1887

Abstract

and are aetiological agents of cryptococcosis, a major opportunistic systemic mycosis of increasing global importance. This study reports the antifungal susceptibility profiles of clinical and environmental isolates of var. , genotype VNI/AFLP1 ( = 246), and serotype B, genotype VGI/AFLP4 ( = 62), originating from patients and environmental sources in north-western India. All of the var. and isolates were mating type α. Using the broth microdilution method, both species were found to be susceptible to the antifungals tested except for two clinical var. isolates that were resistant to 5-flucytosine (MIC >64 µg ml). Data on the geometric mean of MICs revealed that was significantly less susceptible than var. to fluconazole, itraconazole and voriconazole (<0.0001). In addition, the MIC of was twofold higher than that of var. for fluconazole, itraconazole and voriconazole. However, no statistically significant difference in susceptibility of the two species was observed against amphotericin B and 5-flucytosine. Furthermore, the environmental . var. isolates were significantly less susceptible to fluconazole, itraconazole and 5-flucytosine (<0.0001) than the clinical isolates. A continued surveillance of antifungal susceptibility of clinical and environmental strains of and is desirable to monitor the emergence of any resistant strains in order to ensure more successful therapy of cryptococcosis.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.029025-0
2011-07-01
2019-11-17
Loading full text...

Full text loading...

/deliver/fulltext/jmm/60/7/961.html?itemId=/content/journal/jmm/10.1099/jmm.0.029025-0&mimeType=html&fmt=ahah

References

  1. Aller A. I. , Martin-Mazuelos E. , Lozano F. , Gomez-Mateos J. , Steele-Moore L. , Holloway W. J. , Gutiérrez M. J. , Recio F. J. , Espinel-Ingroff A. . ( 2000; ). Correlation of fluconazole MICs with clinical outcome in cryptococcal infection. . Antimicrob Agents Chemother 44:, 1544–1548. [CrossRef].[PubMed]
    [Google Scholar]
  2. Armengou A. , Porcar C. , Mascaró J. , García-Bragado F. . ( 1996; ). Possible development of resistance to fluconazole during suppressive therapy for AIDS-associated cryptococcal meningitis. . Clin Infect Dis 23:, 1337–1338. [CrossRef].[PubMed]
    [Google Scholar]
  3. Berg J. , Clancy C. J. , Nguyen M. H. . ( 1998; ). The hidden danger of primary fluconazole prophylaxis for patients with AIDS. . Clin Infect Dis 26:, 186–187. [CrossRef].[PubMed]
    [Google Scholar]
  4. Birley H. D. , Johnson E. M. , McDonald P. , Parry C. , Carey P. B. , Warnock D. W. . ( 1995; ). Azole drug resistance as a cause of clinical relapse in AIDS patients with cryptococcal meningitis. . Int J STD AIDS 6:, 353–355.[PubMed]
    [Google Scholar]
  5. Byrnes E. J. III , Li W. , Lewit Y. , Ma H. , Voelz K. , Ren P. , Carter D. A. , Chaturvedi V. , Bildfell R. J. et al. ( 2010; ). Emergence and pathogenicity of highly virulent Cryptococcus gattii genotypes in the northwest United States. . PLoS Pathog 6:, e1000850. [CrossRef].[PubMed]
    [Google Scholar]
  6. Calvo B. M. , Colombo A. L. , Fischman O. , Santiago A. , Thompson L. , Lazera M. , Telles F. , Fukushima K. , Nishimura K. et al. ( 2001; ). Antifungal susceptibilities, varieties, and electrophoretic karyotypes of clinical isolates of Cryptococcus neoformans from Brazil, Chile, and Venezuela. . J Clin Microbiol 39:, 2348–2350. [CrossRef].[PubMed]
    [Google Scholar]
  7. Casadevall A. , Perfect J. R. . ( 1998; ). Cryptococcus neoformans. Washington, DC:: American Society for Microbiology;.[CrossRef]
    [Google Scholar]
  8. Chakrabarti A. , Sharma A. , Sood A. , Grover R. , Sakhuja V. , Prabhakar S. , Varma S. . ( 2000; ). Changing scenario of cryptococcosis in a tertiary care hospital in north India. . Indian J Med Res 112:, 56–60.[PubMed]
    [Google Scholar]
  9. Chen S. , Sorrell T. , Nimmo G. , Speed B. , Currie B. , Ellis D. , Marriott D. , Pfeiffer T. , Parr D. et al. ( 2000; ). Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. . Clin Infect Dis 31:, 499–508. [CrossRef].[PubMed]
    [Google Scholar]
  10. CLSI ( 2008; ). Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts, 3rd edn. Approved Standard. M27-A3. Wayne, PA:: Clinical and Laboratory Standards Institute;.
