Molecular type distribution and fluconazole susceptibility of clinical Cryptococcus gattii isolates from South African laboratory-based surveillance, 2005-2013.

Autor: Naicker SD; National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Firacative C; Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia., van Schalkwyk E; National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa., Maphanga TG; National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa., Monroy-Nieto J; Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America., Bowers JR; Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America., Engelthaler DM; Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, United States of America., Meyer W; Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia.; Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, New South Wales, Australia.; Westmead Institute for Medical Research, Westmead, New South Wales, Australia.; Research and Educational Network, Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia.; Curtin Medical School, Curtin University, Perth, Australia., Govender NP; National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.; 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.; Medical Research Council Centre for Medical Mycology, College of Medicine and Health, University of Exeter, Exeter, United Kingdom.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2022 Jun 29; Vol. 16 (6), pp. e0010448. Date of Electronic Publication: 2022 Jun 29 (Print Publication: 2022).
DOI: 10.1371/journal.pntd.0010448
Abstrakt: As is the case globally, Cryptococcus gattii is a less frequent cause of cryptococcosis than Cryptococcus neoformans in South Africa. We performed multilocus sequence typing (MLST) and fluconazole susceptibility testing of 146 isolates randomly selected from 750 South African patients with C. gattii disease identified through enhanced laboratory surveillance, 2005 to 2013. The dominant molecular type was VGIV (101/146, 70%), followed by VGI (40/146, 27%), VGII (3/146, 2%) and VGIII (2/146, 1%). Among the 146 C. gattii isolates, 99 different sequence types (STs) were identified, with ST294 (14/146, 10%) and ST155 (10/146, 7%) being most commonly observed. The fluconazole MIC50 and MIC90 values of 105 (of 146) randomly selected C. gattii isolates were 4 μg/ml and 16 μg/ml, respectively. VGIV isolates had a lower MIC50 value compared to non-VGIV isolates, but these values were within one double-dilution of each other. HIV-seropositive patients had a ten-fold increased adjusted odds of a VGIV infection compared to HIV-seronegative patients, though with small numbers (99/136; 73% vs. 2/10; 20%), the confidence interval (CI) was wide (95% CI: 1.93-55.31, p = 0.006). Whole genome phylogeny of 98 isolates of South Africa's most prevalent molecular type, VGIV, identified that this molecular type is highly diverse, with two interesting clusters of ten and six closely related isolates being identified, respectively. One of these clusters consisted only of patients from the Mpumalanga Province in South Africa, suggesting a similar environmental source. This study contributed new insights into the global population structure of this important human pathogen.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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