Molecular epidemiology and antifungal susceptibility profiles of clinical Cryptococcus neoformans/Cryptococcus gattii species complex

Bandalizadeh, Zainab; Shokohi, Tahereh; Badali, Hamid; Abastabar, Mahdi; Babamahmoudi, Farhang; Davoodi, Lotfolah; Mardani, Masoud; Javanian, Mostafa; Cheraghmakani, Hamed; Sepidgar, Ali Asghar; Badiee, Parisa; Khodavaisy, Sadegh; Afshari, Setareh Agha Kuchak; Ahmadikia, Kazem; Seyedmousavi, Seyedmojtaba

doi:10.1099/jmm.0.001101

Cited by 14 publications

(7 citation statements)

References 47 publications

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“…Although C. neoformans and C. deuterogattii clinical isolates have presented MIC above ECV for FLU, ITR and VOR, most of the clinical isolates are wild‐type to these antifungal drugs. Similarly, most of the C. neoformans clinical isolate from Brazil and other countries have been shown to be wild‐type strain to FLU, ITR and VOR (MIC below the ECV) 13,17,33,34,36,37 . The MICs of 5‐FC for all clinical isolates in our study were within the wild‐type range, which has been found for C. neoformans and C. deuterogattii clinical isolates from the southern and south‐eastern region of Brazil 13,33,34,36 .…”

Section: Discussionsupporting

confidence: 79%

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Molecular typing, in vitro susceptibility and virulence of Cryptococcus neoformans/Cryptococcus gattii species complex clinical isolates from south‐eastern Brazil

Barião

Tonani

Cocio

et al. 2020

Mycoses

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Summary Background Cryptococcus neoformans/ Cryptococcus gattii species complex is composed of encapsulated yeast species that are causative agents of cryptococcosis. The characterisation of pathogenic Cryptococcus species provides useful data for epidemiological studies as well as the clinical diagnosis and treatment of patients. Objectives This study aimed to characterise the epidemiology, antifungal susceptibility and virulence of 72 clinical strains isolated from cryptococcosis cases between 2012 and 2017 in a tertiary reference hospital in south‐eastern Brazil. Methods Species and molecular types were molecularly assessed by PCR and PCR‐restriction fragment length polymorphism (RFLP) of the URA5 gene. Antifungal susceptibility testing was performed according to the CLSI protocols. The virulence was studied in a Galleria mellonella infection model. Results The most frequently isolated strain was C. neoformans molecular type VNI (61/72; 84.7%), although C. neoformans molecular type VNII (3/72; 4.2%) was also isolated. Additionally, C. deuterogattii molecular type VGII (8/72; 11.1%) was present, but most frequently from non‐HIV‐infected patients. Non‐wild‐type phenotype to the antifungals was observed in 26.4% (19/72) of the C. neoformans and C. deuterogattii clinical isolates, and the latter demonstrated higher MIC to fluconazole and itraconazole than C. neoformans clinical isolates. Finally, the virulence of C. neoformans and C. deuterogattii clinical isolates was diverse in G mellonella larvae and uncorrelated with the virulence factors of melanin and capsule. Conclusions The assessment of the spread of cryptococcal species and molecular types as well as the pattern of corresponding antifungal susceptibility and virulence aids in surveil the emergence of resistant strains, ensuring more accurate management of the cryptococcal infection.

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Section: Discussionsupporting

confidence: 79%

“…Our results are in line with most of Cryptococcus spp. isolates since the emergence of HIV, which are mostly wild‐type to AMB 13,17,33,34,36,37 . Therefore, the majority of C. neoformans VNI isolates are currently wild‐type concerning AMB.…”

Section: Discussionmentioning

confidence: 99%

Molecular typing, in vitro susceptibility and virulence of Cryptococcus neoformans/Cryptococcus gattii species complex clinical isolates from south‐eastern Brazil

Barião

Tonani

Cocio

et al. 2020

Mycoses

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“…Bandalizadeh et al in their study reported the mortality rate of CM to be 64%. The higher mortality rate in the study of Bandalizadeh et al may be due to the more severe immunodeficiency condition of patients and also the lack of access to the use of flucytosine in the first-line treatment in combination with amphotericin B [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among numerous species of Cryptococcus , C. neoformans and C. gattii species complexes are the major causative agents of human cryptococcosis [ 7 ]. Measurement of cryptococcal antigen (Ag) titer and/or culture are the mainstay for a definite diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and para-clinical findings of cryptococcal meningitis in the North of Iran during 2011-19

