1887

Abstract

A collection of 48 clinical isolates from Croatia was investigated retrospectively using antifungal susceptibility testing and molecular biological techniques to determine mating type and serotype by PCR and amplified fragment length polymorphism (AFLP) genotyping. These isolates were obtained from 15 patients: ten were human immunodeficiency virus (HIV)-negative (66.7 %) and five were HIV-positive (33.3 %). From five patients, only one isolate was available, whilst from the other ten patients, two to 11 isolates were isolated sequentially. Antifungal susceptibility was tested by a broth microdilution method. Serotype A (genotype AFLP1) and serotype D (genotype AFLP2) were both found in six patients (40 % each), and serotype AD (genotype AFLP3) in three (20.0 %) patients. Mating type α ( = 12; 80.0 %) predominated and α/ hybrids were identified in 20.0 % of patients diagnosed with cryptococcosis. Two AFLP genotypes of were isolated during a single episode from one patient. The antifungal MIC and susceptibility ranges for isolates were 0.5 µg ml (range 0.031–0.5 µg ml) for amphotericin B, 4 µg ml (range 1–4 µg ml) for flucytosine and fluconazole, 0.25 µg ml (range 0.031–0.5 µg ml) for itraconazole and 0.062 µg ml (range 0.031–0.25 µg ml) for voriconazole.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.031344-0
2011-10-01
2019-12-13
Loading full text...

Full text loading...

/deliver/fulltext/jmm/60/10/1487.html?itemId=/content/journal/jmm/10.1099/jmm.0.031344-0&mimeType=html&fmt=ahah

