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Chang CC, Harrison TS, Bicanic TA, Chayakulkeeree M, Sorrell TC, Warris A, Hagen F, Spec A, Oladele R, Govender NP, Chen SC, Mody CH, Groll AH, Chen YC, Lionakis MS, Alanio A, Castañeda E, Lizarazo J, Vidal JE, Takazono T, Hoenigl M, Alffenaar JW, Gangneux JP, Soman R, Zhu LP, Bonifaz A, Jarvis JN, Day JN, Klimko N, Salmanton-García J, Jouvion G, Meya DB, Lawrence D, Rahn S, Bongomin F, McMullan BJ, Sprute R, Nyazika TK, Beardsley J, Carlesse F, Heath CH, Ayanlowo OO, Mashedi OM, Queiroz-Telles Filho F, Hosseinipour MC, Patel AK, Temfack E, Singh N, Cornely OA, Boulware DR, Lortholary O, Pappas PG, Perfect JR. Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM. THE LANCET. INFECTIOUS DISEASES 2024; 24:e495-e512. [PMID: 38346436 DOI: 10.1016/s1473-3099(23)00731-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 03/21/2024]
Abstract
Cryptococcosis is a major worldwide disseminated invasive fungal infection. Cryptococcosis, particularly in its most lethal manifestation of cryptococcal meningitis, accounts for substantial mortality and morbidity. The breadth of the clinical cryptococcosis syndromes, the different patient types at-risk and affected, and the vastly disparate resource settings where clinicians practice pose a complex array of challenges. Expert contributors from diverse regions of the world have collated data, reviewed the evidence, and provided insightful guideline recommendations for health practitioners across the globe. This guideline offers updated practical guidance and implementable recommendations on the clinical approaches, screening, diagnosis, management, and follow-up care of a patient with cryptococcosis and serves as a comprehensive synthesis of current evidence on cryptococcosis. This Review seeks to facilitate optimal clinical decision making on cryptococcosis and addresses the myriad of clinical complications by incorporating data from historical and contemporary clinical trials. This guideline is grounded on a set of core management principles, while acknowledging the practical challenges of antifungal access and resource limitations faced by many clinicians and patients. More than 70 societies internationally have endorsed the content, structure, evidence, recommendation, and pragmatic wisdom of this global cryptococcosis guideline to inform clinicians about the past, present, and future of care for a patient with cryptococcosis.
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Affiliation(s)
- Christina C Chang
- Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.
| | - Thomas S Harrison
- Institute of Infection and Immunity, St George's University London, London, UK; Clinical Academic Group in Infection and Immunity, St George's University Hospitals NHS Foundation Trust, London, UK; Medical Research Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Tihana A Bicanic
- Institute of Infection and Immunity, St George's University London, London, UK; Clinical Academic Group in Infection and Immunity, St George's University Hospitals NHS Foundation Trust, London, UK; Medical Research Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Methee Chayakulkeeree
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tania C Sorrell
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia; Department of Infectious Diseases, Westmead Hospital, Westmead, NSW, Australia
| | - Adilia Warris
- Medical Research Centre for Medical Mycology, University of Exeter, Exeter, UK; Department of Infectious Diseases, Great Ormond Street Hospital, London, UK
| | - Ferry Hagen
- Faculty of Science, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, Netherlands; Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Andrej Spec
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Rita Oladele
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - Nelesh P Govender
- Institute of Infection and Immunity, St George's University London, London, UK; Medical Research Centre for Medical Mycology, University of Exeter, Exeter, UK; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sharon C Chen
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia; Department of Infectious Diseases, Westmead Hospital, Westmead, NSW, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Christopher H Mody
- Department of Microbiology, Immunology and Infectious Diseases, Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Andreas H Groll
- Infectious Disease Research Program, and Department of Pediatric Hematology/Oncology, University Children's Hospital, Münster, Germany; Center for Bone Marrow Transplantation, and Department of Pediatric Hematology/Oncology, University Children's Hospital, Münster, Germany
| | - Yee-Chun Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Michail S Lionakis
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology & Microbiology, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Alexandre Alanio
- Institut Pasteur, Centre National de Référence Mycoses Invasives et Antifongiques, Groupe de recherche Mycologie Translationnelle, Département de Mycologie, Université Paris Cité, Paris, France; Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | | | - Jairo Lizarazo
- Department of Internal Medicine, Hospital Universitario Erasmo Meoz, Faculty of Health, Univesidad de Pamplona, Cúcuta, Colombia
| | - José E Vidal
- Departmento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil; Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Takahiro Takazono
- Department of Infectious Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Martin Hoenigl
- Division of Infectious Diseases, Translational Medical Mycology Research Unit, European Confederation of Medical Mycology Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria; BioTechMed, Graz, Austria
| | - Jan-Willem Alffenaar
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jean-Pierre Gangneux
- Institute for Health, Environment and Work Research-Irset, Inserm UMR_S 1085, University of Rennes, Rennes, France; Laboratory for Parasitology and Mycology, Centre National de Référence Mycoses Invasives et Antifongiques LA Asp-C, University Hospital of Rennes, Rennes, France
| | - Rajeev Soman
- Jupiter Hospital, Pune, India; Deenanath Mangeshkar Hospital, Pune, India; Hinduja Hospital, Mumbai, India
| | - Li-Ping Zhu
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai China
| | - Alexandro Bonifaz
- Hospital General de México, Dermatology Service, Mycology section, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Joseph N Jarvis
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Jeremy N Day
- Department of Clinical Microbiology and Infection, Royal Devon and Exeter University Hospital NHS Trust, Exeter, UK
| | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, I Mechnikov North Western State Medical University, Staint Petersburg, Russia
| | - Jon Salmanton-García
- Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf and Excellence Center for Medical Mycology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Partner Site Bonn-Cologne, German Centre for Infection Research, Cologne, Germany
| | - Grégory Jouvion
- Histology and Pathology Unit, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France; Dynamyc Team, Université Paris Est Créteil and Ecole nationale vétérinaire d'Alfort, Créteil, France
| | - David B Meya
- Infectious Diseases Institute, School of Medicine, College of Heath Sciences, Makerere University, Kampala, Uganda
| | - David Lawrence
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Sebastian Rahn
- Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf and Excellence Center for Medical Mycology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Partner Site Bonn-Cologne, German Centre for Infection Research, Cologne, Germany
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Brendan J McMullan
- Discipline of Paediatrics, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Rosanne Sprute
- Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf and Excellence Center for Medical Mycology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Partner Site Bonn-Cologne, German Centre for Infection Research, Cologne, Germany
| | - Tinashe K Nyazika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Justin Beardsley
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia; Department of Infectious Diseases, Westmead Hospital, Westmead, NSW, Australia
| | - Fabianne Carlesse
- Pediatric Department, Federal University of São Paulo, São Paulo, Brazil; Oncology Pediatric Institute-IOP-GRAACC, Federal Univeristy of São Paulo, São Paulo, Brazil
| | - Christopher H Heath
- Department of Microbiology, Fiona Stanley Hospital Network, PathWest Laboratory Medicine, Perth, WA, Australia; Department of Infectious Diseases, Fiona Stanley Hospital, Perth, WA, Australia; UWA Medical School, Internal Medicine, The University of Western Australia, Perth, WA, Australia
| | - Olusola O Ayanlowo
- Dermatology Unit, Department of Medicine, Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria
| | - Olga M Mashedi
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Mina C Hosseinipour
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; UNC Project Malawi, Lilongwe, Malawi
| | - Atul K Patel
- Department of Infectious Diseases, Sterling Hospitals, Ahmedabad, India
| | - Elvis Temfack
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Nina Singh
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oliver A Cornely
- Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf and Excellence Center for Medical Mycology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Partner Site Bonn-Cologne, German Centre for Infection Research, Cologne, Germany; Clinical Trials Centre Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Olivier Lortholary
- Université de Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, Paris, France; Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR 2000, Paris, France
| | - Peter G Pappas
- Mycoses Study Group Central Unit, Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC, USA; Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA.
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Tassaneeyasin T, Eksombatchai D, Chantharit P, Singhsnaeh A, Boonsarngsuk V. A case of naganishial pleuritis in a kidney transplant recipient. Respirol Case Rep 2024; 12:e01304. [PMID: 38404952 PMCID: PMC10885170 DOI: 10.1002/rcr2.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024] Open
Abstract
The Naganishia species is a mycosis, previously classified as a non-neoformans Cryptococcus species. The increased number of naganishial infections occurs predominantly in immunocompromised conditions, especially in people living with HIV with low CD4 cell count, primary immunodeficiencies, and iatrogenic immunosuppression. The lungs can serve as the primary site of infection, leading to various pulmonary manifestations. However, naganishial pleural effusions are unrecognized and challenged in diagnosis because of their presentation, which can mimic tuberculous pleural effusion. Herein, we report the case of a 53-year-old man who had undergone kidney transplantation for more than 2 years and presented with chest tightness and dyspnea. Computed chest tomography demonstrated left pleural nodules and pleural effusion, later confirmed as exudative pleural effusion with a lymphocyte predominance. Pleuroscopy revealed multiple small pleural nodules, and biopsies of these nodules were performed. Naganishia spp. was identified by the 18S rRNA sequencing technique.
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Affiliation(s)
- Tanapat Tassaneeyasin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of MedicineRamathibodi Hospital, Mahidol UniversitySalayaThailand
| | - Dararat Eksombatchai
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of MedicineRamathibodi Hospital, Mahidol UniversitySalayaThailand
| | - Prawat Chantharit
- Division of Infectious Diseases, Department of Medicine, Faculty of MedicineRamathibodi Hospital, Mahidol UniversitySalayaThailand
| | - Arunee Singhsnaeh
- Department of Pathology, Faculty of MedicineRamathibodi Hospital, Mahidol UniversitySalayaThailand
| | - Viboon Boonsarngsuk
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of MedicineRamathibodi Hospital, Mahidol UniversitySalayaThailand
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3
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Fernández Vecilla D, López-Plandolit Antolín S, Blasco Palacio PB, Unzaga Barañano MJ, Díaz de Tuesta Del Arco JL. Corneal abscess caused by Filobasidium uniguttulatum. Case report and literature review on cryptococcal keratitis. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:112-115. [PMID: 38083838 PMCID: PMC10874669 DOI: 10.37201/req/097.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/06/2023] [Accepted: 10/31/2023] [Indexed: 01/28/2024]
Affiliation(s)
- D Fernández Vecilla
- Domingo Fernández Vecilla, Clinical microbiology service. Basurto University Hospital. Bilbao (Biscay). Spain.
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4
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Borman AM, Johnson EM. Changes in fungal taxonomy: mycological rationale and clinical implications. Clin Microbiol Rev 2023; 36:e0009922. [PMID: 37930182 PMCID: PMC10732072 DOI: 10.1128/cmr.00099-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/13/2023] [Indexed: 11/07/2023] Open
Abstract
Numerous fungal species of medical importance have been recently subjected to and will likely continue to undergo nomenclatural changes as a result of the application of molecular approaches to fungal classification together with abandonment of dual nomenclature. Here, we summarize those changes affecting key groups of fungi of medical importance, explaining the mycological (taxonomic) rationale that underpinned the changes and the clinical relevance/importance (where such exists) of the key nomenclatural revisions. Potential mechanisms to mitigate unnecessary taxonomic instability are suggested, together with approaches to raise awareness of important changes to minimize potential clinical confusion.
