/02/2019] [Accepted: 09/26/2019] [Indexed: 01/07/2023] Open
Abstract
Genetic diversity analyses were performed by sero-genotyping and multi-locus sequence typing on 252 cryptococcal isolates from 13 HIV-positive Ivorian patients followed-up for cryptococcal meningitis. Antifungal susceptibility analyses were performed according to the CLSI M27A3 method. The majority (67.8%) of the isolates belonged to the Cryptococcus neoformans (serotype A) species complex, with 93% being VNI and 7% being VNII. Cryptococcus deuterogattii VGII (serotype B) represented 16.7% of the strains, while C. neoformans/C. deneoformans VNIII (serotype AD) hybrids accounted for 15.1% of the strains. One strain (0.4%) was not identifiable. Nine different sequence types (STs 5, 6, 23, 40, 93, 207, 311, and a new ST; 555) were identified in the C. neoformans population, while the C. deuterogattii population comprised the single ST 173. The distribution of the strains showed that, while the majority of patients (9/13) harboured a single sequence type, 4 patients showed mixed infections. These patients experienced up to 4 shifts in strain content either at the species and/or ST level during their follow-up. This evolution of diversity over time led to the co-existence of up to 3 different Cryptococcus species and 4 different ST within the same individual during the course of infection. Susceptibility testing showed that all strains were susceptible to amphotericin B while 3.6% of them had a none-wild type phenotype to 5-flucytosine. Concerning fluconazole, 2.9% of C.neoformans serotype A strains and 2.4% of C. deuterogattii had also respectively a none-wild type phenotype to this molecule. All C. neoformans x C. deneoformans serotype AD hybrids had however a wild type phenotype to fluconazole. The present study showed that mixed infections exist and could be of particular importance for care outcomes. Indeed, (i) the different Cryptococcus species are known to exhibit different virulence and different susceptibility patterns to antifungal drugs and (ii) the strains genetic diversity within the samples may influence the susceptibility to antifungal treatment.
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Affiliation(s)
- Fulgence Kondo Kassi
- Université Félix Houphouet-Boigny, Unité des Sciences Pharmaceutiques et Biologiques, Abidjan, Côte d’Ivoire
| | - Pascal Drakulovski
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Virginie Bellet
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Frédéric Roger
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Amélie Chabrol
- Service de Maladies Infectieuses et Tropicales, CH Sud Francilien, Corbeil, France
| | - Donika Krasteva
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Adama Doumbia
- Université Félix Houphouet-Boigny, Unité des Sciences Pharmaceutiques et Biologiques, Abidjan, Côte d’Ivoire
| | - Roland Landman
- Institut de Médecine et Epidémiologie Appliquée (IMEA), Fondation Léon M’Ba, Paris, France
| | - Aka Kakou
- Service des Maladies Infectieuses et Tropicales, CHU Treichville, Abidjan, Côte d’Ivoire
| | - Jacques Reynes
- CHU Gui de Chauliac, Service des Maladies Infectieuses et Tropicales, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Eric Delaporte
- TransVIHMI/INSERM1175, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | - Hervé Eby Ignace Menan
- Diagnostic and Research Center on AIDS and Other Infectious Diseases (CeDReS), Abidjan, Côte d'Ivoire
| | - Sébastien Bertout
- Laboratoire de Parasitologie et Mycologie Médicale, IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
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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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11
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Multilocus Sequence Typing Reveals both Shared and Unique Genotypes of Cryptococcus neoformans in Jiangxi Province, China. Sci Rep 2018; 8:1495. [PMID: 29367679 PMCID: PMC5784014 DOI: 10.1038/s41598-018-20054-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/12/2018] [Indexed: 11/09/2022] Open
Abstract
Cryptococcosis is a globally distributed infectious fungal disease. However, much remains unknown about its molecular epidemiology in many parts of the world. In this study, we analyzed 86 clinical Cryptococcus neoformans isolates from 14 regions in Jiangxi Province in south central China. Each isolate was from a different patient and 35 of the 86 (40.7%) patients were infected with HIV. All strains belonged to serotype A and mating type α (MATα). Genotyping based on DNA sequences at seven nuclear loci revealed eight sequence types (STs) among the 86 isolates, including two novel STs that have not been reported from other parts of the world. ST5 was the dominant genotype and our comparative analyses showed that these genotypes in Jiangxi likely originated by dispersal from other regions within and outside of China and/or mutations from another genotype within Jiangxi. Though none of the isolates was resistant to the five tested antifungal drugs (flucytosine, amphotericin B, fluconazole, itraconazole, and voriconazole), obvious differences in their minimum inhibitory concentrations were observed, even among isolates of the same ST. Our results suggest that continuous monitoring should be conducted to understand the changing dynamics of C. neoformans in this and other regions.