Babamahmoodi¹,

Firozjaii²,

Bayani³

et al. 2021

CMM

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Background and Purpose:Cryptococcalmeningitis (CM) is a serious fungal infection that especially affectspatients with human immunodeficiency virus (HIV). In this regard,the present retrospective study aimed to analyze the clinical and laboratory features and therapeutic outcomes of patients with CM admitted to two teaching referral centersin the north of Iran during 2011-19. Materials and Methods:This study was performed onall the hospitalized patients diagnosed with CM in two therapeutic centers of infectious diseases in the north of Iran. The required data,such as demographic characteristics and clinical and paraclinical features of patients, were extracted and entered in the information forms. Finally, the collected data were analyzed inSPSSsoftware(version16). Results:For the purpose of the study, records of 12confirmed CM patients were evaluatedin this research. Based on the results,75% of the patients were male. Moreover,the average age of the subjects was 40.33± 8.93 years old and 66.6%ofthem(n=8) were HIV-positive. Other underlying diseases among HIV-positive patients included infection with hepatitis C virus (25%) and a history of tuberculosis (25%). In total, threeHIV-negative patients suffered from Hodgkin lymphoma (25%), sarcoidosis (25%),and asthma (25%) and one patient (25%) had no underlying disease. Headache (75%), weakness,and fatigue (75%) were the most common symptoms among the participants. The cluster of differentiation 4count in all HIV-positive patients was less than 100 cells/μl. There was no significant difference between symptoms in HIV-positive and HIV-negative patients. Besides, no significant difference was observed between the groups of HIV-positive and HIV-negative patients regarding the period between the onset of symptoms and diagnosis of CM,the length of hospital stay,and the duration of antifungal medication consumption. In total,three patients (25%) expired,and six patients recovered. The CM recurred in two HIV-negative and oneHIV-positive subjects;the two HIV-negative patients were treated,whilethe HIV-positive patient expired due to this recurrence. Conclusion:Clinical features and cerebrospinal fluid parameters were not different in HIV-positive and HIV-negative participants. Despite the fact thatCM is not common in Iran, due to the increasing number of immunosuppressive patients, the differential diagnosis of CM should be considered for patients with signs and symptoms of infection in the central nervous system.

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“…Cases caused by C. neoformans are observed worldwide, but cases caused by C. gattii are not frequently observed globally. In addition, C. gattii exhibits relatively higher resistance to antifungal drugs, while both C. gattii and C. neoformans have been recognized as having different degrees of resistance to certain antifungal drugs, such as azoles ( 5 , 6 ). The differences in epidemiology and drug resistance exhibited by C. gattii may be attributable to different pathogenic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

HOG1 has an essential role in the stress response, virulence and pathogenicity of Cryptococcus gattii

Huang

Tao

et al. 2021

Exp Ther Med

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Cryptococcus gattii ( C. gattii ) is a lethal pathogen that causes the majority of cryptococcosis cases in previously healthy individuals. This pathogen poses an increasing threat to global public health, but the mechanisms underlying the pathogenesis have remained to be fully elucidated. In the present study, the role of high-osmolarity glycerol (HOG)1 in the stress reaction and virulence control of C. gattii was characterized by deleting the HOG1 gene using the clinical isolate strain CZ2012, and finally, the virulence and pathogenic traits of the deletion strain were defined. Deletion of the HOG1 gene resulted in notable growth defects under stress conditions (high salt and antifungal drugs), but different traits were observed under oxidative stress conditions (hydrogen peroxide). Similarly, the C. gattii hog1Δ strains (deletion of HOG1 ) also displayed decreased capsule production and melanin synthesis. Furthermore, mice infected with the hog1Δ strain had longer survival times than those infected with the wild-type strain and the reconstituted strain. The hog1Δ strain recovered from infected organs exhibited significant growth defects in terms of decreased colony count and size. The present results suggested that HOG1 has a significant role in the virulence of C. gattii and these results may help to elucidate the pathogenesis of C. gattii .

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Molecular epidemiology and antifungal susceptibility profiles of clinical Cryptococcus neoformans/Cryptococcus gattii species complex

Abstract: The sequences from the isolates determined in current study has been deposited in GenBank under the accession number from MK591061 to MK591074.

Cited by 14 publications

References 47 publications

Molecular typing, in vitro susceptibility and virulence of Cryptococcus neoformans/Cryptococcus gattii species complex clinical isolates from south‐eastern Brazil

Molecular typing, in vitro susceptibility and virulence of Cryptococcus neoformans/Cryptococcus gattii species complex clinical isolates from south‐eastern Brazil

Clinical features and para-clinical findings of cryptococcal meningitis in the North of Iran during 2011-19

HOG1 has an essential role in the stress response, virulence and pathogenicity of Cryptococcus gattii

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