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Affiliation(s)
- Andrew M. Borman
- UK HSA National Mycology Reference Laboratory, Science Quarter, Southmead Hospital, Bristol, United Kingdom
- Medical Research Council Centre for Medical Mycology (MRC CMM), University of Exeter, Exeter, United Kingdom
| | - Elizabeth M. Johnson
- UK HSA National Mycology Reference Laboratory, Science Quarter, Southmead Hospital, Bristol, United Kingdom
- Medical Research Council Centre for Medical Mycology (MRC CMM), University of Exeter, Exeter, United Kingdom
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Oliveira VFD, Funari AP, Taborda M, Magri ASGK, Levin AS, Magri MMC. Cutaneous Naganishia albida (Cryptococcus albidus) infection: a case report and literature review. Rev Inst Med Trop Sao Paulo 2023; 65:e60. [PMID: 38055378 DOI: 10.1590/s1678-9946202365060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/24/2023] [Indexed: 12/08/2023] Open
Abstract
Naganishia albida (Cryptococcus albidus) is considered saprophytic fungi, and is rarely reported as a human pathogen. Cutaneous infections caused by non-neoformans cryptococcus are rare. We describe a case of an immunocompetent older male with cutaneous cryptococcosis caused by Naganishia albida following skin trauma, and conduct a literature review in PubMed, Lilacs, and Embase. Only six previous similar reports were found. The seven cases (including ours) were widely distributed geographically (Brazil, the US, the UK, Hungary, South Korea, and Iran), all males, and their ages varied, ranging from 14 to 86 years. Four individuals had underlying skin diseases (Sezary Syndrome, psoriasis, and skin rash without etiology) plus potentially immunosuppressive underlying conditions (diabetes mellitus, kidney transplantation, and the use of etanercept, adalimumab, and methylprednisolone). Cutaneous presentation was polymorphic, with lesions characterized as warts, ulcers, plaques, and even macules. Two patients presented disseminated disease. Serum cryptococcal antigen was negative in six patients, and diagnosis was made by fungal culture in all. There is a lack of data on optimal antifungal treatment and outcomes.
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Affiliation(s)
- Vítor Falcão de Oliveira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Infectologia, São Paulo, São Paulo, Brazil
| | - Alexandre Pereira Funari
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Infectologia, São Paulo, São Paulo, Brazil
| | - Mariane Taborda
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Infectologia, São Paulo, São Paulo, Brazil
| | | | - Anna Sara Levin
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Infectologia, São Paulo, São Paulo, Brazil
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Menu E, Filori Q, Dufour JC, Ranque S, L’Ollivier C. A Repertoire of the Less Common Clinical Yeasts. J Fungi (Basel) 2023; 9:1099. [PMID: 37998905 PMCID: PMC10671991 DOI: 10.3390/jof9111099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Invasive fungal diseases are a public health problem. They affect a constantly increasing number of at-risk patients, and their incidence has risen in recent years. These opportunistic infections are mainly due to Candida sp. but less common or rare yeast infections should not be underestimated. These so-called "less common" yeasts include Ascomycota of the genera Candida (excluding the five major Candida species), Magnusiomyces/Saprochaete, Malassezia, and Saccharomyces, and Basidiomycota of the genera Cryptococcus (excluding the Cryptococcus neoformans/gattii complex members), Rhodotorula, and Trichosporon. The aim of this review is to (i) inventory the less common yeasts isolated in humans, (ii) provide details regarding the specific anatomical locations where they have been detected and the clinical characteristics of the resulting infections, and (iii) provide an update on yeast taxonomy. Of the total of 239,890 fungal taxa and their associated synonyms sourced from the MycoBank and NCBI Taxonomy databases, we successfully identified 192 yeasts, including 127 Ascomycota and 65 Basidiomycota. This repertoire allows us to highlight rare yeasts and their tropism for certain anatomical sites and will provide an additional tool for diagnostic management.
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Affiliation(s)
- Estelle Menu
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
| | - Quentin Filori
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Aix Marseille University, 13385 Marseille, France; (Q.F.); (J.-C.D.)
| | - Jean-Charles Dufour
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Aix Marseille University, 13385 Marseille, France; (Q.F.); (J.-C.D.)
- APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l’Information et de la Communication, 13385 Marseille, France
| | - Stéphane Ranque
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
| | - Coralie L’Ollivier
- Laboratoire de Parasitologie-Mycologie, IHU Méditerranée Infection, 13385 Marseille, France; (S.R.); (C.L.)
- Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME: Vecteurs-Infections Tropicales et Méditerranéennes, Aix Marseille Université, 13385 Marseille, France
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Tomazin R, Simčič S, Stopinšek S, Kopitar AN, Kukec A, Matos T, Mulec J. Effects of Anthropogenic Disturbance and Seasonal Variation on Aerobiota in Highly Visited Show Caves in Slovenia. Microorganisms 2023; 11:2381. [PMID: 37894039 PMCID: PMC10608856 DOI: 10.3390/microorganisms11102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Aerosols in caves are natural tracers and, together with climatic parameters, provide a detailed insight into atmospheric conditions, responses to climatic changes and anthropogenic influences in caves. Microbiological air monitoring in show caves is becoming increasingly useful to understand changes in cave ecosystems and to implement and review measures for sustainable cave use and tourism development. In 2017 and 2018, air along tourist trails in caves Postojnska jama and Škocjanske jame (Slovenia) was sampled before and after tourist visits. Samples were analysed using culture-dependent methods, flow cytometry, detection of β-D-glucan and lipopolysaccharide and compared with CO2 and temperature data to measure anthropogenic influences and seasonality on aerobiota. While the presence of tourists significantly increased concentrations of airborne microorganisms (p < 0.05), β-D-glucan and CO2 did not show such a trend and were more dependent on seasonal changes. Locally, concentrations of cultivable microorganisms above 1000 CFU/m3 were detected, which could have negative effects on the autochthonous microbiota and possibly on human health. A mixture of bacteria typically associated with humans was found in the air and identified with MALDI-TOF MS. Using MALDI-TOF MS, we achieved a 69.6% success rate in identification. Micrococcus luteus, Streptococcus mitis, Staphylococcus epidermidis and Moraxella spp. were recognized as good indicators of cave anthropisation.
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Affiliation(s)
- Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia; (R.T.); (S.S.); (A.N.K.); (T.M.)
| | - Saša Simčič
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia; (R.T.); (S.S.); (A.N.K.); (T.M.)
| | - Sanja Stopinšek
- Health Centre Hrastnik, Novi dom 11, SI-1430 Hrastnik, Slovenia;
| | - Andreja Nataša Kopitar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia; (R.T.); (S.S.); (A.N.K.); (T.M.)
| | - Andreja Kukec
- Department of Public Health, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia;
| | - Tadeja Matos
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia; (R.T.); (S.S.); (A.N.K.); (T.M.)
| | - Janez Mulec
- Karst Research Institute, Research Centre of the Slovenian Academy of Sciences and Arts, Titov trg 2, SI-6230 Postojna, Slovenia
- UNESCO Chair on Karst Education, University of Nova Gorica, SI-5271 Vipava, Slovenia
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Kaur H, Gupta P, Pilania R, Suri D, Singh S, Ghosh A, Rudramurthy SM. Trend of pediatric cryptococcosis in a tertiary care centre and review of literature. Indian J Med Microbiol 2022; 43:18-29. [PMID: 36464534 DOI: 10.1016/j.ijmmb.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Cryptococcosis is one of the most significant systemic fungal infections worldwide. Epidemiological data for pediatric cryptococcosis is very limited. Therefore, we planned this study to determine the burden of cryptococcosis in the pediatric population at our tertiary care center and performed review of literature. MATERIAL AND METHODS In this retrospective study, all the patients less than 18 years of age were diagnosed with cryptococcosis, from January 2015-June 2021 were included. Demographic, clinical, and laboratory details of all the patients were noted. Furthermore, PubMed and MedLine databases were comprehensively searched for cases of pediatric cryptococcosis till June 2021. RESULTS Of the total 5420 samples from suspected cryptococcosis cases processed at mycology laboratory, a total of 21 episodes of cryptococcosis (0.39%) were identified in 15 pediatric patients. The majority of the patients were apparently immunocompetent (10/15). Central nervous system (CNS) cryptococcosis was the most common presentation, followed by disseminated disease. All the isolates were identified as Cryptococcus neoformans (formerly referred to as C. neoformans var grubii), except one that was identified as Papiliotrema laurentii (formerly referred to as Cryptococcus laurentii). A standard treatment regimen inclusive of induction and maintenance therapy was provided in only five patients. The literature review revealed a total of 125 studies describing 1134 cases, of which 76.4% are reported from outside Asia, the majority (65.7%) restricted to CNS with C. neoformans as the commonest species. The management profile divulged a significantly higher use of standard drug regimen in Asia as compared to the rest of the world. Mortality of 13.32% was noted worldwide. CONCLUSION To the best of our knowledge, this is the first clinico-epidemiological study of pediatric cryptococcosis from India and the largest retrospective study worldwide. The rising incidence among immunocompetent individuals, especially in Asia, is a matter of concern. Clinical suspicion and early diagnosis are the cornerstones for the management of cases.
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Affiliation(s)
- Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | | | - Rakesh Pilania
- Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepti Suri
- Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surjit Singh
- Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anup Ghosh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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9
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Performance of the Colloidal Gold Immunochromatography of Cryptococcal Antigen on Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Cryptococcosis. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:7876030. [PMID: 35855856 PMCID: PMC9288310 DOI: 10.1155/2022/7876030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Objective This study aimed to investigate the efficacy of the colloidal gold immunochromatography method in the detection of Cryptococcus antigen in bronchoalveolar lavage fluid (BALF) for pulmonary cryptococcosis (PC) diagnosis. Methods A total of 111 patients with clinically suspected PC who were finally diagnosed with nonhuman immunodeficiency virus infection and hospitalized in the Ningbo First Hospital from March 2017 to December 2021 were retrospectively analyzed. All the confirmed cases were divided into two groups as follows: the PC group (33 cases) and the non-PC group (78 cases). All the patients were subjected to serum and BALF cryptococcal capsular polysaccharide antigen-lateral flow immunochromatographic assay (CrAg-LFA) and etiological culturing. Results In the PC group, serum CrAg-LFA was positive for 24 and negative for 9 cases, serum Cryptococcus culture was positive for 1 and negative for 32 cases, BALF CrAg-LFA was positive for 31 and negative for 2 cases, and BALF Cryptococcus culture was positive for 9 and negative for 24 cases. In the non-PC group, serum CrAg-LFA was positive for 1 and negative for 77 cases, serum culture was negative in all the cases, and both BALF CrAg-LFA and culture were negative in all the cases. The sensitivity, specificity, and accuracy of BALF CrAg-LFA for PC diagnosis were 93.9%, 100%, and 98.2%, respectively, whereas those of BALF culture were 27.3%, 100%, and 78.4%, respectively. The sensitivity and accuracy of BALF CrAg-LFA were higher than that of serum CrAg-LFA and BALF etiological culture with statistically significant differences (p < 0.05). Conclusion The diagnostic value of BALF CrAg-LFA for PC is superior to that of serum CrAg-LFA and BALF etiological culture.
