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Kakizaki MIT, Melhem MDESC. CRYPTOCOCCOSIS: A bibliographic narrative review on antifungal resistance. AN ACAD BRAS CIENC 2023; 95:e20220862. [PMID: 37466540 DOI: 10.1590/0001-3765202320220862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/15/2022] [Indexed: 07/20/2023] Open
Abstract
Cryptococcosis is an infectious fungal disease widely studied for its epidemiological importance in the context of public health, given the high morbidity and mortality associated with this invasive fungal infection. Many cases of the disease present clinical resistance and progress to death, even in the presence of antifungal therapy. The prolonged use of triazole drugs to maintain the treatment of cryptococcosis in AIDS patients, can lead to selective pressure from mutant strains, among other resistance mechanisms, justifying the poor clinical evolution of some cases. In this study, a narrative review of the literature on the occurrence of antifungal resistance in cryptococcosis agents was performed. Publications from 2010 to 2022 that address this topic were selected using Google Scholars and Scopus website. Data from the studies were analyzed for the values of minimum inhibitory concentration (MIC) of drugs used in the management of cryptococcosis. The review showed that the highest MIC values occurred for voriconazole, especially against C. neoformans. It is concluded that there is a lack of studies with statistical analysis of the data obtained, in order to provide a better dimensioning of the resistance rates of cryptococcosis agents to different antifungal agents, both in geographical and temporal context.
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Affiliation(s)
- Maria Ismênia T Kakizaki
- Instituto de Assistência Médica ao Servidor Público Estadual: Iamspe, Setor de Oncologia e Hematologia, Rua Pedro de Toledo, 1800, Vila Clementino, 04039-901 São Paulo, SP, Brazil
| | - Marcia DE S C Melhem
- Departmento de Micologia, Associado de pesquisa sênior, Instituto Adolfo Lutz, Av. Dr. Arnaldo, 355, Cerqueira César, 01246-000 São Paulo, SP, Brazil
- Universidade Federal do Mato Grosso do Sul, Departamento de Medicina, Av. Costa e Silva, s/n, Pioneiros, 79070-900 Campo Grande, MS, Brazil
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Taverna CG, Arias BA, Firacative C, Vivot ME, Szusz W, Vivot W, Mazza M, Córdoba SB, Canteros CE. Genotypic Diversity and Antifungal Susceptibility of Clinical Isolates of Cryptococcus Gattii Species Complex from Argentina. Mycopathologia 2023; 188:51-61. [PMID: 36609823 DOI: 10.1007/s11046-022-00705-x] [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: 07/19/2022] [Accepted: 12/24/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study was to determine the genotypic diversity of 22 Cryptococcus gattii species complex clinical isolates from Argentina and to place these genotypes within the diversity of clinical, veterinary and environmental isolates from Latin America. Mating type and antifungal susceptibility of the isolates were also determined. By URA5-RFLP, nine isolates were identified as molecular type VGI, 10 as VGII, one as VGIII and two as VGIV. Multilocus sequence typing (MSLT), following the International Society for Human and Animal Mycology (ISHAM) consensus MLST scheme, was used to determine the genotypic diversity. Our results suggest that, in Argentina, VGI isolates have low genetic diversity, while VGII isolates have high genetic diversity. Both isolates identified as VGIV by URA5-RFLP were genotyped by MLST as belonging to the currently named VGVI clade. From all isolates, eight sequence types (STs) were unique for Argentina, while five STs have been reported already in other countries, being of high interest the genotypes ST20 and ST7 since they belong to the subtypes VGIIa and VGIIb, respectively, which are associated with hypervirulent strains responsible for outbreaks in North America. To note, geographical analysis showed that some genotypes may be associated with some regions in Argentina. Most isolates were MATα, but we are reporting one isolate MATa for the first time in the country. Antifungal susceptibility tests showed that itraconazole, voriconazole and posaconazole had high activity against all isolates, while amphotericin B, fluconazole and 5-fluorocytosine were the least active drugs against all studied isolates.
