Molecular epidemiology of Cryptococcus neoformans species complex isolates from HIV-positive and HIV-negative patients in southeast China

Abstract

This study investigated the molecular types of the Cryptococcus neoformans species complex isolates and their clinical manifestations among human immunodeficiency virus (HIV)-positive and HIV-negative patients in southeast China in the past 15 years. The molecular types of 109 isolates from 108 patients were analyzed by the PCR fingerprinting method, sequences of internal transcribed spacers of rDNA (ITS region), and sequences of the capsule-associated gene (CAP59). In HIV-positive patients, clinical isolates were grouped into molecular types VNI (75%, 15/20), VNII (15%, 3/20), and VNIII (10%, 2/20). In HIV-negative patients, the majority of the clinical isolates were grouped into molecular types VNI (72%, 64/89), VNII (13%, 12/89), VGI (12%, 11/89), VNIII (1%, 1/89), and VGII (1%, 1/89). In reference to the mating type of the isolates, 97% (106/109) were of the MATα, 2% (2/109) were of the MATα/-and 1% (1/109) were of the MATα/a. As for the clinical manifestations of the molecular types among the patients, the average cerebrospinal fluid (CSF) pressure of the patients infected by the C. gattii was higher than that of the patients infected by the C. neoformans. These results suggest that both HIVpositive and HIV-negative cryptococcal patients in the southeast of China are mostly infected by the C. neoformans strains. No C. gattii strains were found in HIVpositive patients.

Cryptococcosis in kidney transplant recipients in a Chinese university hospital and a review of published cases

“…Although several previous studies on cryptococcosis have suggested that these infections most often occur in apparently immunocompetent patients, [16][17][18]27,42 separate case reports of cryptococcosis occurring after kidney transplantation have been reported continually since 1982 in China. [28][29][30][31][32][33][34][35][36][37][38][39][40] According to a review of cryptococcosis, approximately 0.76% of cryptococcosis cases are estimated to be associated with kidney transplantation in China.…”

“…Moreover, no kidney transplant recipient with cryptococcosis in this survey was positive for HIV, although approximately 7% of AIDS patients in China are affected by cryptococcosis. 17 Remarkably, all 29 cases in this study were collected from medical center cities. In our opinion, this is because of the relatively high level of kidney transplantation and diagnosis of cryptococcosis in these cities in China.…”

“…of the species complex in China. [15][16][17][18] Similar to the situation in other countries, kidney transplantation is the most common SOT surgery carried out in China. 19 Currently, the 5-year survival rate of kidney transplant recipients in China has reached approximately 87.5% due to improvements in transplantation and other techniques.…”

Antifungal susceptibilities of Cryptococcus species complex isolates from AIDS and non-AIDS patients in Southeast China

“…complex, and they are closely related to basidiomycetous yeasts. 2 3 Cryptococcosis is mainly found in AIDS patients worldwide, but in China it occurs most commonly in non-AIDS patients, and the proportion of non-AIDS patient cases were reportedly between 80.5-91.5%. 4 The declining incidence of cryptococcosis in developed countries can be attributed to effective antiretroviral therapy.…”

Method for identification ofCryptococcus neoformansandCryptococcus gattiiuseful in resource-limited settings

“…grubii (serotype A), C. neoformans var. gattii (serotype B and C) as well as a hybrid (AD) 8. Recently, it has been proposed that the species complex should be reclassified into two distinct species namely C. neoformans (serotypes A, AD and D) and C. gattii (serotype B and C) based on biological and ecological differences, including differences underscored by how the two species interact with immune cells 9.…”