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10
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Bive BZ, Sacheli R, Situakibanza Nani-Tuma H, Kabututu Zakayi P, Ka A, Mbula Mambimbi M, Muendele G, Boreux R, Landu N, Nzanzu Mudogo C, M’Buze PR, Moutschen M, Meyer W, Mvumbi Lelo G, Hayette MP. Clinical epidemiology and high genetic diversity amongst Cryptococcus spp. isolates infecting people living with HIV in Kinshasa, Democratic Republic of Congo. PLoS One 2022; 17:e0267842. [PMID: 35587939 PMCID: PMC9119562 DOI: 10.1371/journal.pone.0267842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/14/2022] [Indexed: 11/19/2022] Open
Abstract
Neuromeningeal cryptococcosis (NMC) is a life-threatening opportunistic infection in advanced HIV disease patients (AHDP). It is caused by Cryptococcus spp. complexes and mainly occurs in sub-Saharan Africa. In this study, we performed molecular characterization and antifungal susceptibility profiling of Cryptococcus isolates from AHDP in Kinshasa (DRC). Additionally, we investigated a possible association between NMC severity factors and the Cryptococcus neoformans (Cn) multilocus sequence typing (MLST) profiles. We characterized the isolates using PCR serotyping, MALDI-TOF MS, internal transcribed spacer (ITS) sequencing, and MLST. Susceptibility testing for the major antifungal drugs was performed according to the EUCAST guidelines. Parameters associated with NMC severity, such as hypoglycorrhachia (< 50 mg/dL), increased cerebral spinal fluid opening pressure (> 30 cm H2O), and poor therapeutic outcome were compared with the Cn MLST sequences type (ST). Twenty-three out of 29 Cryptococcus isolates were identified as serotype A using PCR serotyping (79.3%; 95% IC: 65.5-93.1), while six (20.7%; 95% IC: 6.9-34.5) were not serotypable. The 29 isolates were identified by ITS sequencing as follows: Cryptococcus neoformans (23/29, 79.3%), Cutaneotrichosporon curvatus (previously called Cryptococcus curvatus) (5/29, 17.2%), and Papiliotrema laurentii (Cryptococcus laurentii) (1/29, 3.5%). Using the ISHAM MLST scheme, all Cn isolates were identified as molecular type VNI. These comprised seven different STs: ST93 (n = 15), ST5 (n = 2), ST53 (n = 1), ST31 (n = 1), ST4 (n = 1), ST69 (n = 1), and one novel ST that has not yet been reported from other parts of the world and was subsequently assigned as ST659 (n = 2). Of the included strains, only Papiliotrema laurentii was resistant to amphoterin B (1/29, 3.5%), 6.8% (2/29) were resistant to 5-flucytosine (the single Papiliotrema laurentii strain and one Cryptococcus neoformans isolate), and 13.8% (4/29) to fluconazole, including two of five (40%) Cutaneotrichosporon curvatus and two of 23 (8.7%) C. neoformans strains. We found a significative association between poor therapeutic outcome and a non-ST93 sequence type of causative strains (these concerned the less common sequence types: ST53, ST31, ST5, ST4, ST659, and ST69) (87.5% versus 40%, p = 0.02). Molecular analysis of Cryptococcus spp. isolates showed a wide species diversity and genetic heterogenicity of Cn within the VNI molecular type. Furthermore, it is worrying that among included strains we found resistances to several of the commonly used antifungals.
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Affiliation(s)
- Bive Zono Bive
- Faculty of Medicine, Department of Basic Sciences, Molecular Biology Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
- Centre for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Rosalie Sacheli
- Centre for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
- National Reference Centre for Mycosis, University Hospital Centre of Liege, Liege, Belgium
| | - Hippolyte Situakibanza Nani-Tuma
- Faculty of Medicine, Department of Internal Medicine/Department of Tropical Medicine, Infectious Diseases Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
| | - Pius Kabututu Zakayi
- Faculty of Medicine, Department of Basic Sciences, Molecular Biology Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
| | - Alex Ka
- Molecular Mycology Research Laboratory, Faculty of Medicine and Health, Centre for Infectious Diseases and Microbiology, Sydney Medical School, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
| | - Marcel Mbula Mambimbi
- Faculty of Medicine, Department of Internal Medicine/Department of Tropical Medicine, Infectious Diseases Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
| | - Gaultier Muendele
- Internal Medicine Department, Advanced HIV Disease Management Unit, Centre Hospitalier Mère et Enfant de NGABA, Kinshasa, The Democratic Republic of Congo
| | - Raphael Boreux
- Centre for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Nicole Landu
- Internal Medicine Department, Advanced HIV Disease Management Unit, Centre Médical et Evangélique Révérend LUYINDU, Kinshasa, The Democratic Republic of Congo
| | - Celestin Nzanzu Mudogo
- Faculty of Medicine, Department of Basic Sciences, Molecular Biology Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
| | - Pierre-Robert M’Buze
- Internal Medicine Department, Advanced HIV Disease Management Unit, Centre Hospitalier Roi Baudouin 1er, Kinshasa, The Democratic Republic of Congo
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital Centre of Liege, Liege, Belgium
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Faculty of Medicine and Health, Centre for Infectious Diseases and Microbiology, Sydney Medical School, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital-Research and Education Network, Westmead Institute for Medical Research, Sydney, Australia
- Curtin Medical School, Curtin University, Perth, Australia
| | - Georges Mvumbi Lelo
- Faculty of Medicine, Department of Basic Sciences, Molecular Biology Service, University of Kinshasa, Kinshasa, The Democratic Republic of Congo
| | - Marie-Pierre Hayette
- Centre for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
- National Reference Centre for Mycosis, University Hospital Centre of Liege, Liege, Belgium
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11
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Egger M, Hoenigl M, Thompson GR, Carvalho A, Jenks JD. Let's talk about Sex Characteristics - as a Risk Factor for Invasive Fungal Diseases. Mycoses 2022; 65:599-612. [PMID: 35484713 DOI: 10.1111/myc.13449] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/01/2022]
Abstract
Biological sex, which comprises differences in host sex hormone homeostasis and immune responses, can have a substantial impact on the epidemiology of infectious diseases. Comprehensive data on sex distributions in invasive fungal diseases (IFDs) is lacking. In this review we performed a literature search of in vitro/animal studies, clinical studies, systematic reviews, and meta-analyses of invasive fungal infections. Females represented 51.2% of invasive candidiasis cases, mostly matching the proportions of females among the general population in the United States and Europe (>51%). In contrast, other IFDs were overrepresented in males, including invasive aspergillosis (51% males), mucormycosis (60%), cryptococcosis (74%), coccidioidomycosis (70%), histoplasmosis (61%), and blastomycosis (66%). Behavioral variations, as well as differences related to biological sex, may only in part explain these findings. Further investigations concerning the association between biological sex/gender and the pathogenesis of IFDs is warranted.
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Affiliation(s)
- Matthias Egger
- Division of Infectious Diseases, Medical University of Graz, Austria
| | - Martin Hoenigl
- Division of Infectious Diseases, Medical University of Graz, Austria.,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Clinical and Translational Fungal - Working Group, University of California San Diego, La Jolla, CA, USA
| | - George R Thompson
- University of California Davis Center for Valley Fever, California, USA.,Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, California, USA.,Department of Medical Microbiology and Immunology, University of California Davis, California, USA
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's -, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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12
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Gan Z, Liu J, Wang Y, Yang L, Lou Z, Xia H, Li M, Chen Z, Jiang Y, Peng F. Performance of Metagenomic Next-Generation Sequencing for the Diagnosis of Cryptococcal Meningitis in HIV-Negative Patients. Front Cell Infect Microbiol 2022; 12:831959. [PMID: 35531340 PMCID: PMC9069553 DOI: 10.3389/fcimb.2022.831959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Metagenomic next-generation sequencing (mNGS) has been applied more and more widely for the diagnosis of infectious diseases, but its performance in the diagnosis of cryptococcal meningitis (CM) remains unclear. Methods Cerebrospinal fluid (CSF) samples from 197 HIV-negative patients with suspected central nervous system infections were tested simultaneously by mNGS and routine methods [India ink staining, fungal culture, or cryptococcal antigen (CrAg) tests]. The performance of mNGS was evaluated. Results Of the 197 enrolled cases, 46 (23.4%) cases were finally diagnosed with CM, including 43 (93.5%) Cryptococcus neoformans infections and 3 (6.5%) Cryptococcus gattii infections. The sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of mNGS were 93.5% [95% confidence interval (CI) at 86.4%~100.0%], 96.0% (95% CI at 92.9%~99.1%), 87.8%, 98.0%, and 95.4%, respectively. Comparing to the conventional diagnostic methods, the sensitivity and concordance rate of mNGS were slightly lower than those of CrAg tests (97.4%) but higher than those of India ink (63.0%) and culture (76.7%). Besides, mNGS had a sensitivity of 100.0% against culture. It should be noted that mNGS could identify Cryptococcus at species level; C. gattii of the 3 cases was only distinguished by mNGS. Conclusions CSF mNGS can be considered as a supplementary test to diagnose CM and directly distinguish C. gattii from C. neoformans in clinical specimens.
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Affiliation(s)
- Zhouqing Gan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yijie Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lu Yang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng Lou
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Han Xia
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Min Li
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhuolin Chen
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Ying Jiang, ; Fuhua Peng,
| | - Fuhua Peng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Ying Jiang, ; Fuhua Peng,
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13
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Rush RE, Dannemiller KC, Cochran SJ, Haines SR, Acosta L, Divjan A, Rundle AG, Miller RL, Perzanowski MS, Croston TL, Green BJ. Vishniacozyma victoriae (syn. Cryptococcus victoriae) in the homes of asthmatic and non-asthmatic children in New York City. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:48-59. [PMID: 34091598 PMCID: PMC10032026 DOI: 10.1038/s41370-021-00342-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Indoor environments contain a broad diversity of non-pathogenic Basidiomycota yeasts, but their role in exacerbating adverse health effects has remained unclear. OBJECTIVE To understand the role of Vishniacozyma victoriae exposure and its impact on human health. METHODS A qPCR assay was developed to detect and quantify an abundant indoor yeast species, Vishniacozyma victoriae (syn. Cryptococcus victoriae), from homes participating in the New York City Neighborhood Asthma and Allergy Study (NAAS). We evaluated the associations between V. victoriae, housing characteristics, and asthma relevant health endpoints. RESULTS V. victoriae was quantified in 236 of the 256 bedroom floor dust samples ranging from less than 300-45,918 cell equivalents/mg of dust. Higher concentrations of V. victoriae were significantly associated with carpeted bedroom floors (P = 0.044), mean specific humidity (P = 0.004), winter (P < 0.0001) and spring (P = 0.001) seasons, and the presence of dog (P = 0.010) and dog allergen Can f 1 (P = 0.027). V. victoriae concentrations were lower in homes of children with asthma vs. without asthma (P = 0.027), an association observed only among the non-seroatopic children.
