Cryptococcus neoformans infections at Vancouver Hospital and Health Sciences Centre (19972002): epidemiology, microbiology and histopathology

Hoang, Linda; Maguire, John A.; Doyle, Patrick; Fyfe, Murray; Roscoe, Diane

doi:10.1099/jmm.0.05427-0

Cited by 189 publications

(130 citation statements)

References 15 publications

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“…Only a few infections have been reported from countries with a moderatetemperate climate. In 1999, a C. gattii outbreak emerged on Vancouver Island, Canada [3]. Although rare autochthonous infections due to C. gattii in Europe have been reported [2,[10][11][12], most infections in European residents were acquired outside Europe.…”

Section: Discussionmentioning

confidence: 99%

“…C. gattii has been isolated from decaying wood, mainly of Eucalyptus trees, with the distribution of human infections corresponding in general to the distribution of these trees, i.e., tropical and subtropical areas such as Australia, Central and South America, India, China, and limited areas in Europe [2]. However, in 1999, a C. gattii outbreak emerged on Vancouver Island, Canada [3].…”

Section: Introductionmentioning

confidence: 99%

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Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

et al. 2009

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A 53-year old immunocompetent Swiss female is described who developed severe meningoencephalitis due to infection with Cryptococcus gattii 13 months following exposure on Vancouver Island, Canada. Diagnosis was based on cerebrospinal fluid (CSF) examination, i.e., positive India-ink staining, positive latex particle agglutination, and positive culture. Species identification was performed by growth on L-canavanine-glycine-bromthymol blue medium and by sequencing of the intergenic and internal transcribed spacer regions of the rRNA genes. After initial therapy with fluconazole by which the patient did not improve, therapy was changed to amphotericin B and flucytosine and later to high-dose fluconazole and amphotericin B. Despite long-term treatment and external drainage of the CSF, the patient's condition improved only slowly. The patient was discharged after 132 days of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

et al. 2009

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“…gattii is predominately restricted to tropical regions; however, a recent outbreak of C. neoformans var. gattii infections on Vancouver Island in Canada (Hoang et al 2004) has raised the level of interest in this pathogen. Except for the recently described high prevalence of serotype C infections in AIDS patients living in sub-Saharan Africa (Litvintseva et al 2005), the majority of cryptococcosis due to serotype B and C strains occurs in immunologically normal individuals.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of phenotypic and genotypic alterations induced by long periods of subculturing of Cryptococcus neoformans strains

Cavalcante

Freitas

Vidal

et al. 2007

Mem. Inst. Oswaldo Cruz

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Cryptococcus neoformans is a basidiomycetous, the etiologic agent of cryptococcosis, yeast-like fungus which, following inhalation from an environmental source causes respiratory and neurological disease in humans and animals. Cryptococcal infections can be fatal if the host does not have adequate T-cell-dependent immune function. Most important predisposing factors for infection with C. neoformans are virus immunodeficiency infection, use of immunosuppressive drugs, organ and bone marrow transplantation, chronic leukemia, and lymphomas (Dismukes 1988, Velegraki, et al. 2001, Horta et al. 2002. Kwon-Chung et al. (1982) established two varieties that were recognized: var. neoformans and var. gattii. Currently we recognize 3 varieties: grubii -serotype A-, gattiiserotype B, C, -and neoformans -serotype D (Franzot et al. 1999). Most likely, var. gattii will be renamed as a novel species and called C. bacillisporus (Diaz et al. 2000).This fungus appears in yeast form, presenting spherical cells (5-100 µm in diameter) with single or multiple buds. The colonies are cream-colored, glossy, viscous, and moist, the amount of mucous being directly related to the size of the capsule. Among the various virulence factors, the most significant are capsular polysaccharides such as glucuronoxylan, galactoxilamanane, and mannoproteins (Kurtzman & Fell 1998, Lacaz et al. 2002, Chiapello et al. 2003, Ellerbroek et al. 2004.The samples of C. neoformans maintained in our Fungus Collection are especially useful for biotechnology projects, scientific research related to antifungal therapy, determination of molecular characteristics, production antigen, and instructional programs, as well as functional as reference cultures. Various preservation techniques are used: successive subculture on solid medium (with or without the addition of mineral oil); spore cultivation (in soil, sand, or silica gel); lyophilized; liquid nitrogen storage; and suspension in distilled water (Castellani 1963, 1967, Urdaneta et al. 1965, Bosmans 1974, Rodrigues et al. 1992, Cavalcanti & Cavalcanti 1994, Spencer & Spencer 1996.With the advent of molecular biology, various techniques have come to be used to analyze the genotype of the potential polymorphism of fungus samples. These include randomly amplified polymorphic DNA (RAPD), pulsed-field gel electrophoresis, (PFGE), restriction fragment length polymorphism (RFLP), and amplified fragment length polymorphism (AFLP). The cost of performing the RFLP, PFGE, and AFLP techniques is prohibitive. However, the RAPD method can be performed at a relatively low cost. This technique suits our needs perfectly, not only due to its cost-effectiveness but also to its reproducibility (Willians 1990).In our Fungus Collection, samples of C. neoformans have been maintained in successive subcultures since 1930. In the 1970s, some of these samples were selected to be stored using the lyophilization technique. The preservation method of choice in our laboratory is still successive subculture since it is considered a simple method...