References

  1. Almeida A. M. , Matsumoto M. T. , Baeza L. C. , de Oliveira e Silva R. B. , Kleiner A. A. , Melhem M. de S. , Mendes Giannini M. J. . Laboratory Group on Cryptococcosis ( 2007; ). Molecular typing and antifungal susceptibility of clinical sequential isolates of Cryptococcus neoformans from Sao Paulo State, Brazil. . FEMS Yeast Res 7:, 152–164.[CrossRef]
    [Google Scholar]
  2. Barreto de Oliveira M. T. , Boekhout T. , Theelen B. , Hagen F. , Baroni F. A. , Lazera M. S. , Lengeler K. B. , Heitman J. , Rivera I. N. G. , Paula C. R. . ( 2004; ). Cryptococcus neoformans shows a remarkable genotypic diversity in Brazil. . J Clin Microbiol 42:, 1356–1359. [CrossRef] [PubMed]
    [Google Scholar]
  3. Bassetti M. , Repetto E. , Mikulska M. , Miglino M. , Clavio M. , Gobbi M. , Righi E. , Viscoli C. . ( 2009; ). Cryptococcus neoformans fatal sepsis in a chronic lymphocytic leukemia patient treated with alemtuzumab: case report and review of the literature. . J Chemother 21:, 211–214.[PubMed] [CrossRef]
    [Google Scholar]
  4. Blasi E. , Brozzetti A. , Francisci D. , Neglia R. , Cardinali G. , Bistoni F. , Vidotto V. , Baldelli F. . ( 2001; ). Evidence of microevolution in a clinical case of recurrent Cryptococcus neoformans meningoencephalitis. . Eur J Clin Microbiol Infect Dis 20:, 535–543. [CrossRef] [PubMed]
    [Google Scholar]
  5. Boekhout T. , Theelen B. , Diaz M. , Fell J. W. , Hop W. C. J. , Abeln E. C. A. , Dromer F. , Meyer W. . ( 2001; ). Hybrid genotypes in the pathogenic yeast Cryptococcus neoformans . . Microbiology 147:, 891–907.[PubMed]
    [Google Scholar]
  6. Bovers M. , Hagen F. , Boekhout T. . ( 2008; ). Diversity of the Cryptococcus neoformansCryptococcus gattii species complex. . Rev Iberoam Micol 25:, S4–S12. [CrossRef] [PubMed]
    [Google Scholar]
  7. Brandt M. E. , Pfaller M. A. , Hajjeh R. A. , Hamill R. J. , Pappas P. G. , Reingold A. L. , Rimland D. , Warnock D. W. . Cryptococcal Disease Active Surveillance Group ( 2001; ). Trends in antifungal drug susceptibility of Cryptococcus neoformans isolates in the United States: 1992 to 1994 and 1996 to 1998. . Antimicrob Agents Chemother 45:, 3065–3069. [CrossRef] [PubMed]
    [Google Scholar]
  8. Casadevall A. , Spitzer E. D. , Webb D. , Rinaldi M. G. . ( 1993; ). Susceptibilities of serial Cryptococcus neoformans isolates from patients with recurrent cryptococcal meningitis to amphotericin B and fluconazole. . Antimicrob Agents Chemother 37:, 1383–1386.[PubMed] [CrossRef]
    [Google Scholar]
  9. CLSI (2008). Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Approved Standard M27–A3. Wayne, PA: Clinical and Laboratory Standards Institute.
  10. Dannaoui E. , Abdul M. , Arpin M. , Michel-Nguyen A. , Piens M. A. , Favel A. , Lortholary O. , Dromer F. . French Cryptococcosis Study Group ( 2006; ). Results obtained with various antifungal susceptibility testing methods do not predict early clinical outcome in patients with cryptococcosis. . Antimicrob Agents Chemother 50:, 2464–2470. [CrossRef] [PubMed]
    [Google Scholar]
  11. Datta K. , Jain N. , Sethi S. , Rattan A. , Casadevall A. , Banerjee U. . ( 2003; ). Fluconazole and itraconazole susceptibility of clinical isolates of Cryptococcus neoformans at a tertiary care centre in India: a need for care. . J Antimicrob Chemother 52:, 683–686. [CrossRef] [PubMed]
    [Google Scholar]
  12. Desnos-Ollivier M. , Patel S. , Spaulding A. R. , Charlier C. , Garcia-Hermoso D. , Nielsen K. , Dromer F. . ( 2010; ). Mixed infections and in vivo evolution in the human fungal pathogen Cryptococcus neoformans . . mBio 1:, e00091. [CrossRef]
    [Google Scholar]
  13. Fries B. C. , Casadevall A. . ( 1998; ). Serial isolates of Cryptococcus neoformans from patients with AIDS differ in virulence for mice. . J Infect Dis 178:, 1761–1766.[CrossRef]
    [Google Scholar]
  14. Guinea J. , Hagen F. , Peláez T. , Boekhout T. , Tahoune H. , Torres-Narbona M. , Bouza E. . ( 2010; ). Antifungal susceptibility, serotyping, and genotyping of clinical Cryptococcus neoformans isolates collected during 18 years in a single institution in Madrid, Spain. . Med Mycol 48:, 942–948. [CrossRef] [PubMed]
    [Google Scholar]
  15. Hagen F. , Illnait-Zaragozi M. T. , Bartlett K. H. , Swinne D. , Geertsen E. , Klaassen C. H. , 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]
  16. Illnait-Zaragozí M. T. , Martínez G. F. , Curfs-Breuker I. , Fernández C. M. , Boekhout T. , Meis J. F. . ( 2008; ). In vitro activity of the new azole isavuconazole (BAL4815) compared with six other antifungal agents against 162 Cryptococcus neoformans isolates from Cuba. . Antimicrob Agents Chemother 52:, 1580–1582. [CrossRef] [PubMed]