    [Google Scholar]
  11. Costa A. K. , Sidrim J. J. , Cordeiro R. A. , Brilhante R. S. , Monteiro A. J. , Rocha M. F. . ( 2010; ). Urban pigeons (Columba livia) as a potential source of pathogenic yeasts: a focus on antifungal susceptibility of Cryptococcus strains in Northeast Brazil. . Mycopathologia 169:, 207–213. [CrossRef].[PubMed]
    [Google Scholar]
  12. Currie B. P. , Ghannoum M. , Bessen L. , Casadevall A. . ( 1995; ). Decreased fluconazole susceptibility of a relapse Cryptococcus neoformans isolate after fluconazole treatment. . Infect Dis Clin Pract 4:, 318–319. [CrossRef]
    [Google Scholar]
  13. Davey K. G. , Johnson E. M. , Holmes A. D. , Szekely A. , Warnock D. W. . ( 1998; ). In-vitro susceptibility of Cryptococcus neoformans isolates to fluconazole and itraconazole. . J Antimicrob Chemother 42:, 217–220. [CrossRef].[PubMed]
    [Google Scholar]
  14. Fernandes O. de F. L. , Passos X. S. , Souza L. K. H. , Miranda A. T. B. , Cerqueira C. H. P. V. , Silva M. do R. R. . ( 2003; ). In vitro susceptibility characteristics of Cryptococcus neoformans varieties from AIDS patients in Goiânia, Brazil. . Mem Inst Oswaldo Cruz 98:, 839–841.[PubMed] [CrossRef]
    [Google Scholar]
  15. Franzot S. P. , Hamdan J. S. . ( 1996; ). In vitro susceptibilities of clinical and environmental isolates of Cryptococcus neoformans to five antifungal drugs. . Antimicrob Agents Chemother 40:, 822–824.[PubMed]
    [Google Scholar]
  16. Gomez-Lopez A. , Zaragoza O. , Dos Anjos Martins M. , Melhem M. C. , Rodriguez-Tudela J. L. , Cuenca-Estrella M. . ( 2008; ). In vitro susceptibility of Cryptococcus gattii clinical isolates. . Clin Microbiol Infect 14:, 727–730. [CrossRef].[PubMed]
    [Google Scholar]
  17. Hagen F. , Illnait-Zaragozi M. T. , Bartlett K. H. , Swinne D. , Geertsen E. , Klaassen C. H. W. , Boekhout T. , Meis J. F. . ( 2010; ). In vitro antifungal susceptibilities and amplified fragment length polymorphism genotyping of a worldwide collection of 350 clinical, veterinary and environmental Cryptococcus gattii isolates. . Antimicrob Agents Chemother 54:, 5139–5145. [CrossRef].[PubMed]
    [Google Scholar]
  18. Hiremath S. S. , Chowdhary A. , Kowshik T. , Randhawa H. S. , Sun S. , Xu J. . ( 2008; ). Long-distance dispersal and recombination in environmental populations of Cryptococcus neoformans var. grubii from India. . Microbiology 154:, 1513–1524. [CrossRef].[PubMed]
    [Google Scholar]
  19. Iqbal N. , DeBess E. E. , Wohrle R. , Sun B. , Nett R. J. , Ahlquist A. M. , Chiller T. , Lockhart S. R. . for the Cryptococcus gattii Public Health Working Group ( 2010; ). Correlation of genotype and in vitro susceptibilities of Cryptococcus gattii strains from the Pacific Northwest of the United States. . J Clin Microbiol 48:, 539–544. [CrossRef].[PubMed]
    [Google Scholar]
