Emerging Cryptococcus gattii species complex infections in Guangxi, southern China

Abstract

The emergence and spread of cryptococcosis caused by the Cryptococcus gattii species complex has become a major public concern worldwide. C. deuterogattii (VGIIa) outbreaks in the Pacific Northwest region demonstrate the expansion of this fungal infection to temperate climate regions. However, infections due to the C. gattii species complex in China have rarely been reported. In this study, we studied eleven clinical strains of the C. gattii species complex isolated from Guangxi, southern China. The genetic identity and variability of these isolates were analyzed via multi-locus sequence typing (MLST), and the phylogenetic relationships among these isolates and global isolates were evaluated. The mating type, physiological features and antifungal susceptibilities of these isolates were also characterized. Among the eleven isolates, six belonged to C. deuterogattii, while five belonged to C. gattii sensu stricto. The C. deuterogattii strains from Guangxi, southern China were genetically variable and clustered with different clinical isolates from Brazil. All strains were MATα, and three C. deuterogattii isolates (GX0104, GX0105 and GX0147) were able to undergo sexual reproduction. Moreover, most strains had capsule and were capable of melanin production when compared to the outbreak strain from Canada. Most isolates were susceptible to antifungal drugs; yet one of eleven immunocompetent patients died of cryptococcal meningitis caused by C. deuterogattii (GX0147). Our study indicated that the highly pathogenic C. deuterogattii may be emerging in southern China, and effective nationwide surveillance of C. gattii species complex infection is necessary.

High Prevalence of HIV-Related Cryptococcosis and Increased Resistance to Fluconazole of the Cryptococcus neoformans Complex in Jiangxi Province, South Central China

“…Recently, Cao et al reported an emergence of C. gattii s.l. infections in Guangxi in South China ( Huang et al, 2020 ) However, the present study and the study of Chen et al (2018) did not detect the strains of C. gattii s.l. in Jiangxi.…”

“…Recently, Cao et al reported emerging C. gattii s.l. infections in Guangxi Province, south of Jiangxi Province ( Huang et al, 2020 ). By increasing the number of Cryptococcus isolates, we aimed to provide a more accurate description of Cryptococcus diversity in Jiangxi Province.…”

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“…To a certain extent, these data can reveal the general distribution of this disease. (Huang et al, 2020) However, the present study and the study of Chen et al (2018) did not detect the strains of C. gattii s.l. in Jiangxi.…”

In vitro Antifungal Susceptibility Profiles of Cryptococcus neoformans var. grubii and Cryptococcus gattii Clinical Isolates in Guangxi, Southern China

“…The identification of C. gattii strains and their genotypes were analyzed in detail in our previous study using multilocus sequence typing (MLST) technique, where five isolates were identified as C. gattii sensu stricto ( C. gattii s.s . ), and six were identified as C. deuterogattii serotype ( Huang et al, 2020 ).…”

“…The DNA results on the database comparison result were 100% consistent with the MALDI-TOF MS identification result, making the results of MALDI-TOF MS in our study credible. The identification of C. gattii strains and their genotypes were analyzed in detail in our previous study using multilocus sequence typing (MLST) technique, where five isolates were identified as C. gattii sensu stricto (C. gattii s.s.), and six were identified as C. deuterogattii serotype (Huang et al, 2020).…”