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“…C. gattii (serotypes B and C) was originally predominantly found in subtropical regions but a newly recombined serotype B clone has emerged over the past 10 years as a cause of cryptococcal infections in animals and otherwise healthy humans on Vancouver Island [17]. More recently, this epidemic is spreading to the Pacific Northwest of the United States [18,19]. The outbreak clone appears to have descended from two alpha mating-type parents.…”

Section: Classification Of Cryptococcus Neoformans and C Gattiimentioning

confidence: 99%

Phenotypic Switching of Cryptococcus neoformans and Cryptococcus gattii

Jain

Fries

2008

Mycopathologia

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Microorganisms that live in fluctuating environments must constantly adapt their behavior to survive. The host constitutes an important microenvironment in opportunistic and primary fungal pathogens like Cryptococcus neoformans (C. neoformans) and Cryptococcus gattii (C. gattii). In clonal populations, adaptation may be achieved through the generation of diversity. For fungi phenotype switching constitutes a mechanism that allows them to change rapidly. Both C. neoformans and C. gattii undergo phenotypic switching, which allows them to be successful pathogens and cause persistent disease. Similar to other encapsulated microbes that exhibit phenotypic variation, phenotypic switching in Cryptococcus changes the polysaccharide capsule. Most importantly, in animal models phenotypic switching affects virulence and can change the outcome of infection. Virulence changes because C. neoformans and C. gattii switch variants elicit different inflammatory responses in the host. This altered host response can also affect the response to antifungal therapy and in some cases may even promote the selection of switch variants. This review highlights the similarity and difference between phenotypic switching in C. neoformans and C. gattii, the two dominant species that cause cryptococcosis in humans.

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Cryptococcus neoformans infections at Vancouver Hospital and Health Sciences Centre (19972002): epidemiology, microbiology and histopathology

Cited by 189 publications

References 15 publications

Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

Evaluation of phenotypic and genotypic alterations induced by long periods of subculturing of Cryptococcus neoformans strains

Phenotypic Switching of Cryptococcus neoformans and Cryptococcus gattii

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Cryptococcus neoformans infections at Vancouver Hospital and Health Sciences Centre (19972002): epidemiology, microbiology and histopathology

Cited by 189 publications

References 15 publications

Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

Evaluation of phenotypic and genotypic alterations induced by long periods of subculturing of Cryptococcus neoformans strains

Phenotypic Switching of Cryptococcus neoformans and Cryptococcus gattii

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Cryptococcus neoformans infections at Vancouver Hospital and Health Sciences Centre (19972002): epidemiology, microbiology and histopathology