  20. Jain N. , Wickes B. L. , Keller S. M. , Fu J. , Casadevall A. , Jain P. , Ragan M. A. , Banerjee U. , Fries B. C. . ( 2005; ). Molecular epidemiology of clinical Cryptococcus neoformans strains from India. . J Clin Microbiol 43:, 5733–5742. [CrossRef].[PubMed]
    [Google Scholar]
  21. Khan Z. U. , Randhawa H. S. , Kowshik T. , Chowdhary A. , Chandy R. . ( 2007; ). Antifungal susceptibility of Cryptococcus neoformans and Cryptococcus gattii isolates from decayed wood of trunk hollows of Ficus religiosa and Syzygium cumini trees in north-western India. . J Antimicrob Chemother 60:, 312–316. [CrossRef].[PubMed]
    [Google Scholar]
  22. Khan Z. U. , Randhawa H. S. , Chehadeh W. , Chowdhary A. , Kowshik T. , Chandy R. . ( 2009; ). Cryptococcus neoformans serotype A and Cryptococcus gattii serotype B isolates differ in their susceptibilities to fluconazole and voriconazole. . Int J Antimicrob Agents 33:, 559–563. [CrossRef].[PubMed]
    [Google Scholar]
  23. Khanna N. , Chandramuki A. , Desai A. , Ravi V. , Santosh V. , Shankar S. K. , Satishchandra P. . ( 2000; ). Cryptococcosis in the immunocompromised host with special reference to AIDS. . Indian J Chest Dis Allied Sci 42:, 311–315.[PubMed]
    [Google Scholar]
  24. Kidd S. E. , Hagen F. , Tscharke R. L. , Huynh M. , Bartlett K. H. , Fyfe M. , MacDougall L. , Boekhout T. , Kwon-Chung K. J. , Meyer W. . ( 2004; ). A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). . Proc Natl Acad Sci U S A 101:, 17258–17263. [CrossRef].[PubMed]
    [Google Scholar]
  25. Kwon-Chung K. J. , Boekhout T. , Fell J. W. , Diaz M. . ( 2002; ). Proposal to conserve the name Cryptocoocus gattii against C. hondurianus and C. bacillisporus (Basidiomycota, Hymenomycetes, Tremellomycetidae). . Taxon 51:, 804–806. [CrossRef]
    [Google Scholar]
  26. Lakshmi V. , Sudha T. , Teja V. D. , Umabala P. . ( 2007; ). Prevalence of central nervous system cryptococcosis in human immunodeficiency virus reactive hospitalized patients. . Indian J Med Microbiol 25:, 146–149. [CrossRef].[PubMed]
    [Google Scholar]
  27. Meyer W. , Marszewska K. , Amirmostofian M. , Igreja R. P. , Hardtke C. , Methling K. , Viviani M. A. , Chindamporn A. , Sukroongreung S. et al. ( 1999; ). Molecular typing of global isolates of Cryptococcus neoformans var. neoformans by polymerase chain reaction fingerprinting and randomly amplified polymorphic DNA – a pilot study to standardize techniques on which to base a detailed epidemiological survey. . Electrophoresis 20:, 1790–1799. [CrossRef].[PubMed]
    [Google Scholar]
  28. Meyer W. , Aanensen D. M. , Boekhout T. , Cogliati M. , Diaz M. R. , Esposto M. C. , Fisher M. , Gilgado F. , Hagen F. et al. ( 2009; ). Consensus multi-locus sequence typing scheme for Cryptococcus neoformans and Cryptococcus gattii . . Med Mycol 47:, 561–570. [CrossRef].[PubMed]