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Affiliation(s)
- Constanza Giselle Taverna
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Barbara Abigail Arias
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá, Colombia
| | - Matías Ezequiel Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Wanda Szusz
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Walter Vivot
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Mazza
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Susana Beatriz Córdoba
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
| | - Cristina Elena Canteros
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina
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Firacative C, Zuluaga-Puerto N, Guevara J. Cryptococcus neoformans Causing Meningoencephalitis in Adults and a Child from Lima, Peru: Genotypic Diversity and Antifungal Susceptibility. J Fungi (Basel) 2022; 8:jof8121306. [PMID: 36547639 PMCID: PMC9781953 DOI: 10.3390/jof8121306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Cryptococcosis, caused predominantly by Cryptococcus neoformans, is a potentially fatal, opportunistic infection that commonly affects the central nervous system of immunocompromised patients. Globally, this mycosis is responsible for almost 20% of AIDS-related deaths, and in countries like Peru, its incidence remains high, mostly due to the annual increase in new cases of HIV infection. This study aimed to establish the genotypic diversity and antifungal susceptibility of C. neoformans isolates causing meningoencephalitis in 25 adults and a 9-year-old girl with HIV and other risk factors from Lima, Peru. To identify the genotype of the isolates, multilocus sequence typing was applied, and to establish the susceptibility of the isolates to six antifungals, a YeastOne® broth microdilution was used. From the isolates, 19 were identified as molecular type VNI, and seven as VNII, grouped in eight and three sequence types, respectively, which shows that the studied population was highly diverse. Most isolates were susceptible to all antifungals tested. However, VNI isolates were less susceptible to fluconazole, itraconazole and voriconazole than VNII isolates (p < 0.05). This study contributes data on the molecular epidemiology and the antifungal susceptibility profile of the most common etiological agent of cryptococcosis, highlighting a pediatric case, something which is rare among cryptococcal infection.
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Affiliation(s)
- Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia
- Correspondence:
| | | | - José Guevara
- Facultad de Medicina “San Fernando”, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
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Phylogenomic Placement of American Southwest-Associated Clinical and Veterinary Isolates Expands Evidence for Distinct Cryptococcus gattii VGVI. Microorganisms 2022; 10:microorganisms10081681. [PMID: 36014098 PMCID: PMC9412296 DOI: 10.3390/microorganisms10081681] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Whole-genome sequencing has advanced our understanding of the population structure of the pathogenic species complex Cryptococcus gattii, which has allowed for the phylogenomic specification of previously described major molecular type groupings and novel lineages. Recently, isolates collected in Mexico in the 1960s were determined to be genetically distant from other known molecular types and were classified as VGVI. We sequenced four clinical isolates and one veterinary isolate collected in the southwestern United States and Argentina from 2012 to 2021. Phylogenomic analysis groups these genomes with those of the Mexican VGVI isolates, expanding VGVI into a clade and establishing this molecular type as a clinically important population. These findings also potentially expand the known Cryptococcus ecological range with a previously unrecognized endemic area.
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McCabe GA, McHugh JW, Goodwin T, Johnson DF, Fok A, Campbell TG. Ophthalmic manifestations of Cryptococcus gattii species complex: a case series and review of the literature. Int J Ophthalmol 2022; 15:119-127. [PMID: 35047366 DOI: 10.18240/ijo.2022.01.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/25/2021] [Indexed: 12/18/2022] Open
Abstract
AIM To report 4 cases of Cryptococcus gattii (C. gattii) species complex infection with diverse ophthalmic manifestations, and to review the literature to examine pathobiology of disease, classical ophthalmic presentations and outcomes, and treatment modalities for this emerging pathogen. METHODS Cases of C. gattii meningoencephalitis with ophthalmic manifestations were identified via chart review at two institutions in Australia and one institution in the mid-west region of the United States and are reported as a case series. Additionally, a MEDLINE literature review was conducted to identify all reported cases of C. gattii with ophthalmic manifestations from 1990-2020. Cases were reviewed and tabulated, together with our series of patients, in this report. RESULTS Four cases of C. gattii with ophthalmic manifestations are presented; three from Australia and one from the USA. A literature review identified a total of 331 cases of C. gattii with visual sequelae. The majority of cases occurred in immunocompetent individuals. Blurred vision and diplopia were the most common presenting symptoms, with papilloedema the most common sign, reported in 10%-50% of cases. Visual loss was reported in 10%-53% of cases, as compared to rates of visual loss of 1%-9% in C. neoformans infection. Elevated intracranial pressure, cerebrospinal fluid (CSF) fungal burden, and abnormal neurological exam at presentation correlated with poor visual outcomes. The mainstays of treatment are anti-fungal agents and aggressive management of intracranial hypertension with serial lumbar punctures. CSF diversion procedures should be considered for refractory cases. Acetazolamide and mannitol are associated with high complication rates, and adjuvant corticosteroids have demonstrated higher mortality rates; these treatments should be avoided. CONCLUSION Permanent visual loss represents a devastating yet potentially preventable sequelae of C. gattii infection. Intracranial hypertension needs to be recognised early and aggressively managed. Referral to an ophthalmologist/neuro-ophthalmologist in all cases of cryptococcal infection independent of visual symptoms at time of diagnosis is recommended.
