Genotypes of Cryptococcus neoformans and Cryptococcus gattii as agents of endemic cryptococcosis in Teresina, Piauí (northeastern Brazil)

Martins, Liline Maria Soares; Wanke, Bodo; Lazéra, Márcia dos Santos; Trilles, Luciana; Barbosa, Gláucia Gonçalves; Macêdo, Regina Célia Lima de; Cavalcanti, Maria do Amparo Salmito; Eulálio, Kelsen Dantas; Castro, Jose; Silva, Adalberto Socorro da; Nascimento, Fernando Ferraz do; Gouveia, Viviane Alves; Monte, Semíramis Jamil Hadad do

doi:10.1590/s0074-02762011000600012

Cited by 48 publications

(49 citation statements)

References 27 publications

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“…The genotype VGII (25/56, 44.6%) was the most frequently isolated, as reported previously [36][37][38][39][40][41][42], and in agreement with this work. Different results have been observed in southern Brazil, with Casali et al [18] reporting 11 isolates of C. gattii serotype B type VGIII among the clinical samples they studied.…”

Section: Discussionsupporting

confidence: 93%

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Favalessa

Paula

Dutra

et al. 2014

J Infect Dev Ctries

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Introduction: Cryptococcosis is a systemic fungal infection that affects humans and animals, mainly due to Cryptococcus neoformans and Cryptococcus gattii. Following the epidemic of acquired immunodeficiency syndrome (AIDS), fungal infections by C. neoformans have become more common among immunocompromised patients. Cryptococcus gattii has primarily been isolated as a primary pathogen in healthy hosts and occurs endemically in northern and northeastern Brazil. We to perform genotypic characterization and determine the in vitro susceptibility profile to antifungal drugs of the Cryptococcus species complex isolated from HIV-positive and HIV-negative patients attended at university hospitals in Cuiabá, MT, in the Midwestern region of Brazil. Methodology: Micromorphological features, chemotyping with canavanine-glycine-bromothymol blue (CGB) agar and genotyping by URA5-RFLP were used to identify the species. The antifungal drugs tested were amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole. Minimum inhibitory concentrations (MICs) were determined according to the CLSI methodology M27-A3. Results: Analysis of samples yelded C. neoformans AFLP1/VNI (17/27, 63.0%) and C. gattii AFLP6/VGII (10/27, 37.0%). The MICs ranges for the antifungal drugs were: amphotericin B (0.5-1 mg/L), fluconazole (1-16 mg/L), flucytosine (1-16 mg/L), itraconazole (0.25-0.12 mg/L) and voriconazole (0.06-0.5 mg/L). Isolates of C. neoformans AFLP1/VNI were predominant in patients with HIV/AIDS, and C. gattii VGII in HIV-negative patients. The genotypes identified were susceptible to the antifungal drugs tested. Conclusion: It is worth emphasizing that AFLP6/VGII is a predominant genotype affecting HIV-negative individuals in Cuiabá. These findings serve as a guide concerning the molecular epidemiology of C. neoformans and C. gattii in the State of Mato Grosso.

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Section: Discussionsupporting

confidence: 93%

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Favalessa

Paula

Dutra

et al. 2014

J Infect Dev Ctries

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“…In Brazil, symptoms of headache, fever nuchal rigidity, nausea, and vomiting were common (219,221,256). Cranial CT scans of 11 children with CNS disease revealed hypodense nodules in all patients, cerebral atrophy in 9, hydrocephalus in 6, and hydrocephalus with cerebral atrophy in 5 (220).…”

Section: Clinical Manifestations In Childrenmentioning

confidence: 97%

“…The mortality rate was high in early studies of C. gattii meningitis in PNG (22.4 to 43%) (210,211,213) and remains so, especially if diagnosis is delayed (218). In Brazil, the mortality rate has ranged from 18.2 to 50% between studies (219,221,248,256), and in the Northern Territory of Australia, it has been as high as 33% (215). Lower death rates of 0 to 15% were reported in three other Australian studies conducted between the late 1980s and 2007 (27,28,299).…”

Section: Mortality From C Gattii Cns Cryptococcosis and Prognostic Dmentioning

confidence: 99%

“…In that same study, 16 of 53 cases (30%) in adults and children were due to C. gattii (256); underlying conditions were not stratified by cryptococcal species, but at least 14 children were previously healthy. Small epidemiological studies suggest that C. gattii molecular genotype VGII predominates in infected children in north/northeast Brazil and that VGI is uncommon (221,222). Infection in immunocompetent children in southern and southeastern Brazil has also been reported (223,224,256).…”

Section: Infection In Childrenmentioning

confidence: 99%

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Cryptococcus gattii Infections

2014

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SUMMARY Understanding of the taxonomy and phylogeny of Cryptococcus gattii has been advanced by modern molecular techniques. C. gattii probably diverged from Cryptococcus neoformans between 16 million and 160 million years ago, depending on the dating methods applied, and maintains diversity by recombining in nature. South America is the likely source of the virulent C. gattii VGII molecular types that have emerged in North America. C. gattii shares major virulence determinants with C. neoformans , although genomic and transcriptomic studies revealed that despite similar genomes, the VGIIa and VGIIb subtypes employ very different transcriptional circuits and manifest differences in virulence phenotypes. Preliminary evidence suggests that C. gattii VGII causes severe lung disease and death without dissemination, whereas C. neoformans disseminates readily to the central nervous system (CNS) and causes death from meningoencephalitis. Overall, currently available data indicate that the C. gattii VGI, VGII, and VGIII molecular types more commonly affect nonimmunocompromised hosts, in contrast to VGIV. New, rapid, cheap diagnostic tests and imaging modalities are assisting early diagnosis and enabling better outcomes of cerebral cryptococcosis. Complications of CNS infection include increased intracranial pressure, severe neurological sequelae, and development of immune reconstitution syndrome, although the mortality rate is low. C. gattii VGII isolates may exhibit higher fluconazole MICs than other genotypes. Optimal therapeutic regimens are yet to be determined; in most cases, initial therapy with amphotericin B and 5-flucytosine is recommended.

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“…Information regarding the conditions that support the development of cryptococcosis in immunocompetent individuals remains elusive. However, it is possible that environmental factors play an important role in this process, considering that people living in endemic areas are at high risk for developing the disease [21,[25][26][27][28][29][30]. Preventative measures that effectively combat infection by C. gattii are not available at present.…”

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confidence: 99%

Immunoproteomics and immunoinformatics analysis of Cryptococcus gattii: novel candidate antigens for diagnosis

Martins

Andrade

Vainstein

et al. 2013

Future Microbiology

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Genotypes of Cryptococcus neoformans and Cryptococcus gattii as agents of endemic cryptococcosis in Teresina, Piauí (northeastern Brazil)

Cited by 48 publications

References 27 publications

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Cryptococcus gattii Infections

Immunoproteomics and immunoinformatics analysis of Cryptococcus gattii: novel candidate antigens for diagnosis

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