Cryptococcus gattii: a resurgent fungal pathogen

Chaturvedi, Vishnu

doi:10.1016/j.tim.2011.07.010

Cited by 85 publications

(81 citation statements)

References 71 publications

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“…Table 4 summarizes the pertinent epidemiological and clinical features in case series involving three or more patients. In addition, a number of reviews, editorials, and book chapters with substantive discussion on C. gattii clinical epidemiology and infection in humans have been published since 2000 (39,85,122,(254)(255)(256)(257)(258)(259)(260)(261)(262)(263)(264)(265).…”

Section: Epidemiology Of Human Infectionmentioning

confidence: 99%

Cryptococcus gattii Infections

2014

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SUMMARY Understanding of the taxonomy and phylogeny of Cryptococcus gattii has been advanced by modern molecular techniques. C. gattii probably diverged from Cryptococcus neoformans between 16 million and 160 million years ago, depending on the dating methods applied, and maintains diversity by recombining in nature. South America is the likely source of the virulent C. gattii VGII molecular types that have emerged in North America. C. gattii shares major virulence determinants with C. neoformans , although genomic and transcriptomic studies revealed that despite similar genomes, the VGIIa and VGIIb subtypes employ very different transcriptional circuits and manifest differences in virulence phenotypes. Preliminary evidence suggests that C. gattii VGII causes severe lung disease and death without dissemination, whereas C. neoformans disseminates readily to the central nervous system (CNS) and causes death from meningoencephalitis. Overall, currently available data indicate that the C. gattii VGI, VGII, and VGIII molecular types more commonly affect nonimmunocompromised hosts, in contrast to VGIV. New, rapid, cheap diagnostic tests and imaging modalities are assisting early diagnosis and enabling better outcomes of cerebral cryptococcosis. Complications of CNS infection include increased intracranial pressure, severe neurological sequelae, and development of immune reconstitution syndrome, although the mortality rate is low. C. gattii VGII isolates may exhibit higher fluconazole MICs than other genotypes. Optimal therapeutic regimens are yet to be determined; in most cases, initial therapy with amphotericin B and 5-flucytosine is recommended.

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Section: Epidemiology Of Human Infectionmentioning

confidence: 99%

Cryptococcus gattii Infections

2014

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“…neoformans) are recognized and have been extensively studied. In contrast, another species, C. gattii (serotypes B and C), is clinically rare at Ͻ1% of cryptococcosis cases and was historically considered to have a limited distribution within tropical and subtropical parts of the world (3,4).…”

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Congenic Strains for Genetic Analysis of Virulence Traits in Cryptococcus gattii

et al. 2013

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cCryptococcus gattii is responsible for a large outbreak of potentially fatal disease that started in the late 1990s on Vancouver Island, Canada. How this fungus and the outbreak isolates in particular cause disease in immunocompetent people is unknown, with differing hypotheses. To explore genetic contributions, a pair of congenic a and ␣ mating type strains was generated by a series of 11 backcrosses to introgress the MAT locus from a nonoutbreak strain into the background of strain R265, isolated from a Vancouver Island patient. The congenic pair was used to investigate three traits: mitochondrial inheritance, the effect of the MAT alleles on virulence, and the impact of a predicted virulence factor on pathogenicity. The two congenic strains show the same virulence in different models of cryptococcosis and equivalent levels of competition in coinfection assays. These results rule out a role of the MAT locus and mitochondrial genotype as major virulence factors in the outbreak strains. Disruption of Bwc2, a light-dependent transcription factor, resulted in reduced virulence, consistent with a similar function in the related species Cryptococcus neoformans. The C. gattii congenic strains represent a new resource for exploring the evolution of virulence in the C. neoformans-C. gattii clade.

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“…Differences exist among the molecular types of C. neoformans and C. gattii with regard to the in vitro susceptibility to antifungal agents, especially azoles (8,18). Also, the emergence of highly virulent C. gattii strains (6,7,23) has positioned causative species, genotype, and geographic origin as important considerations when deciding on treatment options for cryptococcosis.…”

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Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry-Based Method for Discrimination between Molecular Types of Cryptococcus neoformans and Cryptococcus gattii

et al. 2012

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We evaluated the usefulness of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for Cryptococcus identification at the species and subspecies levels by using an in-house database of 25 reference cryptococcal spectra. Eighty-one out of the 82 Cryptococcus isolates (72 Cryptococcus neoformans and 10 Cryptococcus gattii) tested were correctly identified with respect to their molecular type designations. We showed that MALDI-TOF MS is a practicable alternative to conventional mycology or DNA-based methods.

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Cryptococcus gattii: a resurgent fungal pathogen

Cited by 85 publications

References 71 publications

Cryptococcus gattii Infections

Cryptococcus gattii Infections

Congenic Strains for Genetic Analysis of Virulence Traits in Cryptococcus gattii

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry-Based Method for Discrimination between Molecular Types of Cryptococcus neoformans and Cryptococcus gattii

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