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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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Vreulink JM, Khayhan K, Hagen F, Botes A, Moller L, Boekhout T, Vismer H, Botha A. Presence of pathogenic cryptococci on trees situated in two recreational areas in South Africa. FUNGAL ECOL 2017. [DOI: 10.1016/j.funeco.2017.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Ecoepidemiology of Cryptococcus gattii in Developing Countries. J Fungi (Basel) 2017; 3:jof3040062. [PMID: 29371578 PMCID: PMC5753164 DOI: 10.3390/jof3040062] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/28/2017] [Accepted: 10/30/2017] [Indexed: 01/06/2023] Open
Abstract
Cryptococcosis is a systemic infection caused by species of the encapsulated yeast Cryptococcus. The disease may occur in immunocompromised and immunocompetent hosts and is acquired by the inhalation of infectious propagules present in the environment. Cryptococcus is distributed in a plethora of ecological niches, such as soil, pigeon droppings, and tree hollows, and each year new reservoirs are discovered, which helps researchers to better understand the epidemiology of the disease. In this review, we describe the ecoepidemiology of the C. gattii species complex focusing on clinical cases and ecological reservoirs in developing countries from different continents. We also discuss some important aspects related to the antifungal susceptibility of different species within the C. gattii species complex and bring new insights on the revised Cryptococcus taxonomy.
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15
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Hatthakaroon C, Pharkjaksu S, Chongtrakool P, Suwannakarn K, Kiratisin P, Ngamskulrungroj P. Molecular epidemiology of cryptococcal genotype VNIc/ST5 in Siriraj Hospital, Thailand. PLoS One 2017; 12:e0173744. [PMID: 28323835 PMCID: PMC5360237 DOI: 10.1371/journal.pone.0173744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/24/2017] [Indexed: 12/23/2022] Open
Abstract
Despite the strong association between Cryptococcus neoformans infection and the Human immunodeficiency virus (HIV) status of patients globally, most cryptococcosis cases in Far East Asia occur in non-HIV individuals. Molecular epidemiological studies, using multilocus sequence typing (MLST), have shown that more than 95% of cryptococcal strains belong to a specific subtype of VNI. However, this association has never been specifically examined in other parts of Asia. Therefore, in this study, we investigated the VNIc/ST5 genotype distribution among cryptococcosis patients in Thailand. Fifty-one C. neoformans isolates were collected from clinical samples in Siriraj Hospital, Bangkok, Thailand. The strains were predominantly isolated from HIV-positive patients (88.57%) and all were molecular type VNI MATα. An MLST analysis identified five sequence types (ST) in Siriraj Hospital, of which ST4 (45.10%) and ST6 (35.29%) were most common, and ST5 (15.69%), ST32 (1.96%), and ST93 (1.96) were less common. Contrary to reports from Far East Asia, ST5 was predominantly (83.33%) found in HIV patients (P = 0.657), and there was no significant change in the prevalence of ST5 over the past 10 years (P = 0.548). A further analysis of comorbidities showed higher morbidity and delays in the cryptococcal diagnosis in patients with tuberculosis coinfection or without HIV. Our study suggests that although the Thai population is genetically closely related to the Far East Asian population, ST5 is not associated with non-HIV status in Thailand. Therefore, this association may not be related to the host’s genetic background. However, its mechanism remains unclear.