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Affiliation(s)
- Rachael E Rush
- Department of Microbiology, Immunology and Cell Biology, West Virginia University, Morgantown, WV, USA
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Karen C Dannemiller
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, USA
| | - Samuel J Cochran
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, USA
- Environmental Sciences Graduate Program, Ohio State University, Columbus, OH, USA
| | - Sarah R Haines
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, USA
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, USA
- Environmental Sciences Graduate Program, Ohio State University, Columbus, OH, USA
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Adnan Divjan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tara L Croston
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Brett J Green
- Office of the Director, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
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14
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Prevalence, Genetic Structure, and Antifungal Susceptibility of the Cryptococcus neoformans/C. gattii Species Complex Strains Collected from the Arboreal Niche in Poland. Pathogens 2021; 11:pathogens11010008. [PMID: 35055956 PMCID: PMC8780472 DOI: 10.3390/pathogens11010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022] Open
Abstract
Fungi belonging to the Cryptococcus neoformans/C. gattii species complex (CNGSC) are etiological agents of serious and not infrequently fatal infections in both humans and animals. Trees are the main ecological niche and source of potential exposition concerning these pathogens. With regard to epidemiology of cryptococcosis, various surveys were performed worldwide, enabling the establishment of a map of distribution and genetic structure of the arboreal population of the CNGSC. However, there are regions, among them Central and Eastern Europe, in which the data are lacking. The present study shows the results of such an environmental study performed in Wrocław, Poland. The CNGSC strains were detected in 2.2% of the tested trees belonging to four genera. The obtained pathogen population consisted exclusively of C. neoformans, represented by both the major molecular type VNI and VNIV. Within the tested group of isolates, resistance to commonly used antimycotics was not found, except for 5-fluorocytosine, in which about 5% of the strains were classified as a non-wild type.
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15
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Zono B, Moutschen M, Situakibanza H, Sacheli R, Muendele G, Kabututu P, Biakabuswa A, Landu N, Mvumbi G, Hayette MP. Comparison of clinical and biological characteristics of HIV-infected patients presenting Cryptococcus neoformans versus C. curvatus/C. laurentii meningitis. BMC Infect Dis 2021; 21:1157. [PMID: 34781895 PMCID: PMC8591831 DOI: 10.1186/s12879-021-06849-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cryptococcal meningitis is mainly caused by Cryptococcus neoformans/C. gattii complex. We compared the clinical, biological, and antifungal susceptibility profiles of isolates from HIV-Infected Patients (HIVIP) with C. neoformans (Cn) versus C. curvatus/C. laurentii (Cc/Cl) meningitis. Methods Comparative analytical study were conducted. Apart from patients’ clinical data, the following analysis were performed and the results were compared in both groups: biochemical examination, cryptococcal antigen test, India ink staining, and culture on Cerebral Spinal Fluid (CSF), strains identification by mass spectrometry, ITS sequencing, PCR serotyping and antifungal susceptibility. The main outcome variable was the “species of Cryptococcus identified”, which was compared to other variables of the same type using the Pearson Chi-square test or the Fisher exact test. Results A total of 23 (79.3%) Cn meningitis cases versus 6 (20.7%) Cc/Cl meningitis were retained.Cn meningitis was more frequently associated with headache (100% vs 50%, p = 0.005) than Cc/Cl meningitis and meningeal signs were more frequent in Cn infected patients. Biologically, hypoglycorrhachia and low CD4 count were more observed in Cn group (90% vs 20% of patients, p = 0.01; 45.6 vs 129.8 cells/µL, p = 0.02, respectively). A higher proportion of Cn strains (91.3%) showed a low Minimum Inhibitory Concentration (MIC) (< 8 mg/L) for fluconazole compared to Cc/Cl strains (66.7%). Also, Cc/Cl strains resistant to 5-flucytosine and amphotericin B were found in 16.7% of cases for each of the two antifungal agents. Cryptococcus detection by routine analysis (India ink, culture, and antigens) was better for Cn samples than Cc/Cl. Except ITS sequencing, which identified all strains of both groups, mass spectrometry and serotyping PCR identified Cn strains better than Cc/Cl (100% vs 80%, p = 0.1; 100% vs 0%, p < 0.0001, respectively). After treatment with amphotericin B, 5-flucytosine, and fluconazole in both groups, the outcome was similar. Conclusions Clinical presentation of Cn meningitis is certainly more severe than that of Cc/Cl meningitis, but Cc/Cl infection should be considered in the management of HIVIP with meningeal syndrome because of the diagnostic difficulty and the high MICs of antifungal agents required for the treatment of meningitis due to these cryptococcal species.
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Affiliation(s)
- Bive Zono
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo. .,Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium.
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital Center of Liege, Liege, Belgium
| | - Hippolyte Situakibanza
- Infectious Diseases Service, Department of Internal Medicine/Department of Tropical Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Rosalie Sacheli
- National Reference Center for Mycosis, University Hospital Center of Liege, Liege, Belgium.,Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
| | - Gaultier Muendele
- Advanced HIV Infection Management Unit, Internal Medicine Department, Centre Hospitalier Mère et Enfant de NGABA, Kinshasa, Democratic Republic of Congo
| | - Pius Kabututu
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Adolphe Biakabuswa
- Advanced HIV Infection Management Unit, Internal Medicine Department, Centre Médical et Evangélique Révérend LUYINDU, Kinshasa, Democratic Republic of Congo
| | - Nicole Landu
- Advanced HIV Infection Management Unit, Internal Medicine Department, Centre Médical et Evangélique Révérend LUYINDU, Kinshasa, Democratic Republic of Congo
| | - Georges Mvumbi
- Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Marie-Pierre Hayette
- National Reference Center for Mycosis, University Hospital Center of Liege, Liege, Belgium.,Center for Interdisciplinary Research on Medicines, University of Liege, Liege, Belgium
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16
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Alves PGV, de Paula Menezes R, de Oliveira Brito M, de Oliveira Faria G, Silva NBS, Cruvinel RS, Penatti MPA, Dos Santos Pedroso R, de Brito Röder DVD. Cryptococcus liquefaciens isolated from the hand of a healthcare professional in a neonatal intensive care unit. Braz J Microbiol 2021; 52:2085-2089. [PMID: 34545554 DOI: 10.1007/s42770-021-00601-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Fungal infections are responsible for high morbidity and mortality in neonatal patients, especially in premature newborns. Infections in neonates caused by Cryptococcus spp. are rare, but it has occurred in an immunocompromised population. This study aims to describe the isolation of Cryptococcus liquefaciens from the hands of a health professional in a neonatal intensive care unit, and to evaluate the production of biofilm and virulence factors and susceptibility to antifungals. Antifungal susceptibility tests were performed according to Clinical and Laboratory Standard Institute document M27-A3. Thermotolerance virulence factors and DNase, phospholipase, proteinase, and hemolytic activities were verified through phenotypic tests; biofilm was evaluated by determining the metabolic activity and biomass. The isolate did not produce any of the tested enzymes and was susceptible to all antifungals (amphotericin B, fluconazole, and micafungin). The growth at 37 °C was very weak; however, the isolate showed a strong biomass production and low metabolic activity. This is the first report of C. liquefaciens isolated from the hands of a health professional. The isolate did not express any of the studied virulence factors in vitro, except for the low growth at 37 °C in the first 48 h, and the strong production of biofilm biomass. Cryptococcus liquefaciens can remain in the environment for a long time and is a human pathogen because it tolerates temperature variations. This report draws attention to the circulation of rare species in critical locations, information that may help in a fast and correct diagnosis and, consequently, implementation of an appropriate treatment.
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Affiliation(s)
- Priscila Guerino Vilela Alves
- Faculty of Medicine, Federal University of Uberlândia, Umuarama Campus, 111 Ave. Amazonas, Uberlândia, Minas Gerais, CEP 38400-902, Brazil
| | | | | | - Gabriel de Oliveira Faria
- Faculty of Medicine, Federal University of Uberlândia, Umuarama Campus, 111 Ave. Amazonas, Uberlândia, Minas Gerais, CEP 38400-902, Brazil.,Nurse in Neonatology, Hospital Santa Clara, Uberlândia, Minas Gerais, Brazil
| | | | - Renner Soares Cruvinel
- Institute of Biology, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Reginaldo Dos Santos Pedroso
- Faculty of Medicine, Federal University of Uberlândia, Umuarama Campus, 111 Ave. Amazonas, Uberlândia, Minas Gerais, CEP 38400-902, Brazil. .,Technical School of Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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17
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Francisco EC, de Jong AW, Hagen F. Cryptococcosis and Cryptococcus. Mycopathologia 2021; 186:729-731. [PMID: 34224075 PMCID: PMC8536568 DOI: 10.1007/s11046-021-00577-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Elaine Cristina Francisco
- Laboratório Especial de Micologia, Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, Utrecht, 3584CT, The Netherlands
| | - Auke W de Jong
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, Utrecht, 3584CT, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, Utrecht, 3584CT, The Netherlands.
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Oliveira LSDS, Pinto LM, de Medeiros MAP, Toffaletti DL, Tenor JL, Barros TF, Neves RP, Neto RGDL, Milan EP, Padovan ACB, Rocha WPDS, Perfect JR, Chaves GM. Comparison of Cryptococcus gattii/ neoformans Species Complex to Related Genera ( Papiliotrema and Naganishia) Reveal Variances in Virulence Associated Factors and Antifungal Susceptibility. Front Cell Infect Microbiol 2021; 11:642658. [PMID: 34277464 PMCID: PMC8281300 DOI: 10.3389/fcimb.2021.642658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
Cryptococcosis is an infectious disease of worldwide distribution, caused by encapsulated yeasts belonging to the phylum Basidiomycota. The genus Cryptococcus includes several species distributed around the world. The C. gattii/neoformans species complex is largely responsible for most cases of cryptococcosis. However, clinical series have been published of infections caused by Papiliotrema (Cryptococcus) laurentii and Naganishia albida (Cryptococcus albidus), among other related genera. Here, we examined the pathogenic potential and antifungal susceptibility of C. gattii/neoformans species complex (clades I and II) and related genera (Papiliotrema and Naganishia) isolated from environmental and clinical samples. P. laurentii (clade III), N. liquefasciens/N. albidosimilis (clade IV); and N. adeliensis/N. albida (clade V) strains produced higher levels of phospholipase and hemolysins, whereas the C. gattii/neoformans species complex strains (clades I and II) had markedly thicker capsules, produced more biofilm biomass and melanin, which are known virulence attributes. Interestingly, 40% of C. neoformans strains (clade II) had MICs above the ECV established for this species to amphotericin B. Several non-C. gattii/neoformans species complex (clades III to V) had MICs equal to or above the ECVs established for C. deuterogattii and C. neoformans for all the three antifungal drugs tested. Finally, all the non-C. gattii/neoformans clinical isolates (clades III to V) produced more melanin than the environmental isolates might reflect their particularly enhanced need for melanin during in vivo protection. It is very clear that C. gattii/neoformans species complex (clades I and II) strains, in general, show more similar virulence phenotypes between each other when compared to non-C. gattii/neoformans species complex (clades III to V) isolates. These observations together with the fact that P. laurentii and Naganishia spp. (clades III to V) strains were collected from the outside of a University Hospital, identify features of these yeasts important for environmental and patient colonization and furthermore, define mechanisms for infections with these uncommon pathogens.
