What’s New in Cryptococcus gattii: From Bench to Bedside and Beyond

Beardsley, Justin; Dao, Aiken; Keighley, Caitlin; Garnham, Katherine; Halliday, Catriona; Chen, Sharon C.-A.; Sorrell, Tania C.

doi:10.3390/jof9010041

Cited by 8 publications

(4 citation statements)

References 106 publications

(146 reference statements)

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“…The mechanism of IRIS in HIV negative individuals with C. gattii is incompletely understood [2]. IRIS is hypothesized to occur in this setting when the transient immunosuppression or immune-evasion, attributed to direct effects of cryptococcal capsule components, resolves with successful treatment, leading to an exaggerated inflammatory response and worsening of clinical and/or radiological findings [31][32][33]. In our study, the few individuals with IRIS all had CNS disease including brain cryptococcomas, in keeping with previous studies [1,8].…”

Section: Discussionsupporting

confidence: 87%

Epidemiology, management and outcomes of Cryptococcus gattii infections: A 22-year cohort

et al. 2023

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Background Cryptococcus gattii is a globally endemic pathogen causing disease in apparently immune-competent hosts. We describe a 22-year cohort study from Australia’s Northern Territory to evaluate trends in epidemiology and management, and outcome predictors. Methods A retrospective cohort study of all C. gattii infections at the northern Australian referral hospital 1996–2018 was conducted. Cases were defined as confirmed (culture-positive) or probable. Demographic, clinical and outcome data were extracted from medical records. Results 45 individuals with C. gattii infection were included: 44 Aboriginal Australians; 35 with confirmed infection; none HIV positive out of 38 tested. Multifocal disease (pulmonary and central nervous system) occurred in 20/45 (44%). Nine people (20%) died within 12 months of diagnosis, five attributed directly to C. gattii. Significant residual disability was evident in 4/36 (11%) survivors. Predictors of mortality included: treatment before the year 2002 (4/11 versus 1/34); interruption to induction therapy (2/8 versus 3/37) and end-stage kidney disease (2/5 versus 3/40). Prolonged antifungal therapy was the standard approach in this cohort, with median treatment duration being 425 days (IQR 166–715). Ten individuals had adjunctive lung resection surgery for large pulmonary cryptococcomas (median diameter 6cm [range 2.2-10cm], versus 2.8cm [1.2-9cm] in those managed non-operatively). One died post-operatively, and 7 had thoracic surgical complications, but ultimately 9/10 (90%) treated surgically were cured compared with 10/15 (67%) who did not have lung surgery. Four patients were diagnosed with immune reconstitution inflammatory syndrome which was associated with age <40 years, brain cryptococcomas, high cerebrospinal fluid pressure, and serum cryptococcal antigen titre >1:512. Conclusion C. gattii infection remains a challenging condition but treatment outcomes have significantly improved over 2 decades, with eradication of infection the norm. Adjunctive surgery for the management of bulky pulmonary C. gattii infection appears to increase the likelihood of durable cure and likely reduces the required duration of antifungal therapy.

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Section: Discussionsupporting

confidence: 87%

Epidemiology, management and outcomes of Cryptococcus gattii infections: A 22-year cohort

et al. 2023

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“…Two species complexes of the genus Cryptococcus cause Cryptococcosis: Cryptococcus neoformans and Cryptococcus gattii . Several variants within the Cryptococcus neoformans species complex and C. gattii species complex have been recognized [ 6 , 7 ]. In the case of the Cryptococcus neoformans species complex, there are five main molecular types: VNI, VNII, VNB (collectively known as C. neoformans ), VNIV (known as C. deneoformans ), and VNIII (a hybrid of the two last varieties) [ 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several variants within the Cryptococcus neoformans species complex and C. gattii species complex have been recognized [ 6 , 7 ]. In the case of the Cryptococcus neoformans species complex, there are five main molecular types: VNI, VNII, VNB (collectively known as C. neoformans ), VNIV (known as C. deneoformans ), and VNIII (a hybrid of the two last varieties) [ 6 , 8 ]. In the Cryptococcus gattii species complex, there are six known molecular types: VGI ( C. gattii ), VGII ( C. deuterogattii and subclassified into four genotypes: VGIIa, VGIIb, VGIIc, and VGIId [ 6 , 9 ]), VGIII ( C. bacillisporus ), VGIV ( C. tetragattii ), VGV, and VGVI ( C. decagattii ) [ 6 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…grubii strains (VNI molecular type) are the most widely distributed all over the world. This type has been associated with 99% of infections in HIV patients with cryptococcal meningitis [ 6 , 11 , 12 , 13 ]. In Latin America, this molecular type is not only the principal etiologic agent of Cryptococcosis (~76%) but also the most recovered molecular type from environmental reservoirs (~69%) [ 3 , 5 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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A Landscape of the Genomic Structure of Cryptococcus neoformans in Colombian Isolates

Patiño

Muñoz

Ramírez

et al. 2023

JoF

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Cryptococcus neoformans species complexes are recognized as environmental fungi responsible for lethal meningoencephalitis in immunocompromised individuals. Despite the vast knowledge about the epidemiology and genetic diversity of this fungus in different regions of the world, more studies are necessary to comprehend the genomic profiles across South America, including Colombia, considered to be the second country with the highest number of Cryptococcosis. Here, we sequenced and analyzed the genomic architecture of 29 Colombian C. neoformans isolates and evaluated the phylogenetic relationship of these strains with publicly available C. neoformans genomes. The phylogenomic analysis showed that 97% of the isolates belonged to the VNI molecular type and the presence of sub-lineages and sub-clades. We evidenced a karyotype without changes, a low number of genes with copy number variations, and a moderate number of single-nucleotide polymorphisms (SNPs). Additionally, a difference in the number of SNPs between the sub-lineages/sub-clades was observed; some were involved in crucial fungi biological processes. Our study demonstrated the intraspecific divergence of C. neoformans in Colombia. These findings provide evidence that Colombian C. neoformans isolates do not probably require significant structural changes as adaptation mechanisms to the host. To the best of our knowledge, this is the first study to report the whole genome sequence of Colombian C. neoformans isolates.

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Molecular characterization of clinical and environmental isolates from the Cryptococcus neoformans/C. Gattii species complexes of Maceió, Alagoas, Brazil

de Holanda Fonseca,

Silva,

de Albuquerque Maranhão

2024

Braz J Microbiol

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What’s New in Cryptococcus gattii: From Bench to Bedside and Beyond

Cited by 8 publications

References 106 publications

Epidemiology, management and outcomes of Cryptococcus gattii infections: A 22-year cohort

Epidemiology, management and outcomes of Cryptococcus gattii infections: A 22-year cohort

A Landscape of the Genomic Structure of Cryptococcus neoformans in Colombian Isolates

Molecular characterization of clinical and environmental isolates from the Cryptococcus neoformans/C. Gattii species complexes of Maceió, Alagoas, Brazil

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