    [Google Scholar]
  29. Mitchell D. H. , Sorrell T. C. , Allworth A. M. , Heath C. H. , McGregor A. R. , Papanaoum K. , Richards M. J. , Gottlieb T. . ( 1995; ). Cryptococcal disease of the CNS in immunocompetent hosts: influence of cryptococcal variety on clinical manifestations and outcome. . Clin Infect Dis 20:, 611–616. [CrossRef].[PubMed]
    [Google Scholar]
  30. Moraes E. M. , Prímola N. S. , Hamdan J. S. . ( 2003; ). Antifungal susceptibility of clinical and environmental isolates of Cryptococcus neoformans to four antifungal drugs determined by two techniques. . Mycoses 46:, 164–168. [CrossRef].[PubMed]
    [Google Scholar]
  31. Morgan J. , McCarthy K. M. , Gould S. , Fan K. , Arthington-Skaggs B. , Iqbal N. , Stamey K. , Hajjeh R. A. , Brandt M. E. . Gauteng Cryptococcal Surveillance Initiative Group ( 2006; ). Cryptococcus gattii infection: characteristics and epidemiology of cases identified in a South African province with high HIV seroprevalence, 2002–2004. . Clin Infect Dis 43:, 1077–1080. [CrossRef].[PubMed]
    [Google Scholar]
  32. Orni-Wasserlauf R. , Izkhakov E. , Siegman-Igra Y. , Bash E. , Polacheck I. , Giladi M. . ( 1999; ). Fluconazole-resistant Cryptococcus neoformans isolated from an immunocompetent patient without prior exposure to fluconazole. . Clin Infect Dis 29:, 1592–1593. [CrossRef].[PubMed]
    [Google Scholar]
  33. Paugam A. , Dupouy-Camet J. , Blanche P. , Gangneux J. P. , Tourte-Schaefer C. , Sicard D. . ( 1994; ). Increased fluconazole resistance of Cryptococcus neoformans isolated from a patient with AIDS and recurrent meningitis. . Clin Infect Dis 19:, 975–976. [CrossRef].[PubMed]
    [Google Scholar]
  34. Perfect J. R. , Dismukes W. E. , Dromer F. , Goldman D. L. , Graybill J. R. , Hamill R. J. , Harrison T. S. , Larsen R. A. , Lortholary O. et al. ( 2010; ). Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. . Clin Infect Dis 50:, 291–322. [CrossRef].[PubMed]
    [Google Scholar]
  35. Randhawa H. S. , Kowshik T. , Preeti Sinha K. , Chowdhary A. , Khan Z. U. , Yan Z. , Xu J. , Kumar A. . ( 2006; ). Distribution of Cryptococcus gattii and Cryptococcus neoformans in decayed trunk wood of Syzygium cumini trees in north-western India. . Med Mycol 44:, 623–630. [CrossRef].[PubMed]
    [Google Scholar]
  36. Randhawa H. S. , Kowshik T. , Chowdhary A. , Preeti Sinha K. , Khan Z. U. , Sun S. , Xu J. . ( 2008; ). The expanding host tree species spectrum of Cryptococcus gattii and Cryptococcus neoformans and their isolations from surrounding soil in India. . Med Mycol 46:, 823–833. [CrossRef].[PubMed]
    [Google Scholar]
  37. Scholer H. J. , Polak A. . ( 1984; ). Resistance to systemic antifungal agents. . In Antimicrobial Drug Resistance, pp. 393–460. Edited by Bryan L. E. . . Orlando, FL:: Academic Press;.