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Affiliation(s)
- Lana Sarita de Souza Oliveira
- Laboratory of Medical and Molecular Mycology, Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Luciana Magalhães Pinto
- Laboratory of Medical and Molecular Mycology, Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Mariana Araújo Paulo de Medeiros
- Laboratory of Medical and Molecular Mycology, Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dena L Toffaletti
- Division of Infectious Disease, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Jennifer L Tenor
- Division of Infectious Disease, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Tânia Fraga Barros
- Department of Clinical and Toxicological Analyses, Federal University of Bahia, Salvador, Brazil
| | | | | | - Eveline Pipolo Milan
- Department of Infectology, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - John R Perfect
- Division of Infectious Disease, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Guilherme Maranhão Chaves
- Laboratory of Medical and Molecular Mycology, Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Brazil
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19
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Yamamura D, Xu J. Update on Pulmonary Cryptococcosis. Mycopathologia 2021; 186:717-728. [PMID: 34181160 DOI: 10.1007/s11046-021-00575-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
Pulmonary cryptococcosis is a common but underdiagnosed opportunistic fungal infection in both immunocompromised and immunocompetent patients. The causal agents include at least eight evolutionary distinct haploid lineages as well as their hybrids of the human pathogenic Cryptococcus complex. In this update, we review recent advances in epidemiology, mode of transmission, risk factors, diagnostic methods, and therapy of pulmonary cryptococcosis. Our review suggests significant challenges and opportunities for research, from bedside to benchside and back to bedside.
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Affiliation(s)
- Deborah Yamamura
- Microbiology Department, Hamilton Regional Laboratory Medicine Program, Hamilton General Hospital, Hamilton, ON, L8L 2X2, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, L8S 4K1, Canada
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, L8S 4K1, Canada.
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20
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Abstract
Cryptococcosis is an invasive fungal infection of global significance caused by yeasts of the genus Cryptococcus. The prevalence of HIV in certain areas of the world and the expanding population of immunocompromised patients contribute to the ongoing global disease burden. Point-of-care serologic testing has allowed for more rapid diagnosis and implementation of screening programs in resource-limited settings. Management involves therapy aimed at reduction in fungal burden, maintenance of intracranial pressure, and optimization of host immunity. Despite diagnostic and therapeutic advances, cryptococcosis continues to be a disease with unacceptably high incidence and mortality, particularly in resource-limited settings.
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Affiliation(s)
- Alexis C Gushiken
- Division of Infectious Diseases, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, MD 21201, USA
| | - Kapil K Saharia
- Division of Infectious Diseases, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, MD 21201, USA
| | - John W Baddley
- Division of Infectious Diseases, Institute of Human Virology, University of Maryland School of Medicine, 725 West Lombard Street, Baltimore, MD 21201, USA.
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21
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van Rhijn N, Bromley M. The Consequences of Our Changing Environment on Life Threatening and Debilitating Fungal Diseases in Humans. J Fungi (Basel) 2021; 7:367. [PMID: 34067211 PMCID: PMC8151111 DOI: 10.3390/jof7050367] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Human activities have significantly impacted the environment and are changing our climate in ways that will have major consequences for ourselves, and endanger animal, plant and microbial life on Earth. Rising global temperatures and pollution have been highlighted as potential drivers for increases in infectious diseases. Although infrequently highlighted, fungi are amongst the leading causes of infectious disease mortality, resulting in more than 1.5 million deaths every year. In this review we evaluate the evidence linking anthropomorphic impacts with changing epidemiology of fungal disease. We highlight how the geographic footprint of endemic mycosis has expanded, how populations susceptible to fungal infection and fungal allergy may increase and how climate change may select for pathogenic traits and indirectly contribute to the emergence of drug resistance.
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Affiliation(s)
| | - Michael Bromley
- Manchester Fungal Infection Group, University of Manchester, Manchester M13 9PL, UK;
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22
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Morales-López SE, Garcia-Effron G. Infections due to Rare Cryptococcus Species. A Literature Review. J Fungi (Basel) 2021; 7:jof7040279. [PMID: 33917243 PMCID: PMC8067992 DOI: 10.3390/jof7040279] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/30/2020] [Accepted: 01/07/2021] [Indexed: 12/23/2022] Open
Abstract
Infections due to rare Cryptococcus species (other than C. neoformans species complex, C. gattii species complex, C. albidus or C. laurentii) are barely reported. The aim of this work is to present a comprehensive literature review of all the papers describing infections due to these species referenced in the main databases (PubMed/MEDLINE, ScienceDirect, Scopus, and Google Scholar). Clinical and epidemiological data together with laboratory findings (identification and antifungal susceptibility) of each isolate were analyzed. Fifty-eight cryptococosis due to rare species were described in 46 papers between 1934-2018. These reports included 16 rare Cryptococcus spp. that were generally associated with nervous system infections and fungemias. Some species are non-capsulated and are not able to grow at 37 °C. Few species were identified by commercially available methods, making internal transcriber spacer (ITS) and D1/D2 regions sequencing mandatory. The most potent antifungal was amphotericin B (although some species showed high MIC values). The studied strains showed high MICs values to 5-fluorocytosine (all >64 µg/mL), echinocandins (all >8 µg/mL), and fluconazole (>80% of the MICs >4 µg/mL). Due to the scarcity of the data and the absence of guidelines for the treatment of these infections, this review could be informative and could help in the diagnosis and treatment of these infections.
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Affiliation(s)
- Soraya E. Morales-López
- Grupo CINBIOS, Programa de Microbiología, Universidad Popular del Cesar, Valledupar 200002, Colombia;
| | - Guillermo Garcia-Effron
- Laboratorio de Micología y Diagnóstico Molecular, Consejo Nacional de Investigaciones Científicas y Tecnológicas, Santa Fe 3000, Argentina
- Cátedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe 3000, Argentina
- Correspondence: ; Tel.: +54-0342-4575209
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23
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Al-Otaibi H, Asadzadeh M, Ahmad S, Al-Sweih N, Joseph L. Papiliotrema laurentii fungemia in a premature, very low-birth-weight neonate in Kuwait successfully treated with liposomal amphotericin B. J Mycol Med 2021; 31:101123. [PMID: 33639444 DOI: 10.1016/j.mycmed.2021.101123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
Papiliotrema laurentii (formerly Cryptococcus laurentii) and Papiliotrema albidus (formerly Cryptococcus albidus) are yeast-like environmental fungi which are largely considered as non-pathogenic to humans. However, invasive infections caused by P. laurentii have recently been reported in some patients with an impaired immune system. Here, we describe the first case of P. laurentii fungemia in a premature, very low-birth-weight neonate in Kuwait and the Middle East. Repeated bloodstream isolates were obtained and were tentatively identified as P. laurentii by Vitek 2 yeast identification system. The identification of the yeast isolates as P. laurentii was confirmed by PCR-sequencing of ribosomal DNA (rDNA). Antifungal susceptibility testing data showed that the isolates were susceptible to amphotericin B, fluconazole and voriconazole but appeared resistant to caspofungin. The baby was successfully treated with liposomal amphotericin B.
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Affiliation(s)
- Hissa Al-Otaibi
- Microbiology Department, Maternity Hospital, Shuwaikh, Kuwait
| | - Mohammad Asadzadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Noura Al-Sweih
- Microbiology Department, Maternity Hospital, Shuwaikh, Kuwait; Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Leena Joseph
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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24
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Pereira TC, de Menezes RT, de Oliveira HC, de Oliveira LD, Scorzoni L. In vitro synergistic effects of fluoxetine and paroxetine in combination with amphotericin B against Cryptococcus neoformans. Pathog Dis 2021; 79:6070654. [PMID: 33417701 DOI: 10.1093/femspd/ftab001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/05/2021] [Indexed: 12/16/2022] Open
Abstract
Cryptococcus neoformans is a yeast that mainly affects immunocompromised individuals and causes meningoencephalitis depending on the immune status of the host. The present study aimed to validate the efficacy of selective serotonin reuptake inhibitors, fluoxetine hydrochloride (FLH) and paroxetine hydrochloride (PAH), alone and in combination with amphotericin B (AmB) against C. neoformans. Susceptibility tests were conducted using the broth microdilution method and synergistic effects of combining FLH and PAH with AmB were analyzed using the checkerboard assay. Effects of minimum inhibitory concentration (MIC) and synergistic concentration were evaluated in biofilms by quantifying the biomass, measuring the viability by counting the colony-forming units (CFU/mL) and examining the size of the induced capsules. Cryptococcus neoformans was susceptible to FLH and PAH and the synergistic effect of FLH and PAH in combination with AmB reduced the MIC of AmB by up to 8-fold. The isolated substances and combination with AmB were able to reduce biofilm biomass and biofilm viability. In addition, FLH and PAH alone or in combination with AmB significantly decreased the size of the yeast capsules. Collectively, our results indicate the use of FLH and PAH as a promising prototype for the development of anti-cryptococcal drugs.
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Affiliation(s)
- Thaís Cristine Pereira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo, 777 São José dos Campos, São Paulo 12245-000, Brazil
| | - Raquel Teles de Menezes
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo, 777 São José dos Campos, São Paulo 12245-000, Brazil
| | - Haroldo Cesar de Oliveira
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Rua Prof. Algacyr Munhoz Mader, 3775 Curitiba, PR 81350-010, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo, 777 São José dos Campos, São Paulo 12245-000, Brazil
| | - Liliana Scorzoni
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo, 777 São José dos Campos, São Paulo 12245-000, Brazil
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25
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Fischer C, Kleinschmidt T. Synthesis of galactooligosaccharides by Cryptococcus laurentii and Aspergillus oryzae using different kinds of acid whey. Int Dairy J 2021. [DOI: 10.1016/j.idairyj.2020.104867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Molecular identification, genotypic heterogeneity and comparative pathogenicity of environmental isolates of Papiliotrema laurentii. J Med Microbiol 2020; 69:1285-1292. [DOI: 10.1099/jmm.0.001254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction.
Papiliotrema laurentii, formerly Cryptococcus laurentii, is typically isolated from environmental sources, but also occasionally from clinical specimens. Other close relatives may be misidentified as P. laurentii by phenotypic methods. P. laurentii usually lacks melanin; however, melanin-forming strains have also been isolated.
Hypothesis/Gap Statement. Although melanin production by encapsulated budding yeasts is considered a major virulence factor, the comparative pathogenicity of melanin-forming and non-melanized environmental strains of P. laurentii has rarely been studied.
Aim. We performed phenotypic and molecular identification and determined the genotypic heterogeneity among P. laurentii isolates. We also studied the pathogenicity of melanin-forming and non-melanized strains in normal and immunosuppressed mice.
Methodology. Eleven environmental isolates were tested for their identity by Vitek2 and/or ID32C systems, and by PCR-sequencing of the internal transcribed spacer (ITS) region and D1/D2 domains of ribosomal DNA (rDNA). Genotypic heterogeneity was studied by sequence comparisons. The pathogenicity of melanized and non-melanized P. laurentii strains was studied in intravenously infected normal and immunosuppressed BALB/c mice.
