<i>Crytococcus neoformans</i>var.<i>gattii</i>in an AIDS patient: first observation in Mexico

Castañón-Olivares, Laura Rocío; López-Martínez, Rubén; Barriga-Angulo, Gustavo; Ríos-Rosas, C.

doi:10.1080/02681219780000881

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…However, C. gattii has been reported in southern California among an HIV/AIDS patient cohort and one AIDS patient in Mexico, and C. gattii VGIII/VGIV have been reported in clinical cases from Mexico [21], [22], [31]. Additionally, there are three reported VGIII isolates from the Pacific Northwest outbreak [6], [7], [10].…”

Section: Introductionmentioning

confidence: 99%

A Diverse Population of Cryptococcus gattii Molecular Type VGIII in Southern Californian HIV/AIDS Patients

et al. 2011

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Cryptococcus gattii infections in southern California have been reported in patients with HIV/AIDS. In this study, we examined the molecular epidemiology, population structure, and virulence attributes of isolates collected from HIV/AIDS patients in Los Angeles County, California. We show that these isolates consist almost exclusively of VGIII molecular type, in contrast to the VGII molecular type isolates causing the North American Pacific Northwest outbreak. The global VGIII population structure can be divided into two molecular groups, VGIIIa and VGIIIb. Isolates from the Californian patients are virulent in murine and macrophage models of infection, with VGIIIa significantly more virulent than VGIIIb. Several VGIII isolates are highly fertile and produce abundant sexual spores that may serve as infectious propagules. The a and α VGIII MAT locus alleles are largely syntenic with limited rearrangements compared to the known VGI (a/α) and VGII (α) MAT loci, but each has unique characteristics including a distinct deletion flanking the 5′ VGIII MAT a alleles and the α allele is more heterogeneous than the a allele. Our studies indicate that C. gattii VGIII is endemic in southern California, with other isolates originating from the neighboring regions of Mexico, and in rarer cases from Oregon and Washington state. Given that >1,000,000 cases of cryptococcal infection and >620,000 attributable mortalities occur annually in the context of the global AIDS pandemic, our findings suggest a significant burden of C. gattii may be unrecognized, with potential prognostic and therapeutic implications. These results signify the need to classify pathogenic Cryptococcus cases and highlight possible host differences among the C. gattii molecular types influencing infection of immunocompetent (VGI/VGII) vs. immunocompromised (VGIII/VGIV) hosts.

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Section: Introductionmentioning

confidence: 99%

A Diverse Population of Cryptococcus gattii Molecular Type VGIII in Southern Californian HIV/AIDS Patients

et al. 2011

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“…Besides the C . gattii VGIII infections reported amongst HIV positive patients from Southern California and Mexico [ 20 , 21 , 33 ], the same molecular type has been recovered from immunocompetent human and veterinary patients. Several cases, including fatal infections, have been reported in patients without predisposing risk factors in Brazil, Colombia, Cuba, Mexico and the USA [ 17 , 23 , 24 , 34 – 39 ].…”

Section: Introductionmentioning

confidence: 84%

“…Although C . gattii VGIII has been recovered infrequently from human cases in Argentina, Guatemala [ 8 ], Cuba [ 37 ], Western Europe [ 72 ] and Korea [ 73 , 74 ], and from the environment in Argentina [ 31 ] and India [ 30 ], this molecular type remains an important cause of neglected cryptococcosis cases in Brazil [ 34 , 38 ], Colombia [ 23 , 24 ] and Mexico [ 21 , 35 ]. In addition, the previously described endemic region of C .…”

Section: Discussionmentioning

confidence: 99%

MLST and Whole-Genome-Based Population Analysis of Cryptococcus gattii VGIII Links Clinical, Veterinary and Environmental Strains, and Reveals Divergent Serotype Specific Sub-populations and Distant Ancestors

Firacative¹,

Roe

Malík

et al. 2016

PLoS Negl Trop Dis

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The emerging pathogen Cryptococcus gattii causes life-threatening disease in immunocompetent and immunocompromised hosts. Of the four major molecular types (VGI-VGIV), the molecular type VGIII has recently emerged as cause of disease in otherwise healthy individuals, prompting a need to investigate its population genetic structure to understand if there are potential genotype-dependent characteristics in its epidemiology, environmental niche(s), host range and clinical features of disease. Multilocus sequence typing (MLST) of 122 clinical, environmental and veterinary C. gattii VGIII isolates from Australia, Colombia, Guatemala, Mexico, New Zealand, Paraguay, USA and Venezuela, and whole genome sequencing (WGS) of 60 isolates representing all established MLST types identified four divergent sub-populations. The majority of the isolates belong to two main clades, corresponding either to serotype B or C, indicating an ongoing species evolution. Both major clades included clinical, environmental and veterinary isolates. The C. gattii VGIII population was genetically highly diverse, with minor differences between countries, isolation source, serotype and mating type. Little to no recombination was found between the two major groups, serotype B and C, at the whole and mitochondrial genome level. C. gattii VGIII is widespread in the Americas, with sporadic cases occurring elsewhere, WGS revealed Mexico and USA as a likely origin of the serotype B VGIII population and Colombia as a possible origin of the serotype C VGIII population. Serotype B isolates are more virulent than serotype C isolates in a murine model of infection, causing predominantly pulmonary cryptococcosis. No specific link between genotype and virulence was observed. Antifungal susceptibility testing against six antifungal drugs revealed that serotype B isolates are more susceptible to azoles than serotype C isolates, highlighting the importance of strain typing to guide effective treatment to improve the disease outcome.

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“…As stated above, molecular type VGII accounts for about 95% of all cases in the Pacific Northwest, as far south as northern California. However, recent studies identified that more than 90% of cases from a cohort of patients in Southern California were molecular type VGIII, a type that has also been reported in Mexico [22-25]. The diversity observed in Southern California also indicates that VGIII may have been endemic and unrecognized in the region for longer than appreciated [24], highlighting the complexity of the North American outbreak.…”

Section: Introductionmentioning

confidence: 99%

The Outbreak of Cryptococcus gattii in Western North America: Epidemiology and Clinical Issues

Byrnes

Marr

2011

Curr Infect Dis Rep

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Over the previous decade, we observed the emergence of the fungal pathogen, Cryptococcus gattii, as a cause of disease in humans and animals in a temperate climate. This outbreak, first documented on Vancouver Island, has since expanded throughout Western North America, with non–travel-associated cases now in British Columbia, Washington, Oregon, and California. Additionally, a secondary outbreak, originating in and still restricted to Oregon, has also occurred. During the past several years, several studies detailing molecular typing, virulence, antifungal susceptibilities, epidemiology, and clinical issues have been published. These studies begin to address the complex dynamics of this novel emergence of a rare and fatal fungus, outline clinical characteristics of human cases, and also opened several new areas that should be explored in the upcoming years.

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Crytococcus neoformansvar.gattiiin an AIDS patient: first observation in Mexico

Cited by 14 publications

References 16 publications

A Diverse Population of Cryptococcus gattii Molecular Type VGIII in Southern Californian HIV/AIDS Patients

A Diverse Population of Cryptococcus gattii Molecular Type VGIII in Southern Californian HIV/AIDS Patients

MLST and Whole-Genome-Based Population Analysis of Cryptococcus gattii VGIII Links Clinical, Veterinary and Environmental Strains, and Reveals Divergent Serotype Specific Sub-populations and Distant Ancestors

The Outbreak of Cryptococcus gattii in Western North America: Epidemiology and Clinical Issues

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