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Affiliation(s)
- Grace A McCabe
- Department of Ophthalmology, the Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Jack W McHugh
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55902, USA
| | - Todd Goodwin
- James Cook University, Townsville, Queensland 4811, Australia.,NQ Eye Foundation, Townsville, Queensland 4811, Australia
| | - Douglas F Johnson
- Department of Infectious Disease, the Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Anthony Fok
- Department of Neurology, the Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Thomas G Campbell
- Department of Ophthalmology, the Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia.,NQ Eye Foundation, Townsville, Queensland 4811, Australia.,Centre for Eye Research Australia, East Melbourne, Victoria 3002, Australia.,Ophthalmology, Department of Surgery, the University of Melbourne, Melbourne, Victoria 3010, Australia
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Bellet V, Roger F, Krasteva D, Gouveia T, Drakulovski P, Pottier C, Bertout S. Multilocus sequence typing of strains from the Cryptococcus gattii species complex from different continents. Mycoses 2021; 65:88-96. [PMID: 34726802 DOI: 10.1111/myc.13389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cryptococcus neoformans and Cryptococcus gattii species complexes are pathogens causing cryptococcal meningitis, a fungal infection that leads to death unless treated. Worldwide, it is estimated to kill over 180,000 individuals annually. OBJECTIVES We aim to investigate the molecular diversity of C. gattii isolates from strains isolated from 1995 to the present day from different continents. METHOD In this study, we analysed the molecular diversity by MLST and antifungal susceptibility by using the broth microdilution method according to the CLSI M27-A4 protocol of a total of 26 strains from Cryptococcus gattii species complex from both clinical and environmental sources. RESULTS Genotyping showed that most of the strains (17/26; 65.4%) belonged to serotype B and were distributed between three genotypes: VGI (13/17; 76.5%), VGII (3/17; 17.6%) and VGVI (1/17; 5.9%). The serotype C strains (9/26; 34.6%) were distributed between the VGIII (1/9; 11.1%) and VGIV (8/9; 88.9%) genotypes. The 26 strains belonged to 17 different MLST subtypes, and we highlight four new MLST genotypes (ST553, 554, 555 and 556). The two environmental strains were identified as serotype B and genotype VGI, but were of ST 51 and 154. All isolates have wild-type MIC of fluconazole and flucytosine. Regarding amphotericin B, five VGI strains showed MICs to AMB equal to 1 µg/ml, and according to the ECV for these genotypes, they were considered non-wild-type strains. CONCLUSIONS The current study reveals the genetic diversity and new sequence types among strains from the C. gattii complex species.
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Affiliation(s)
- Virginie Bellet
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Frédéric Roger
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Donika Krasteva
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Tiphany Gouveia
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Pascal Drakulovski
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Cyril Pottier
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
| | - Sébastien Bertout
- UMI 233 IRD-UM INSERM U1175 TransVIHMI, Infections mycosiques et parasitaires liées au VIH, Laboratoire de Parasitologie et de Mycologie Médicale, UFR Pharmacie, Montpellier, France
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Firacative C, Meyer W, Castañeda E. Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group. J Fungi (Basel) 2021; 7:jof7040282. [PMID: 33918572 PMCID: PMC8069395 DOI: 10.3390/jof7040282] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023] Open
Abstract
Cryptococcosis, a potentially fatal mycosis, is caused by members of the Cryptococcus neoformans and Cryptococcus gattii species complexes. In Latin America, cryptococcal meningitis is still an important health threat with a significant clinical burden. Analysis of publicly available molecular data from 5686 clinical, environmental, and veterinary cryptococcal isolates from member countries of the Latin American Cryptococcal Study Group showed that, as worldwide, C. neoformans molecular type VNI is the most common cause of cryptococcosis (76.01%) in HIV-infected people, followed by C. gattii molecular type VGII (12.37%), affecting mostly otherwise healthy hosts. These two molecular types also predominate in the environment (68.60% for VNI and 20.70% for VGII). Among the scarce number of veterinary cases, VGII is the predominant molecular type (73.68%). Multilocus sequence typing analysis showed that, in Latin America, the C. neoformans population is less diverse than the C. gattii population (D of 0.7104 vs. 0.9755). Analysis of antifungal susceptibility data showed the presence of non-wild-type VNI, VGI, VGII, and VGIII isolates in the region. Overall, the data presented herein summarize the progress that has been made towards the molecular epidemiology of cryptococcal isolates in Latin America, contributing to the characterization of the genetic diversity and antifungal susceptibility of these globally spreading pathogenic yeasts.