Results. Phenotypic methods identified seven of the environmental isolates, while PCR-sequencing of the ITS region and D1/D2 domains of rDNA detected two and five isolates, respectively, as P. laurentii. Sequence comparisons demonstrated genotypic heterogeneity among P. laurentii. The remaining four environmental isolates yielded expected results. None of the normal mice infected with 105 cells of melanized/non-melanized P. laurentii strains died. Infection of immunosuppressed mice with 107 cells caused higher mortality with non-melanized P. laurentii, while viable counts in brain/lung tissue were higher in mice infected with a melanized strain and were detectable for up to 14 days.
Conclusion. Phenotypic methods lacked specificity, but PCR-sequencing of D1/D2 domains correctly identified P. laurentii and sequence comparisons demonstrated the genotypic heterogeneity of the isolates. Both melanized and non-melanized strains at a higher dose caused mortality in immunosuppressed mice and persisted in brain/lung tissue up to 14 days post-infection.
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27
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Cano EJ, Yetmar ZA, Razonable RR. Cryptococcus Species Other Than Cryptococcus neoformans and Cryptococcus gattii: Are They Clinically Significant? Open Forum Infect Dis 2020; 7:ofaa527. [PMID: 33324722 PMCID: PMC7717158 DOI: 10.1093/ofid/ofaa527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Background Cryptococcus spp is a major cause of opportunistic infections in immunocompromised patients, primarily due to Cryptococcus neoformans and Cryptococcus gattii. There are occasional reports of other Cryptococcus species causing invasive human disease. However, their epidemiology and clinical significance are not fully defined. We sought to describe cases with cultures positive for Cryptococcus species other than C neoformans and C gattii. Methods A retrospective descriptive analysis of clinical and laboratory data of patients with cultures growing Cryptococcus species other than C neoformans and C gattii from November 2011 to February 2019 was performed. Three Mayo Clinic sites in Arizona, Florida, and Minnesota were included. Results From 176 cases with a culture growing Cryptococcus spp, 54 patients (30%) had a culture for Cryptococcus other than C neoformans and C gattii in the study time frame. The most common species were Cryptococcus magnus, Cryptococcus laurentii, and Cryptococcus ater. The organisms were isolated and identified in culture of bronchoalveolar lavage (11), skin (11), urine (7), oral (4), sinus (3), intraoperative soft tissue (3), sputum (2), synovial fluid (2), cerebrospinal fluid (2), and intravenous catheter (2), among others (7). Only 8 (15%) cases were considered to be potentially pathogenic, with 1 case of invasive disease. Antifungal treatment was fluconazole, itraconazole, and griseofulvin, for a mean systemic antifungal duration of 42 days. Conclusions This large series of patients with Cryptococcus spp other than C neoformans and C gattii suggests that these species rarely cause clinically significant infection in humans. Only 1 case of invasive disease was found.
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Affiliation(s)
- Edison J Cano
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Zachary A Yetmar
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
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Rare Invasive Yeast Infections in Greek Neonates and Children, a Retrospective 12-Year Study. J Fungi (Basel) 2020; 6:jof6040194. [PMID: 32998455 PMCID: PMC7711555 DOI: 10.3390/jof6040194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
Although Candida species remain the leading cause of invasive fungal infections (IFI), the list of other isolated fungal pathogens is increasing. The aim of the study was to report cases of IFI caused by rare yeasts in the largest tertiary Greek pediatric hospital. A retrospective study was performed from 6/2008–6/2020 regarding IFI caused by rare species. Identification of isolates was attained by conventional, molecular, and MALDI TOF MS methods, and susceptibility testing was performed according to the Clinical and Laboratory Standards (CLSI) methodology. During a 12-year period, 14 different rare fungal species in 33 neonates and children with IFI hospitalized in intensive care and oncology units were isolated from blood, central catheters, peritoneal, pleural, or pericardial fluid specimens. It is the first time for IFI caused by Wickerhamomyces anomalus (Candida pelliculosa), Pichia fermentans (Candida lambica), Yarrowia (Candida) lipolytica, Pichia (Hansenula) kluyveri, Rhodotorula mucilaginosa, Wickerhamiella (Candida) pararugosa and Cyberlindnera (Candida) fabianii in Greek neonates and children to be reported. For most of these rare fungal species isolated in the present study, no official antifungal breakpoints have been defined, and there are no guidelines for their treatment. Clinical laboratories should be aware of uncommon and emerging yeast pathogens and be able to detect them with molecular and proteomic methods.
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29
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Huang H, Pan J, Yang W, Lin J, Han Y, Lan K, Zeng L, Liang G, Liu J. First case report of Cryptococcus laurentii knee infection in a previously healthy patient. BMC Infect Dis 2020; 20:681. [PMID: 32943003 PMCID: PMC7500548 DOI: 10.1186/s12879-020-05401-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/08/2020] [Indexed: 11/12/2022] Open
Abstract
Background The purpose of this case report was to report a case of Cryptococcus laurentii infection in the left knee of a previously healthy 29 year old male patient. Case presentation After an initial misdiagnosis and 7 months of failed treatment, the patient received nearly a month of treatment with voriconazole (200 mg IV q12 h) and knee irrigation with amphotericin B until the infection was controlled. The treatment continued with fluconazole for nearly 7 months and approximately 5 weeks of antibiotic treatment for a skin bacterial coinfection. In the end, the patient’s symptoms disappeared completely, the left knee recovered well, and there was no recurrence of infection. Conclusion The key points of successful treatment in this case were the thorough debridement, the adequate course of knee irrigation with antifungal drugs and more than 6 months of oral antifungal drugs that were able to eradicate the infection.
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Affiliation(s)
- Hetao Huang
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianke Pan
- Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Weiyi Yang
- Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jiongtong Lin
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanhong Han
- Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kai Lan
- Department of Clinical Laboratory, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Lingfeng Zeng
- Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Guihong Liang
- Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Jun Liu
- Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. .,Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.
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Cryptococcosis in Hematopoietic Stem Cell Transplant Recipients: A Rare Presentation Warranting Recognition. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2020; 2020:3713241. [PMID: 33144899 PMCID: PMC7599392 DOI: 10.1155/2020/3713241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/06/2020] [Accepted: 07/15/2020] [Indexed: 12/18/2022]
Abstract
Cryptococcosis, a life-threatening mycosis caused mainly by Cryptococcus neoformans, appears to be distinctly rare in hematopoietic stem cell transplant (HSCT) recipients. When it occurs, this fungal infection is a major limitation for a successful transplant. This review comprehensively analyses 24 cases, reported in the literature, of patients with haematological malignancies including leukemias, multiple myeloma, and lymphomas, as indication for HSCT, who presented with cryptococcosis after transplantation. Of the 24 cases, 11 each occurred in patients receiving allogeneic and autologous stem cell transplants, from bone marrow, peripheral blood, and umbilical cord blood. HSCT recipients were slightly more often male, and the age of the patients ranged from 12 to 74 years. Antifungal prophylaxis was reported in most cases. Clinical manifestations of cryptococcal disease included more frequently central nervous system involvement followed by fungaemia, disseminated infection, pulmonary cryptococcosis, cerebellitis, and diarrhea. Diagnosis differed depending on the clinical presentation but habitually included cryptococcal antigen assay, India ink, and culture. Notably, not only C. neoformans but also C. albidus, C. terreus, C. laurentii, and C. adeliensis were identified as the causal species, the last two including strains resistant to fluconazole. Amphotericin B, alone or in combination, was the most common antifungal drug used for the treatment of cryptococcosis in HSCT recipients. Due to the small number of cases, it was not possible to establish if mortality rate, which was the same as survival rate, depends on the effect of the immunosuppressive regimen, the site of cryptococcal infection, and/or the antifungal therapy used to control the mycosis. Although uncommon, the recognition of cryptococcal disease in stem cell transplant is essential for a timely and adequate treatment, improved prognosis, reduced morbidity and mortality, and successful transplantation.
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Evaluation of antifungal activity of cinnamaldehyde against Cryptococcus neoformans var. grubii. Folia Microbiol (Praha) 2020; 65:973-987. [PMID: 32617865 DOI: 10.1007/s12223-020-00806-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/18/2020] [Indexed: 12/21/2022]
Abstract
Cryptococcosis is a potentially fatal fungal disease which has aggrandized with the emergence of AIDS and antifungal resistance. The currently used antifungals lack the broad-spectrum activity and result in several toxicities during long treatment regimens. Thus, the present study aims to evaluate the antifungal activity of cinnamaldehyde against Cryptococcus neoformans var. grubii, the etiological agent of the disease. Quantitative and qualitative in vitro fungal susceptibilities were carried out by minimum inhibitory concentration assay, flow cytometric analysis, and confocal microscopy. Micromorphological alterations were studied through scanning electron and light microscopies. "In vivo" antifungal efficacy of cinnamaldehyde was assessed. Cinnamaldehyde showed antifungal activity against C. neoformans in a dose-dependent manner. A concentration of 1.37 mg/mL of cinnamaldehyde was found to be inhibitory and fungicidal while the low concentration (0.68 mg/mL) was found to induce micromorphological changes and formation of giant/titan-like cells in this pathogen. The reparative activity of cinnamaldehyde and its ability to prolong the life even after the advent of cryptococcal meningitis in mice was also noticed. This study suggests potent anti-cryptococcal activity of cinnamaldehyde. Though, it has a couple of limitations like allergy and low bioavailability. However, these problems can be circumvented by developing suitable analogs of the compound. It, therefore, could be used as a therapeutic option against cryptococcosis and cryptococcal meningitis. Moreover, the evaluation of its pharmacokinetic and pharmacodynamic properties is desirable.
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Draft Genome Sequences of Tremellomycetes Strains Isolated from the International Space Station. Microbiol Resour Announc 2020; 9:9/26/e00504-20. [PMID: 32586865 PMCID: PMC7317102 DOI: 10.1128/mra.00504-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The draft genome sequences of six eukaryotic microbial strains belonging to the class Tremellomycetes isolated from the International Space Station were assembled. Further characterization of these sequences will aid in the understanding of the influence of microgravity conditions on these organisms’ potential pathogenicity. The draft genome sequences of six eukaryotic microbial strains belonging to the class Tremellomycetes isolated from the International Space Station were assembled. Further characterization of these sequences will aid in the understanding of the influence of microgravity conditions on these organisms’ potential pathogenicity.
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Rodríguez-Leguizamón G, Coque-Burgos E, Espitia-Castro O, Firacative C. Fatal fungaemia due to Cryptococcus albidus in an elderly diabetic woman presenting with pleural effusion. Rev Inst Med Trop Sao Paulo 2020; 62:e34. [PMID: 32491141 PMCID: PMC7266613 DOI: 10.1590/s1678-9946202062034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
This is a fatal case of fungaemia due to Cryptococcus albidus in an elderly woman with type 2 diabetes mellitus who presented pleural effusion as the only clinical presentation. Not only infections of the pleura are uncommon presentations of pulmonary cryptococcosis, but these infections due to non-C. neoformans species are extremely rare. This report places C. albidus on the growing number of disseminated mycosis-causing agents in diabetic patients.
