Geographic distribution of patients affected by <i>Cryptococcus neoformans</i>/<i>Cryptococcus gattii</i> species complexes meningitis, pigeon and tree populations in Southern Brazil

Tensini, Tallulah Spina; Muro, Marisol Dominguez; Queiroz‐Telles, Flávio; Strozzi, Isabella; Moraes, Samia Talise; Petterle, Ricardo Rasmussen; Vettorello, Marcelo; Staudacher, Claudia; Miguez, Luiz Alberto Lopes; Almeida, Sérgio Monteiro de

doi:10.1111/myc.12550

Cited by 18 publications

(12 citation statements)

References 56 publications

(113 reference statements)

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“…Lately, Spina-Tensini et al [22] also reported a relationship between isolation sites and places frequented by people. Areas where there are large populations of pigeons and trees of the species Araucaria angustifolia, according to authors, would increase the likelihood of an individual developing cryptococcosis due to exposure to opportunistic species as well as the great load of infectious cells present in the environment.…”

Section: Discussionmentioning

confidence: 99%

“…Hospital and academic areas are usually frequented by immunocompetent and immunocompromising individuals. Public places that are frequented by pigeons denote the necessity of educational and preventive measures that may contribute to the reduction or elimination of sources of disease agents, such as those caused by opportunistic fungi [22].…”

Section: Introductionmentioning

confidence: 99%

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Isolation of Cryptococcus species from the external environments of hospital and academic areas

Brito

Bessa

Menezes

et al. 2019

J Infect Dev Ctries

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Introduction: Fungi of the genus Cryptococcus are cosmopolitan and may be agents of opportunistic mycoses in immunocompromised and sometimes immunocompetent individuals. Cryptococcus species are frequently isolated from trees and bird excreta in the environment and infection occurs by inhalation of propagules dispersed in the air. The aim was to investigate Cryptococcus species in bird excreta and tree hollows located in a university hospital area and in an academic area of a university campus. Methodology: A total of 40 samples of bird excreta and 41 samples of tree hollows were collected. The identification of the isolates was done by classical methodology and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Results: Twenty (62.5%) isolates of Cryptococcus were found in bird excreta and 12 (37.5%) in tree hollows. C. laurentii (currently Papiliotrema laurentii) was the most frequent species in both samples, being found in 5 samples of excreta and in 8 tree hollows. The diversity of species found in excreta (C. laurentii, C. albidus [currently Naganishia albida], C. liquefaciens [currently N. liquefaciens], C. friedmanii [currently N. friedmannii] and others) was higher than in tree hollows (C. laurentii, C. flavescens [currently Papiliotrema flavescens], and other yeasts). Conclusion: Many Cryptococcus species were isolated from excreta and tree hollows, and this fact is important for understanding the environmental epidemiology of those emerging pathogens for public health, as a way to implement surveillance actions and control of cryptococcosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Isolation of Cryptococcus species from the external environments of hospital and academic areas

Brito

Bessa

Menezes

et al. 2019

J Infect Dev Ctries

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“…Drying of avian excreta generated smaller cryptococcal cells and increased the probability of aerosolisation and inhalation into the susceptible host (Emmons, 1951). A recent analysis with 30 years data of the patients suffering with cryptococcal meningitis showed a positive correlation between occurrence of infection and pigeon population in Southern Brazil (Spina-Tensini et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

Antifungal resistance in cnlac1 possessing Cryptococcus neoformans isolated from domestic and feral pigeons in West Bengal, India

Banerjee

Batabyal

Debnath

et al. 2019

IJAR

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Cryptococcus neoformans acts as a major etiology of human infections in immunocompromised, cancer and transplant patients. The present study was conducted to detect the occurrence and antifungal resistance of C. neoformans in domestic and feral pigeons in and around Kolkata, a metropolitan city in India with considerable size of pigeon population. Weathered droppings of domestic and feral pigeons (n=917) were collected from different pet bird shelters, different buildings and other places. Isolation and identification of C. neoformans was performed based on cultural, biochemical properties. Antifungal sensitivity of the confirmed isolates were performed according to standard CLSI protocols with seven antifungals and caspofungin. A total of 153(16.68%) samples were found positive for Cryptococcus neoformans var. neoformans. All the isolates possessed CNLAC1 outer gene in PCR. Antifungal sensitivity revealed marked resistance to amphotericin-B (33.33%), fluconazole (20.91%), flucytosine (11.11%), and ketoconazole (8.49%). This is of great concern as the study area (Kolkata) is a densely populated city and the birds are in close proximity to the people.