    [Google Scholar]
  38. Soares M. C. , Paula C. R. , Dias A. L. , Caseiro M. M. , Costa S. O. . ( 2005; ). Environmental strains of Cryptococcus neoformans variety grubii in the city of Santos, SP, Brazil. . Rev Inst Med Trop Sao Paulo 47:, 31–36.[PubMed] [CrossRef]
    [Google Scholar]
  39. Souza L. K. , Fernandes O. de F. L. , Kobayashi C. C. , Passos X. S. , Costa C. R. , Lemos J. A. , Souza-Júnior A. H. , Silva M. do R. R. . ( 2005; ). Antifungal susceptibilities of clinical and environmental isolates of Cryptococcus neoformans in Goiânia city, Goiás, Brazil. . Rev Inst Med Trop Sao Paulo 47:, 253–256.[PubMed] [CrossRef]
    [Google Scholar]
  40. Speed B. , Dunt D. . ( 1995; ). Clinical and host differences between infections with the two varieties of Cryptococcus neoformans . . Clin Infect Dis 21:, 28–34, discussion 35–36. [CrossRef].[PubMed]
    [Google Scholar]
  41. Tay S. T. , Tanty Haryanty T. , Ng K. P. , Rohani M. Y. , Hamimah H. . ( 2006; ). In vitro susceptibilities of Malaysian clinical isolates of Cryptococcus neoformans var. grubii and Cryptococcus gattii to five antifungal drugs. . Mycoses 49:, 324–330. [CrossRef].[PubMed]
    [Google Scholar]
  42. Thakur R. , Sarma S. , Kushwaha S. . ( 2008; ). Prevalence of HIV-associated cryptococcal meningitis and utility of microbiological determinants for its diagnosis in a tertiary care center. . Indian J Pathol Microbiol 51:, 212–214. [CrossRef].[PubMed]
    [Google Scholar]
  43. Thompson G. R. III , Wiederhold N. P. , Fothergill A. W. , Vallor A. C. , Wickes B. L. , Patterson T. F. . ( 2009; ). Antifungal susceptibilities among different serotypes of Cryptococcus gattii and Cryptococcus neoformans . . Antimicrob Agents Chemother 53:, 309–311. [CrossRef].[PubMed]
    [Google Scholar]
  44. Trilles L. , Fernández-Torres B. , Lazéra M. dos S. , Wanke B. , Guarro J. . ( 2004; ). In vitro antifungal susceptibility of Cryptococcus gattii . . J Clin Microbiol 42:, 4815–4817. [CrossRef].[PubMed]
    [Google Scholar]
  45. van Duin D. , Cleare W. , Zaragoza O. , Casadevall A. , Nosanchuk J. D. . ( 2004; ). Effects of voriconazole on Cryptococcus neoformans . . Antimicrob Agents Chemother 48:, 2014–2020. [CrossRef].[PubMed]
    [Google Scholar]
  46. Varma A. , Kwon-Chung K. J. . ( 2010; ). Heteroresistance of Cryptococcus gattii to fluconazole. . Antimicrob Agents Chemother 54:, 2303–2311. [CrossRef].[PubMed]
    [Google Scholar]
  47. Witt M. D. , Lewis R. J. , Larsen R. A. , Milefchik E. N. , Leal M. A. , Haubrich R. H. , Richie J. A. , Edwards J. E. Jr , Ghannoum M. A. . ( 1996; ). Identification of patients with acute AIDS-associated cryptococcal meningitis who can be effectively treated with fluconazole: the role of antifungal susceptibility testing. . Clin Infect Dis 22:, 322–328. [CrossRef].[PubMed]
    [Google Scholar]
  48. Yildiran S. T. , Saracli M. A. , Fothergill A. W. , Rinaldi M. G. . ( 2000; ). In vitro susceptibility of environmental Cryptococcus neoformans variety neoformans isolates from Turkey to six antifungal agents, including SCH56592 and voriconazole. . Eur J Clin Microbiol Infect Dis 19:, 317–319. [CrossRef].[PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.029025-0
Loading
/content/journal/jmm/10.1099/jmm.0.029025-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error