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Affiliation(s)
- Giovanni Rodríguez-Leguizamón
- Hospital Universitario Mayor-Méderi, Bogotá, Colombia,Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | | | | | - Carolina Firacative
- Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Grupo de Estudios en Microbiología Traslacional y Enfermedades Emergentes, Bogotá, Colombia
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Aboutalebian S, Mahmoudi S, Okhovat A, Khodavaisy S, Mirhendi H. Otomycosis Due to the Rare Fungi Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. Mycopathologia 2020; 185:569-575. [PMID: 32232764 DOI: 10.1007/s11046-020-00439-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/19/2020] [Indexed: 12/19/2022]
Abstract
Otomycosis is a common finding in otorhinolaryngology clinics and is usually caused by species of Candida and Aspergillus, particularly black aspergilli. Meanwhile, other fungi can give rise to this infection, and the identification of these requires accurate methods. Here, we report three cases of otomycosis due to rare fungal pathogens. All the patients were young females, and manipulation of the ear canal was identified as a common potentially predisposing factor. In direct examination, filamentous fungal elements (in one case) and yeast cells (in two other cases) were seen. Culture was positive in all cases. Based on PCR-sequencing of internal transcribed spacers and β-tubulin (for mold isolate), the isolated fungi were identified as Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. By susceptibility testing of the isolates to fluconazole, itraconazole, voriconazole and amphotericin B, the lowest minimum inhibitory concentration values were observed for amphotericin B followed by voriconazole. Patients were successfully treated by a combination of antifungals and corticosteroids with no relapse over the next year, except for the case due to F. magnum, in which, despite partial recovery, a course of relapse was reported in the 1-year follow-up call.
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Affiliation(s)
- Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Mahmoudi
- Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Okhovat
- Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Coelho C, Farrer RA. Pathogen and host genetics underpinning cryptococcal disease. ADVANCES IN GENETICS 2020; 105:1-66. [PMID: 32560785 DOI: 10.1016/bs.adgen.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cryptococcosis is a severe fungal disease causing 220,000 cases of cryptococcal meningitis yearly. The etiological agents of cryptococcosis are taxonomically grouped into at least two species complexes belonging to the genus Cryptococcus. All of these yeasts are environmentally ubiquitous fungi (often found in soil, leaves and decaying wood, tree hollows, and associated with bird feces especially pigeon guano). Infection in a range of animals including humans begins following inhalation of spores or aerosolized yeasts. Recent advances provide fundamental insights into the factors from both the pathogen and its hosts which influence pathogenesis and disease. The complex interactions leading to disease in mammalian hosts have also updated from the availability of better genomic tools and datasets. In this review, we discuss recent genetic research on Cryptococcus, covering the epidemiology, ecology, and evolution of Cryptococcus pathogenic species. We also discuss the insights into the host immune response obtained from the latest genetic modified host models as well as insights from monogenic disorders in humans. Finally we highlight outstanding questions that can be answered in the near future using bioinformatics and genomic tools.
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Affiliation(s)
- Carolina Coelho
- Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, United Kingdom
| | - Rhys A Farrer
- Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, United Kingdom.
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Choe YJ, Blatt DB, Yalcindag A, Geffert SF, Bobenchik AM, Michelow IC. Cryptococcus albidus Fungemia in an Immunosuppressed Child: Case Report and Systematic Literature Review. J Pediatric Infect Dis Soc 2020; 9:100-105. [PMID: 31183496 DOI: 10.1093/jpids/piz039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/17/2019] [Indexed: 12/21/2022]
Abstract
Cryptococcus albidus, synonymous with Naganishia albida, rarely causes opportunistic infection in immunocompromised individuals. Its clinical features, particularly in children, are not well defined. Here, we report a case of C albidus fungemia in an immunosuppressed child; we also present results of a systematic review, for which we searched PubMed, Embase, and Web of Science using the keywords "cryptococcus" and "albidus." Our goal was to describe the spectrum of disease, diagnostic approaches, therapies, and outcomes. We identified 20 cases of invasive infection, only 2 of which involved children, and 7 cases of noninvasive infection. The reports originated in the Americas, Europe, and Asia. Of those with invasive infection, 16 (80%) patients had an underlying chronic disorder or had received immunosuppressive therapy, 8 (40%) had fungemia, and 6 (30%) had a central nervous system infection. The attributable case fatality rate was 40%. C albidus is an opportunistic yeast that can rarely cause life-threatening fungemia and central nervous system infection in individuals of any age, especially those who are immunocompromised.
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Affiliation(s)
- Young June Choe
- Division of Infectious Diseases, Departments of Pediatrics, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
| | - Daniel B Blatt
- Division of Infectious Diseases, Departments of Pediatrics, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
| | - Ali Yalcindag
- Division of Rheumatology, Department of Pediatrics, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
| | - Sara F Geffert
- Division of Infectious Diseases, Departments of Medicine, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
| | - April M Bobenchik
- Division of Infectious Diseases, Departments of Pathology and Laboratory Medicine, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
| | - Ian C Michelow
- Division of Infectious Diseases, Departments of Pediatrics, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence
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Zhang Y, Cooper B, Gui X, Sherer R, Cao Q. Clinical diversity of invasive cryptococcosis in AIDS patients from central China: report of two cases with review of literature. BMC Infect Dis 2019; 19:1003. [PMID: 31775716 PMCID: PMC6882200 DOI: 10.1186/s12879-019-4634-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/13/2019] [Indexed: 01/09/2023] Open
Abstract
Background Although antiretroviral therapy (ART) has greatly improved the prognosis of acquired immunodeficiency syndrome (AIDS) patients globally, opportunistic infections (OIs) are still common in Chinese AIDS patients, especially cryptococcosis. Case presentation We described here two Chinese AIDS patients with cryptococcal infections. Case one was a fifty-year-old male. At admission, he was conscious and oriented, with papulonodular and umbilicated skin lesions, some with ulceration and central necrosis resembling molluscum contagiosum. The overall impression reminded us of talaromycosis: we therefore initiated empirical treatment with amphotericin B, even though the case history of this patient did not support such a diagnosis. On the second day of infusion, the patient complained of intermittent headache, but the brain CT revealed no abnormalities. On the third day, a lumbar puncture was performed. The cerebral spinal fluid (CSF) was turbid, with slightly increased pressure. India ink staining was positive, but the cryptococcus antigen latex agglutination test (CrAgLAT: IMMY, USA) was negative. Two days later, the blood culture showed a growth of Cryptococcus neoformans, and the same result came from the skin culture. We added fluconazole to the patient’s treatment, but unfortunately, he died three days later. Case two was a sixty-four-year-old female patient with mild fever, productive cough, dyspnea upon movement, and swelling in both lower limbs. The patient was empirically put on cotrimoxazole per os and moxifloxacin by infusion. A bronchofibroscopy was conducted with a fungal culture, showing growth of Cryptococcus laurentii colonies. Amphotericin B was started thereafter but discontinued three days later in favor of fluconazole 400 mg/d due to worsening renal function. The patient became afebrile after 72 h of treatment with considerable improvement of other comorbidities and was finally discharged with continuing oral antifungal therapy. Conclusions Our cases illustrate that cryptococcal disease is an important consideration when treating immunocompromised individuals such as AIDS patients. Life threatening meningitis or meningoencephalitis caused by C. neoformansmay still common in these populations and can vary greatly in clinical presentations, especially with regard to skin lesions. Pulmonary cryptococcosis caused by C. laurentii is rare, but should also be considered in certain contexts. Guidelines for its earlier diagnosis, treatment and prophylaxis are needed.
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Affiliation(s)
- Yongxi Zhang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Brian Cooper
- Section of Infectious Diseases and Global Health, University of Chicago, 5841 S. Maryland Avenue, MC5065, Chicago, IL, 60637, USA
| | - Xi'en Gui
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Renslow Sherer
- Section of Infectious Diseases and Global Health, University of Chicago, 5841 S. Maryland Avenue, MC5065, Chicago, IL, 60637, USA
| | - Qian Cao
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
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Perini L, Mogrovejo DC, Tomazin R, Gostinčar C, Brill FHH, Gunde-Cimerman N. Phenotypes Associated with Pathogenicity: Their Expression in Arctic Fungal Isolates. Microorganisms 2019; 7:microorganisms7120600. [PMID: 31766661 PMCID: PMC6955883 DOI: 10.3390/microorganisms7120600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/01/2023] Open
Abstract
Around 85% of the environments on Earth are permanently or seasonally colder than 5 °C. Among those, the poles constitute unique biomes, which harbor a broad variety of microbial life, including an abundance of fungi. Many fungi have an outstanding ability to withstand extreme conditions and play vital ecosystem roles of decomposers as well as obligate or facultative symbionts of many other organisms. Due to their dispersal capabilities, microorganisms from cryosphere samples can be distributed around the world. Such dispersal involves both species with undefined pathogenicity and potentially pathogenic strains. Here we describe the isolation of fungal species from pristine Arctic locations in Greenland and Svalbard and the testing of the expression of characteristics usually associated with pathogenic species, such as growth at 37 °C, hemolytic ability, and susceptibility to antifungal agents. A total of 320 fungal isolates were obtained, and 24 of the most abundant and representative species were further analyzed. Species known as emerging pathogens, like Aureobasidium melanogenum, Naganishia albida, and Rhodotorula mucilaginosa, were able to grow at 37 °C, showed beta-hemolytic activity, and were intrinsically resistant to commonly used antifungals such as azoles and echinocandins. Antifungal resistance screening revealed a low susceptibility to voriconazole in N. albida and Penicillium spp. and to fluconazole in Glaciozyma watsonii and Glaciozyma-related taxon.
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Affiliation(s)
- Laura Perini
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia; (C.G.); (N.G.-C.)
- Correspondence:
| | - Diana C. Mogrovejo
- MicroArctic Research Group, Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Stiegstück 34, 22339 Hamburg, Germany; (D.C.M.); (F.H.H.B.)
| | - Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia;
| | - Cene Gostinčar
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia; (C.G.); (N.G.-C.)
- Lars Bolund Institute of Regenerative Medicine, BGI-Qingdao, Qingdao 266555, China
| | - Florian H. H. Brill
- MicroArctic Research Group, Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Stiegstück 34, 22339 Hamburg, Germany; (D.C.M.); (F.H.H.B.)
| | - Nina Gunde-Cimerman
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia; (C.G.); (N.G.-C.)
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Londero MR, Zanrosso CD, Corso LL, Michelin L, Soldera J. Catheter-related infection due to Papiliotrema laurentii in an oncologic patient: Case report and systematic review. Braz J Infect Dis 2019; 23:451-461. [PMID: 31738886 PMCID: PMC9428202 DOI: 10.1016/j.bjid.2019.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background Papiliotrema laurentii is one of several non-neoformans cryptococci that have rarely been associated with human infection, since it was previously considered saprophyte and thought to be non-pathogenic to humans. Nevertheless, increasing number of reports of human infection have emerged in recent years, mostly in oncologic patients. Aim To report a case of a female patient with pyloric obstructive cancer with a catheter-related Papiliotrema laurentii blood stream infection and systematically review the available evidence on P. laurentii infection in humans. Methods Retrieval of studies was based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library for Systematic Reviews and Opengray.eu. There was no language or date of publication restrictions. The reference lists of the studies retrieved were searched manually. Results The search strategy retrieved 1703 references. In the final analysis, 31 references were included, with the description of 35 cases. Every patient but one had a previous co-morbidity - 48.4 % of patients had a neoplasm. Amphotericin B was the most used treatment and only a single case of resistance to it was reported. Most patients were cured of the infection. Conclusion P. laurentii infection in humans is usually associated to neoplasia and multiple co-morbidities, and amphotericin B seems to be a reliable agent for treatment.