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Affiliation(s)
- Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
- Correspondence: ; Tel.: +57-1-297-0200 (ext. 3404)
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Research and Education Network Westmead Hospital, Faculty of Medicine and Health, Sydney Medical School-Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, The University of Sydney, Sydney 2145, Australia;
| | - Elizabeth Castañeda
- Grupo de Microbiología, Instituto Nacional de Salud, Bogota 111321, Colombia;
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Mazza M, Davel GO, Refojo N, Taverna CG, Bueno NS, Canteros CE, Córdoba SB, Rivas MC, Joffre MC, Isla G, Abrantes RA, Hevia AI, Toranzo A, Viale M. Effectiveness of the National Quality Control Program in Mycology of Argentina and performance evaluation of participating laboratories. Rev Argent Microbiol 2020; 53:104-109. [PMID: 33010958 DOI: 10.1016/j.ram.2020.06.009] [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: 09/19/2019] [Revised: 05/11/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022] Open
Abstract
The National Quality Control Program in Mycology (PNCCM) of Argentina was established in 1996 to improve the quality of the mycological diagnosis, to help establish and to set up standardized procedures and continuous training of laboratory staff. The aim of this study was to assess the effectiveness of the PNCCM in the 1996-2018 period. Data from the National Mycology Laboratory Network (NMLN) and PNCCM database was used to estimate the increase in the number of controlled laboratories and jurisdictions, the percentage of participation, the improvement in the quality of results and the adherence to the program. Satisfaction surveys were performed to assess user satisfaction. The number of controlled laboratories increased from 29 to 146; participation increased from 49% to 93% and general adherence was 72% in the evaluated period (1996-2018). Improvement in the quality of the results was 15% for low complexity samples; 7% for intermediate complexity samples and 14% for the identification of high complexity strains. Up to 84% of the users consider the PNCCM to be "very good" and 16% "satisfactory". These results show the importance of the PNCCM, which is widely accepted by mycological diagnostic laboratories from Argentina.
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Affiliation(s)
- Mariana Mazza
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina.
| | - Graciela Odelsia Davel
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Nicolás Refojo
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Constanza Giselle Taverna
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Nadia Soledad Bueno
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Cristina Elena Canteros
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Susana Beatriz Córdoba
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - María Cristina Rivas
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - María Cecilia Joffre
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Guillermina Isla
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Ruben Antonio Abrantes
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Alejandra Inés Hevia
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Adriana Toranzo
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
| | - Mariana Viale
- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
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- Mycology Department, INEI (Instituto Nacional de Enfermedades Infecciosas) "Dr. C. G. Malbrán", ANLIS (Administración Nacional de Laboratorios e Institutos de Salud), Avenida Vélez Sarsfield 563, C1282AFF City of Buenos Aires (CABA), Argentina
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Carvajal JG, Alaniz AJ, Carvajal MA, Acheson ES, Cruz R, Vergara PM, Cogliati M. Expansion of the Emerging Fungal Pathogen Cryptococcus bacillisporus Into America: Linking Phylogenetic Origin, Geographical Spread and Population Under Exposure Risk. Front Microbiol 2020; 11:2117. [PMID: 32983073 PMCID: PMC7485214 DOI: 10.3389/fmicb.2020.02117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
In 2018 the fungal pathogen Cryptococcus bacillisporus (AFLP5/VGIII) was isolated for the first time in Chile, representing the only report in a temperate region in South America. We reconstructed the colonization process of C. bacillisporus in Chile, estimating the phylogenetic origin, the potential spread zone, and the population at risk. We performed a phylogenetic analysis of the strain and modeled the environmental niche of the pathogen projecting its potential spread zone into the new colonized region. Finally, we generated risk maps and quantified the people under potential risk. Phylogenetic analysis showed high similarity between the Chilean isolate and two clonal clusters from California, United States and Colombia in South America. The pathogen can expand into all the temperate Mediterranean zone in central Chile and western Argentina, exposing more than 12 million people to this pathogen in Chile. This study has epidemiological and public health implications for the response to a potential C. bacillisporus outbreak, optimizing budgets, routing for screening diagnosis, and treatment implementation.
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Affiliation(s)
- Jorge G Carvajal
- Facultad Tecnológica, Universidad de Santiago de Chile, Santiago, Chile
| | - Alberto J Alaniz
- Facultad de Ingeniería, Universidad de Santiago de Chile, Santiago, Chile
| | - Mario A Carvajal
- Facultad Tecnológica, Universidad de Santiago de Chile, Santiago, Chile
| | - Emily S Acheson
- Department of Geography, The University of British Columbia, Vancouver, BC, Canada
| | - Rodrigo Cruz
- Laboratorio de Micología, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo M Vergara
- Facultad Tecnológica, Universidad de Santiago de Chile, Santiago, Chile
| | - Massimo Cogliati
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
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