    [Google Scholar]
  17. Illnait-Zaragozí M. T. , Martínez-Machín G. F. , Fernández-Andreu C. M. , Hagen F. , Boekhout T. , Klaassen C. H. W. , Meis J. F. . ( 2010; ). Microsatellite typing and susceptibilities of serial Cryptococcus neoformans isolates from Cuban patients with recurrent cryptococcal meningitis. . BMC Infect Dis 10:, 289. [CrossRef] [PubMed]
    [Google Scholar]
  18. 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]
  19. Kwon-Chung K. J. , Boekhout T. , Fell J. W. , Diaz M. . ( 2002; ). Proposal to conserve the name Cryptococcus gattii against C. hondurianus and C. bacillisporus (Basidiomycota, Hymenomycetes, Tremellomycetidae). . Taxon 51:, 804–806. [CrossRef]
    [Google Scholar]
  20. López-Jodra O. , Torres-Rodríguez J. M. , Méndez-Vásquez R. , Ribas-Forcadell E. , Morera-López Y. , Baró-Tomás T. , Alia-Aponte C. . ( 2000; ). In vitro susceptibility of Cryptococcus neoformans isolates to five antifungal drugs using a colorimetric system and the reference microbroth method. . J Antimicrob Chemother 45:, 645–649. [CrossRef] [PubMed]
    [Google Scholar]
  21. 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]
  22. Park B. J. , Wannemuehler K. A. , Marston B. J. , Govender N. , Pappas P. G. , Chiller T. M. . ( 2009; ). Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. . AIDS 23:, 525–530. [CrossRef] [PubMed]
    [Google Scholar]
  23. 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]
  24. Perkins A. , Gomez-Lopez A. , Mellado E. , Rodriguez-Tudela J. L. , Cuenca-Estrella M. . ( 2005; ). Rates of antifungal resistance among Spanish clinical isolates of Cryptococcus neoformans var. neoformans . . J Antimicrob Chemother 56:, 1144–1147. [CrossRef] [PubMed]
    [Google Scholar]
  25. Pfaller M. A. , Zhang J. , Messer S. , Tumberland M. , Mbidde E. , Jessup C. , Ghannoum M. . ( 1998; ). Molecular epidemiology and antifungal susceptibility of Cryptococcus neoformans isolates from Ugandan AIDS patients. . Diagn Microbiol Infect Dis 32:, 191–199. [CrossRef] [PubMed]
    [Google Scholar]
  26. Pfaller M. A. , Messer S. A. , Boyken L. , Rice C. , Tendolkar S. , Hollis R. J. , Doern G. V. , Diekema D. J. . ( 2005; ). Global trends in the antifungal susceptibility of Cryptococcus neoformans (1990 to 2004). . J Clin Microbiol 43:, 2163–2167. [CrossRef] [PubMed]
    [Google Scholar]
  27. Souza L. K. , Fernandes O. F. , Kobayashi C. C. B. A. , Passos X. S. , Costa C. R. , Lemos J. A. , Souza-Júnior A. H. , Silva M. 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. [CrossRef] [PubMed]
    [Google Scholar]
  28. Spitzer E. D. , Spitzer S. G. , Freundlich L. F. , Casadevall A. . ( 1993; ). Persistence of initial infection in recurrent Cryptococcus neoformans meningitis. . Lancet 341:, 595–596. [CrossRef] [PubMed]
    [Google Scholar]
  29. Sullivan D. , Haynes K. , Moran G. , Shanley D. , Coleman D. . ( 1996; ). Persistence, replacement, and microevolution of Cryptococcus neoformans strains in recurrent meningitis in AIDS patients. . J Clin Microbiol 34:, 1739–1744.[PubMed]
    [Google Scholar]
  30. Tortorano A. M. , Viviani M. A. , Rigoni A. L. , Cogliati M. , Roverselli A. , Pagano A. . ( 1997; ). Prevalence of serotype D in Cryptococcus neoformans isolates from HIV positive and HIV negative patients in Italy. . Mycoses 40:, 297–302. [CrossRef] [PubMed]
    [Google Scholar]
  31. van Elden L. J. , Walenkamp A. M. , Lipovsky M. M. , Reiss P. , Meis J. F. , de Marie S. , Dankert J. , Hoepelman A. I. . ( 2000; ). Declining number of patients with cryptococcosis in the Netherlands in the era of highly active antiretroviral therapy. . AIDS 14:, 2787–2788. [CrossRef] [PubMed]
    [Google Scholar]
  32. Vigouroux S. , Morin O. , Milpied N. , Mahé B. , Rapp M. J. , Harousseau J. L. . ( 2000; ). [Cryptococcus neoformans infection in hematologic malignancies]. . Rev Med Interne 21:, 955–960 (in French). [CrossRef] [PubMed]
    [Google Scholar]
  33. Viviani M. A. , Cogliati M. , Esposto M. C. , Lemmer K. , Tintelnot K. , Colom Valiente M. F. , Swinne D. , Velegraki A. , Velho R. . European Confederation of Medical Mycology (ECMM) Cryptococcosis Working Group ( 2006; ). Molecular analysis of 311 Cryptococcus neoformans isolates from a 30-month ECMM survey of cryptococcosis in Europe. . FEM Yeast Res 6:, 614–619. [CrossRef] [PubMed]
    [Google Scholar]
  34. Warkentien T. , Crum-Cianflone N. F. . ( 2010; ). An update on Cryptococcus among HIV-infected patients. . Int J STD AIDS 21:, 679–684. [CrossRef] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.031344-0
Loading
/content/journal/jmm/10.1099/jmm.0.031344-0
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