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Affiliation(s)
- Chanin Hatthakaroon
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
| | - Sujiraphong Pharkjaksu
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
| | - Piriyaporn Chongtrakool
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
| | - Kamol Suwannakarn
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
| | - Pattarachai Kiratisin
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
| | - Popchai Ngamskulrungroj
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand
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16
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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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17
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Figueiredo TP, Lucas RCD, Cazzaniga RA, França CN, Segato F, Taglialegna R, Maffei CML. ANTIFUNGAL SUSCEPTIBILITY TESTING AND GENOTYPING CHARACTERIZATION OF Cryptococcus neoformans AND gattii ISOLATES FROM HIV-INFECTED PATIENTS OF RIBEIRÃO PRETO, SÃO PAULO, BRAZIL. Rev Inst Med Trop Sao Paulo 2016; 58:69. [PMID: 27680174 PMCID: PMC5048640 DOI: 10.1590/s1678-9946201658069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 04/26/2016] [Indexed: 12/20/2022] Open
Abstract
Cryptococcosis is a leading invasive fungal infection in immunocompromised patients.
Considering the high prevalence and severity of these infections in immunocompromised
patients attended at HC-FMRP-USP, the present research aimed to characterize the
clinical isolates of Cryptococcus strains by biochemical and
molecular methods and evaluate antifungal susceptibility of clinical isolates. Fifty
isolates from 32 HIV-positive patients were obtained at HC-FMRP-USP. Most of the
isolates (78.1%) were identified as C. neoformans, and 100% of
C. neoformans and C. gattii strains were
susceptible to amphotericin B, ketoconazole and fluconazole. All isolates were
classified as serotype A (grubbii variety) by PCR and most of them
were characterized in mating type MATa. PCR analysis of specific M13 microsatellite
sequence revealed that VNI type was predominant among C. neoformans,
while VGII was predominant among C. gattii. The strains did not show
a significant resistance to the antifungals tested, and Canavanine-Glycine-Bromthymol
Blue Agar (CGB) proved to be a reliable test presenting a good correlation with the
molecular characterization. C. neoformans isolated from disseminated
infections in the same patient showed molecular identity when different anatomical
sites were compared; besides, the studied strains did not present a significant
increase in resistance to antifungal agents. In addition, the homogeneity of the
molecular types and detection of the mating types suggested a low possibility of
crossing among the strains.
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Affiliation(s)
- Thais Pandini Figueiredo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica. 14049-900 Ribeirão Preto, SP, Brazil. E-mail: .,Universidade Federal de Ouro Preto, Núcleo de Inovação Tecnológica, 35400-000 Ouro Preto, MG, Brazil. E-mail:
| | - Rosymar Coutinho de Lucas
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Bioquímica. 14049-900 Ribeirão Preto, SP, Brazil. E-mail: .,Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Biologia. 14040-901 Ribeirão Preto, SP, Brazil. E-mail:
| | | | - Carolina Nunes França
- Universidade de Santo Amaro, UNISA, Pós Graduação em Ciências da Saúde, São Paulo, SP, Brazil. E-mail: .,Universidade Federal de São Paulo, UNIFESP, Departamento de Medicina, São Paulo, SP, Brazil. E-mail:
| | - Fernando Segato
- , Escola de Engenharia de Lorena, Departamento de Biotecnologia. 12602-810, Lorena, SP,Universidade de São Paulo Brazil. E-mail:
| | - Rafael Taglialegna
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Biologia Celular, Molecular e Bioagentes Patogênicos. 14049-900 Ribeirão Preto, SP, Brazil. E-mails: ;
| | - Claudia Maria Leite Maffei
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Biologia Celular, Molecular e Bioagentes Patogênicos. 14049-900 Ribeirão Preto, SP, Brazil. E-mails: ;
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