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“…C. neoformans is globally the major fungal pathogen causing infections in immunocompromised individuals such as AIDS patients, with an estimated incidence of 223,100 cases in 2014 [ 4 ]. C. neoformans has long been considered as the culprit causing cryptococcosis in HIV-infected patients including countries in Latin America [ 12 , 13 ]. The third largest number of cases in the world occurred in Latin America, with an estimated incidence of 5,300 cases per year.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal Meningitis: A Retrospective Cohort of a Brazilian Reference Hospital in the Post-HAART Era of Universal Access

Azambuja

Neto

Watte

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Objective Cryptococcus neoformans is a common opportunistic infection in adults with acquired immunodeficiency syndrome worldwide. However, limited data exist for HIV-infected patients in the post-HAART (highly active antiretroviral therapy) era in Brazil. The aim of this study was to describe the clinical characteristics and outcomes of cryptococcosis in a cohort of patients attending a teaching tertiary care hospital in southern Brazil after the introduction of HAART in Brazil. Patients and Methods A retrospective study was conducted in tertiary care hospital in southern Brazil. Detailed data on risk factors, clinical manifestations, diagnosis methods, treatment, and prognosis of patients with meningeal cryptococcosis were evaluated from January 2009 to December 2016. Results Seventy-nine cases of cryptococcal meningitis were identified. Most of the patients presented positive CSF (cerebrospinal fluid) cultures for Cryptococcus neoformans (96%). The prevalence of males and females with meningeal cryptococcosis was similar. The age of the patients ranged from 5 to 67 years. The median time of hospitalization was 28 days. The most common underlying disease was HIV (82%), followed by solid transplant (10%). Fever, nausea, vomiting, headache, and altered mental status were the most common clinical manifestations. Initial opening intracranial pressures varied from 30 to 130 cm H2O. CNS imaging abnormalities include hydrocephalus and hypodensities. Widened Virchow–Robin spaces were described in only 2 patients (2.5%). Induction treatment of the majority of the patients consisted of amphotericin B and flucytosine (67%) followed by amphotericin B and fluconazole (19%). Multivariate analysis of Cox regression identified headache at presentation, mechanical ventilation, CSF glucose <20 mg/dL, and CSF cryptococcal antigen ≥1 : 1000 for independent risk factors for death. All-cause 30-day and 60-day mortalities were 19% and 24%, respectively. Conclusions Meningeal cryptococcosis mostly caused by C. neoformans continues to occur predominantly in HIV-infected adults despite HAART being widely distributed in Brazil. Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Despite adequate antifungal treatment and management of intracranial hypertension in a reference tertiary care hospital, mortality was high. Identification of risk factors and additional treatment modalities, especially for intracranial hypertension, are necessary to improve care for patients with cryptococcal meningitis.

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Geographic distribution of patients affected by Cryptococcus neoformans/Cryptococcus gattii species complexes meningitis, pigeon and tree populations in Southern Brazil

Cited by 18 publications

References 56 publications

Isolation of Cryptococcus species from the external environments of hospital and academic areas

Isolation of Cryptococcus species from the external environments of hospital and academic areas

Antifungal resistance in cnlac1 possessing Cryptococcus neoformans isolated from domestic and feral pigeons in West Bengal, India

Cryptococcal Meningitis: A Retrospective Cohort of a Brazilian Reference Hospital in the Post-HAART Era of Universal Access

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