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Clinical significance of nosocomial Cryptococcus laurentii in urine: A case series. Infect Control Hosp Epidemiol 2019; 40:1442-1444. [PMID: 31566144 DOI: 10.1017/ice.2019.263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Syakalima M, Ramatla T, Lubanza N. Opportunistic pathogenic fungi isolated from feces of feral pigeons in Mafikeng, North West Province of South Africa. Vet World 2019; 12:1066-1069. [PMID: 31528034 PMCID: PMC6702576 DOI: 10.14202/vetworld.2019.1066-1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/07/2019] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Pigeon feces are increasingly being implicated in the spread of bacterial pathogens such as Escherichia coli, Campylobacter, Salmonella, Listeria, and Chlamydia. Fungi are rarely investigated except for Cryptococcus that has emerged as an important pathogen in old people and immunosuppressed patients. This study investigated fungi in pigeon feces collected from Mafikeng, the North West Province of South Africa. Materials and Methods: Freshly dropped feces were collected and enriched in phosphate-buffered saline overnight at 48°C and then subcultured on Sabouraud’s dextrose agar and incubated at 48°C for 2 weeks observing any fungal growth from day 2. The growths were picked up, DNA extracted, and polymerase chain reaction was done using the internal transcribed spacer primers. Results: Fungi isolated included: Aspergillus (Aspergillus tubingensis), Cryptococcus (Cryptococcus albidus and Cryptococcus randhawai), Fusarium spp., and Rhodotorula (Rhodotorula mucilaginosa and Rhodotorula kratochvilovae). Most of these isolates are known opportunistic pathogens and have been isolated in clinical conditions elsewhere. Other isolates such as Graphium dubautiae, Myrmecridium schulzeri, Naganishia albida, Paecilomyces lilacinus, and Zygopleurage zygospora were not found to be of any human health significance. Conclusion: We, therefore, concluded that the presence of these opportunistic pathogens is a significant human health risk, especially in the face of the HIV/AIDS pandemic that results in immunosuppression.
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Affiliation(s)
- Michelo Syakalima
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Tsepo Ramatla
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Ngoma Lubanza
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
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Setianingrum F, Rautemaa-Richardson R, Denning DW. Pulmonary cryptococcosis: A review of pathobiology and clinical aspects. Med Mycol 2019; 57:133-150. [PMID: 30329097 DOI: 10.1093/mmy/myy086] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/05/2018] [Indexed: 01/13/2023] Open
Abstract
Pulmonary cryptococcosis is an important opportunistic invasive mycosis in immunocompromised patients, but it is also increasingly seen in immunocompetent patients. The main human pathogens are Cryptococcus neoformans and C. gattii, which have a worldwide distribution. In contrast to cryptococcal meningitis, pulmonary cryptococcosis is still underdiagnosed because of limitations in diagnostic tools. It can mimic lung cancer, pulmonary tuberculosis, bacterial pneumonia, and other pulmonary mycoses both clinically and radiologically. Pulmonary nodules are the most common radiological feature, but these are not specific to pulmonary cryptococcosis. The sensitivity of culture of respiratory samples for Cryptococcus is poor and a positive result may also reflect colonisation. Cryptococcal antigen (CrAg) with lateral flow device is a fast and sensitive test and widely used on serum and cerebrospinal fluid, but sera from patients with pulmonary cryptococcosis are rarely positive in the absence of disseminated disease. Detection of CrAg from respiratory specimens might assist the diagnosis of pulmonary cryptococcosis but there are very few data. Molecular detection techniques such as multiplex reverse transcription polymerase chain reaction (RT-PCR) could also provide better sensitivity but these still require validation for respiratory specimens. The first line of treatment for pulmonary cryptococcosis is fluconazole, or amphotericin B and flucytosine for those with central nervous system involvement. Pulmonary cryptococcosis worsens the prognosis of cryptococcal meningitis. In this review, we summarize the biological aspects of Cryptococcus and provide an update on the diagnosis and management of pulmonary cryptococcosis.
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Affiliation(s)
- Findra Setianingrum
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Parasitology Department, Universitas Indonesia, Jakarta, Indonesia
| | - Riina Rautemaa-Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Mycology Reference Centre Manchester, ECMM Centre of Excellence in Clinical and Laboratory Mycology and Clinical Studies, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Department of Infectious Diseases, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
| | - David W Denning
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
- Department of Infectious Diseases, Wythenshawe Hospital Manchester University NHS Foundation Trust, Manchester, UK
- National Aspergillosis Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Warren WA, Franco-Palacios D, King CS, Shlobin OA, Nathan SD, Katugaha SB, Mani H, Brown AW. A 24-Year-Old Woman With Precipitous Respiratory Failure After Lung Transplantation. Chest 2019. [PMID: 29519311 DOI: 10.1016/j.chest.2017.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
CASE PRESENTATION A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation. Two days after surgery, she developed acute respiratory failure requiring mechanical ventilation. On day 4 of mechanical ventilation, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was initiated for refractory respiratory failure. The following day, she was listed for bilateral lung transplant and was transplanted 4 days later. Following transplantation, she was decannulated from ECMO; however, over the next 12 hours, oxygenation deteriorated requiring reinstitution of VV-ECMO for presumed severe primary graft dysfunction. Despite treatment with broad spectrum antimicrobial coverage with piperacillin/tazobactam, ciprofloxacin, linezolid, micafungin, voriconazole, and ganciclovir, she failed to improve and developed complex bilateral pleural effusions.
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Affiliation(s)
- Whittney A Warren
- Walter Reed National Military Medical Center Department of Pulmonary and Critical Care, Walter Reed Military Medical Center, Bethesda, MD.
| | - Domingo Franco-Palacios
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Christopher S King
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Oksana A Shlobin
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Steven D Nathan
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
| | - Shalika B Katugaha
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA; Infectious Diseases Physicians, Inc., Annandale, VA
| | - Haresh Mani
- Department of Pathology, Inova Fairfax Hospital, Falls Church, VA
| | - A Whitney Brown
- Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA
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Cryptococcus laurentii meningitis in a non-HIV patient. IDCases 2019; 18:e00612. [PMID: 31463196 PMCID: PMC6710230 DOI: 10.1016/j.idcr.2019.e00612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 11/28/2022] Open
Abstract
Cryptococcus species (other than Cryptococcus neoformans) have been labeled as saprophytic and nonpathogenic in immunocompetent individuals in the past. In recent years, infections caused by non-neoformans Cryptococcus species have been recognized. Cryptococcus laurentii is known to be a rare human pathogen. In this case report, we present a 59-year-old man who did not have HIV infection with meningoencephalitis caused by Cryptococcus laurentii. No significant underlying immunosuppressive disorder was found. The only identifiable risk factors were that the patient was a farmer with previous exposure to pigeon droppings. Here, we describe what we believe to be the fifth reported case of meningitis caused by Cryptococcus laurentii.
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Frickmann H, Künne C, Hagen RM, Podbielski A, Normann J, Poppert S, Looso M, Kreikemeyer B. Next-generation sequencing for hypothesis-free genomic detection of invasive tropical infections in poly-microbially contaminated, formalin-fixed, paraffin-embedded tissue samples - a proof-of-principle assessment. BMC Microbiol 2019; 19:75. [PMID: 30961537 PMCID: PMC6454699 DOI: 10.1186/s12866-019-1448-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/28/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The potential of next-generation sequencing (NGS) for hypothesis-free pathogen diagnosis from (poly-)microbially contaminated, formalin-fixed, paraffin embedded tissue samples from patients with invasive fungal infections and amebiasis was investigated. Samples from patients with chromoblastomycosis (n = 3), coccidioidomycosis (n = 2), histoplasmosis (n = 4), histoplasmosis or cryptococcosis with poor histological discriminability (n = 1), mucormycosis (n = 2), mycetoma (n = 3), rhinosporidiosis (n = 2), and invasive Entamoeba histolytica infections (n = 6) were analyzed by NGS (each one Illumina v3 run per sample). To discriminate contamination from putative infections in NGS analysis, mean and standard deviation of the number of specific sequence fragments (paired reads) were determined and compared in all samples examined for the pathogens in question. RESULTS For matches between NGS results and histological diagnoses, a percentage of species-specific reads greater than the 4th standard deviation above the mean value of all 23 assessed sample materials was required. Potentially etiologically relevant pathogens could be identified by NGS in 5 out of 17 samples of patients with invasive mycoses and in 1 out of 6 samples of patients with amebiasis. CONCLUSIONS The use of NGS for hypothesis-free pathogen diagnosis from contamination-prone formalin-fixed, paraffin-embedded tissue requires further standardization.
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Affiliation(s)
- Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Bernhard-Nocht Str. 74, 20359, Hamburg, Germany. .,Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany.
| | - Carsten Künne
- Department of Bioinformatics, Max-Planck Institute for Heart and Lung Research Bad Nauheim, Parkstraße 1, 61231, Bad Nauheim, Germany
| | - Ralf Matthias Hagen
- Department of Preventive Medicine, Bundeswehr Medical Academy, Neuherbergstraße 11, 80937, Munich, Germany
| | - Andreas Podbielski
- Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Jana Normann
- Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Sven Poppert
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland.,Faculty of Medicine, University Basel, Socinstrasse 57, 4051, Basel, Switzerland
| | - Mario Looso
- Department of Bioinformatics, Max-Planck Institute for Heart and Lung Research Bad Nauheim, Parkstraße 1, 61231, Bad Nauheim, Germany
| | - Bernd Kreikemeyer
- Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
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Polymicrobial Keratitis With Cryptococcus curvatus, Candida parapsilosis, and Stenotrophomonas maltophilia After Penetrating Keratoplasty: A Rare Case Report With Literature Review. Eye Contact Lens 2019; 45:e5-e10. [DOI: 10.1097/icl.0000000000000517] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jaiswal K, Singh AK, Mishra S. Mycotic Infections in Bovines: Recent Trends and Insights on Pathogenicity After Post-Industrial Temperature Rise. Fungal Biol 2019. [DOI: 10.1007/978-3-030-18586-2_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Animal Infections: The Role of Fungal Biofilms. Fungal Biol 2019. [DOI: 10.1007/978-3-030-18586-2_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Geddes-McAlister J, Shapiro RS. New pathogens, new tricks: emerging, drug-resistant fungal pathogens and future prospects for antifungal therapeutics. Ann N Y Acad Sci 2018; 1435:57-78. [DOI: 10.1111/nyas.13739] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/19/2018] [Accepted: 03/28/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Jennifer Geddes-McAlister
- Department of Molecular and Cellular Biology; University of Guelph; Guelph Ontario Canada
- Department of Proteomics and Signal Transduction; Max Planck Institute of Biochemistry; Munich Germany
| | - Rebecca S. Shapiro
- Department of Molecular and Cellular Biology; University of Guelph; Guelph Ontario Canada
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