Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

Day, Jeremy; Hoang, Thu Nha; Duong, Anh Van; Hong, Chau Tran Thi; Diep, Pham Thi; Campbell, James; Sieu, Tran Phu Manh; Hien, Tran T.; Bui, Tien; Boni, Maciej F.; Lalloo, David G.; Carter, Dee; Baker, Stephen; Farrar, Jeremy

doi:10.1128/jcm.01985-10

Cited by 43 publications

(60 citation statements)

References 51 publications

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“…neoformans var. grubii isolates from HIV-positive and HIV-negative patients in Asia [8], [17], [68], [69]. Therefore, this finding may explain the observed correlation of MLST genotypes and HIV status in our study.…”

Section: Discussionsupporting

confidence: 65%

Geographically Structured Populations of Cryptococcus neoformans Variety grubii in Asia Correlate with HIV Status and Show a Clonal Population Structure

et al. 2013

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Cryptococcosis is an important fungal disease in Asia with an estimated 140,000 new infections annually the majority of which occurs in patients suffering from HIV/AIDS. Cryptococcus neoformans variety grubii (serotype A) is the major causative agent of this disease. In the present study, multilocus sequence typing (MLST) using the ISHAM MLST consensus scheme for the C. neoformans/C. gattii species complex was used to analyse nucleotide polymorphisms among 476 isolates of this pathogen obtained from 8 Asian countries. Population genetic analysis showed that the Asian C. neoformans var. grubii population shows limited genetic diversity and demonstrates a largely clonal mode of reproduction when compared with the global MLST dataset. HIV-status, sequence types and geography were found to be confounded. However, a correlation between sequence types and isolates from HIV-negative patients was observed among the Asian isolates. Observations of high gene flow between the Middle Eastern and the Southeastern Asian populations suggest that immigrant workers in the Middle East were originally infected in Southeastern Asia.

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Section: Discussionsupporting

confidence: 65%

Geographically Structured Populations of Cryptococcus neoformans Variety grubii in Asia Correlate with HIV Status and Show a Clonal Population Structure

et al. 2013

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“…However, the different strains probably also preferentially infect different patient types, perhaps because of innate requirements of different C. gattii strains. Day et al and Varma et al also found that different genetic types of C. neoformans infected immunocompetent and immunocompromised (HIV-infected) persons living in comparable environments and circumstances ( 30 , 31 ); different C. gattii strains might also have predilections for different types of patients. Given the apparent correlation observed in the United States between molecular type of reported C. gattii infections and patient immune status, disentangling these characteristics might be difficult.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcus gattiiInfections in Multiple States Outside the US Pacific Northwest

Harris¹,

Lockhart²,

Sondermeyer³

et al. 2013

Emerg. Infect. Dis.

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Clonal VGII subtypes (outbreak strains) of Cryptococcus gattii have caused an outbreak in the US Pacific Northwest since 2004. Outbreak-associated infections occur equally in male and female patients (median age 56 years) and usually cause pulmonary disease in persons with underlying medical conditions. Since 2009, a total of 25 C. gattii infections, 23 (92%) caused by non–outbreak strain C. gattii, have been reported from 8 non–Pacific Northwest states. Sixteen (64%) patients were previously healthy, and 21 (84%) were male; median age was 43 years (range 15–83 years). Ten patients who provided information reported no past-year travel to areas where C. gattii is known to be endemic. Nineteen (76%) patients had central nervous system infections; 6 (24%) died. C. gattii infection in persons without exposure to known disease-endemic areas suggests possible endemicity in the United States outside the outbreak-affected region; these infections appear to differ in clinical and demographic characteristics from outbreak-associated C. gattii. Clinicians outside the outbreak-affected areas should be aware of locally acquired C. gattii infection and its varied signs and symptoms.

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“…Recent studies from South Korea and Viet- nam have observed a correlation between the immune status of the patient and the genotype of the isolated C. neoformans var. grubii strain (10,14).…”

Section: Discussionmentioning

confidence: 99%

“…Third, it has recently been shown that C. neoformans can produce in vivo diploid offspring from haploid parental isolates, via either cell fusion or endoreplication (15). Thus, a further possibility is that dormant C. neoformans isolates become activated upon immune suppression and that during the course of infection and/or antifungal therapy, C. neoformans cells fuse to form hybrids that are more resistant to the antifungal compounds (14). The recent observation of clinical interspecies hybrids between C. neoformans and C. gattii from clinical sources suggests that these hybrids can be formed in vivo (7,8).…”

Section: Discussionmentioning

confidence: 99%

Extensive Genetic Diversity within the Dutch Clinical Cryptococcus neoformans Population

et al. 2012

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A set of 300 Dutch Cryptococcus neoformans isolates, obtained from 237 patients during 1977 to 2007, was investigated by determining the mating type, serotype, and AFLP and microsatellite genotype and susceptibility to seven antifungal compounds. Almost half of the studied cases were from HIV-infected patients, followed by a patient group of individuals with other underlying diseases and immunocompetent individuals. The majority of the isolates were mating type ␣ and serotype A, followed by ␣D isolates and other minor categories. The most frequently observed genotype was AFLP1, distantly followed by AFLP2 and AFLP3. Microsatellite typing revealed a high genetic diversity among serotype A isolates but a lower diversity within the serotype D set of isolates. One patient was infected by multiple AFLP genotypes. Fluconazole and flucytosine had the highest geometric mean MICs of 2.9 and 3.5 g/ml, respectively, while amphotericin B (0.24 g/ml), itraconazole (0.08 g/ml), voriconazole (0.07 g/ml), posaconazole (0.06 g/ml), and isavuconazole (0.03 g/ml) had much lower geometric mean MICs. One isolate had a high flucytosine MIC (>64 g/ml), while decreased susceptibility (>16 g/ml) for flucytosine and fluconazole was found in 9 and 10 C. neoformans isolates, respectively.

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Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

Abstract: Cryptococcal disease most commonly occurs in patients with an underlying immune deficit, most commonly HIV infection, and is due to Cryptococcus neoformans var.

Cited by 43 publications

References 51 publications

Geographically Structured Populations of Cryptococcus neoformans Variety grubii in Asia Correlate with HIV Status and Show a Clonal Population Structure

Geographically Structured Populations of Cryptococcus neoformans Variety grubii in Asia Correlate with HIV Status and Show a Clonal Population Structure

Cryptococcus gattiiInfections in Multiple States Outside the US Pacific Northwest

Extensive Genetic Diversity within the Dutch Clinical Cryptococcus neoformans Population

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