Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group

Abstract

Cryptococcosis, a potentially fatal mycosis, is caused by members of the Cryptococcus neoformans and Cryptococcus gattii species complexes. In Latin America, cryptococcal meningitis is still an important health threat with a significant clinical burden. Analysis of publicly available molecular data from 5686 clinical, environmental, and veterinary cryptococcal isolates from member countries of the Latin American Cryptococcal Study Group showed that, as worldwide, C. neoformans molecular type VNI is the most common cause of cryptococcosis (76.01%) in HIV-infected people, followed by C. gattii molecular type VGII (12.37%), affecting mostly otherwise healthy hosts. These two molecular types also predominate in the environment (68.60% for VNI and 20.70% for VGII). Among the scarce number of veterinary cases, VGII is the predominant molecular type (73.68%). Multilocus sequence typing analysis showed that, in Latin America, the C. neoformans population is less diverse than the C. gattii population (D of 0.7104 vs. 0.9755). Analysis of antifungal susceptibility data showed the presence of non-wild-type VNI, VGI, VGII, and VGIII isolates in the region. Overall, the data presented herein summarize the progress that has been made towards the molecular epidemiology of cryptococcal isolates in Latin America, contributing to the characterization of the genetic diversity and antifungal susceptibility of these globally spreading pathogenic yeasts.

Deciphering the Association among Pathogenicity, Production and Polymorphisms of Capsule/Melanin in Clinical Isolates of Cryptococcus neoformans var. grubii VNI

“…In a recent study carried out by the Latin American Cryptococcosis Study Group, 41 STs were identified from published data available on C. neoformans. The most frequent sequence types encountered among clinical, environmental, and veterinary strains included ST2, ST5, ST23, ST77, and ST93 [ 58 ]. These findings are comparable with the present investigation, in which we report a high frequency of ST2 and ST93.…”

Central Nervous System Cryptococcosis due to Cryptococcus gattii in the Tropics

“…Progress has been made in the knowledge of the molecular epidemiology of the etiological agents of cryptococcosis in Latin America [ 29 , 30 ]. In this region, C. neoformans molecular-type VNI is the main cause of this mycosis (76%), followed by C. gattii molecular-type VGII.…”

“…Since the end of the last century, the association of serotype B molecular pattern VGII with eucalyptus ( Eucalyptus camaldulensis ) in Australia [ 34 ] and serotype C molecular pattern VGIII with almond trees ( Terminalia catappa ) in Colombia [ 35 ] was established. Since then, an increasing number of trees have been identified as environmental reservoirs of C. gattii , many of these studies have been carried out in Latin America [ 29 , 30 ] and in Africa [ 31 ]. Extensive environmental sampling in Zambia, Africa, allowed to recognize a new lineage of C. gattii , the molecular pattern VGV [ 8 •].…”

Emerging Animal-Associated Fungal Diseases

“…However, species belonging to both the C. neoformans and C. gattii species complexes shift to an infective yeast form once they go through the respiratory system of mammals. Numerous cases, outbreaks and epidemics of cryptococcosis by the two species complexes have been documented in farmed and companion animals: birds, cattle, horses, cats and dogs, among others [ 92 , 93 , 94 ]. The risk of human cryptococcosis by these infected animals should not be neglected given that they are part of our daily life and have a high potential to contaminate the environment.…”