The findings suggest that these isolates of an emmonsia species represent a new species of dimorphic fungus that is pathogenic to humans. The species appears to be an important cause of infections in Cape Town.

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The pathogenic species of Cryptococcus are a major cause of mortality owing to severe infections in immunocompromised as well as immunocompetent individuals. Although antifungal treatment is usually effective, many patients relapse after treatment, and in such cases, comparative analyses of the genomes of incident and relapse isolates may reveal evidence of determinative, microevolutionary changes within the host. Here, we analyzed serial isolates cultured from cerebrospinal fluid specimens of 18 South African patients with recurrent cryptococcal meningitis. The time between collection of the incident isolates and collection of the relapse isolates ranged from 124 days to 290 days, and the analyses revealed that, during this period within the patients, the isolates underwent several genetic and phenotypic changes. Considering the vast genetic diversity of cryptococcal isolates in sub-Saharan Africa, it was not surprising to find that the relapse isolates had acquired different genetic and correlative phenotypic changes. They exhibited various mechanisms for enhancing virulence, such as growth at 39°C, adaptation to stress, and capsule production; a remarkable amplification of ERG11 at the native and unlinked locus may provide stable resistance to fluconazole. Our data provide a deeper understanding of the microevolution of Cryptococcus species under pressure from antifungal chemotherapy and host immune responses. This investigation clearly suggests a promising strategy to identify novel targets for improved diagnosis, therapy, and prognosis.

cPatients with cryptococcal meningitis in sub-Saharan Africa frequently relapse following treatment. The natural history and etiology of these recurrent episodes warrant investigation. Here, we used multilocus sequence typing (MLST) to compare the molecular genotypes of strains of Cryptococcus neoformans and Cryptococcus gattii isolated from serial episodes of cryptococcal meningitis that were separated by at least 110 days. The most common MLST genotypes among the isolates were the dominant global clinical genotypes (M5 and M4) of molecular type VNI, as well as the VNI genotypes apparently restricted to southern Africa. In addition, there was considerable genetic diversity among these South African isolates, as 15% of the patients had unique genotypes. Eleven percent of the patients were reinfected with a genetically different strain following their initial diagnosis and treatment. However, the majority of serial episodes (89%) were caused by strains with the same genotype as the original strain. These results indicate that serial episodes of cryptococcosis in South Africa are frequently associated with persistence or relapse of the original infection. Using a reference broth microdilution method, we found that the serial isolates of 11% of the patients infected with strains of C. neoformans var. grubii with identical genotypes exhibited >4-fold increases in the MICs to fluconazole. Therefore, these recurrent episodes may have been precipitated by inadequate induction or consolidation of antifungal treatment and occasionally may have been due to increased resistance to fluconazole, which may have developed during the chronic infection.

Reports of Ceratocystis spp. causing disease of exotic plantation hardwood species have increased in recent years. Ceratocystis fimbriata causes wilt and canker on Eucalyptus spp. in Africa and South America, and C. albofundus results in wilt and death of Acacia mearnsii in Africa. Ceratocystis spp. generally infect wounds on trees, and artificial stem wounding can thus be used to determine the presence of these fungi. The aim of this study was to identify Ceratocystis spp. infecting wounds on Eucalyptus grandis in South Africa. Isolated Ceratocystis spp. were identified using morphological characteristics and comparisons of DNA sequence data for the ITS and 5·8S regions of the rRNA operon. Pathogenicity trials were conducted in the greenhouse to determine the possible role that these Ceratocystis spp. could have in disease development. These trials were also conducted under field conditions. Three Ceratocystis spp. were collected: C. fimbriata, C. moniliformis and C. pirilliformis. This is the first report of C. fimbriata and C. pirilliformis from Eucalyptus spp. in South Africa, and the first report of the latter fungus outside Australia. Both C. fimbriata and C. pirilliformis caused significant lesions on inoculated E. grandis trees. This is the first evidence that C. pirilliformis is a pathogen of Eucalyptus spp. From the results of both greenhouse and field trials, it has the potential to cause serious disease problems in Eucalyptus plantations.

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The genus Ceratocystis includes many important tree pathogens and agents of sap stain. These fungi have a global distribution and commonly infect wounds on trees. During a survey of woundinfecting pathogens in the genus Ceratocystis on plantation-grown Acacia mangium trees in Indonesia, several isolates resembling Ceratocystis moniliformis sensu lato (s.l.) were obtained. The aim of this study was to identify these isolates and to test their pathogenicity on commercially grown Acacia spp. in the country. Use was made of morphology and comparisons of DNA sequence data for the ITS, β-tubulin, and transcription elongation factor 1-α gene regions to identify the isolates. Three previously undescribed species in the C. moniliformis s.l. species complex were identified and are described here as C. inquinans sp. nov., C. sumatrana sp. nov., and C. microbasis sp. nov. Pathogenicity trials on Acacia mangium and A. crassicarpa in the greenhouse and in the field indicated that all three species have the potential to infect A. mangium and A. crassicarpa, although they are not considered important pathogens.