Infections due to non-neoformans cryptococcal species

McCurdy, Lewis; Morrow, Jason D.

doi:10.1007/s12019-003-0012-9

Cited by 21 publications

(28 citation statements)

References 54 publications

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“…Some non-neoformans species, such as Cryptococcus laurentii and Cryptococcus uniguttulatus, had been reported to colonize humans [3,6].…”

Section: Epidemiologymentioning

confidence: 99%

“…have been ascribed to capsule formation against phagocytosis, the expression of the laccase enzyme, and production of melanin [12][13][14]. The presence of the polysaccharide capsule in non-neoformans cryptococci shares common features with that of C. neoformans [3]. The process of melanin deposition observed in non-neoformans cryptococci is responsible for the alteration in cell wall integrity, immune evasion and decreased susceptibility to antifungal therapy [14].…”

Section: Transmission Virulence Factors and Host Immune Responsementioning

confidence: 99%

“…The process of melanin deposition observed in non-neoformans cryptococci is responsible for the alteration in cell wall integrity, immune evasion and decreased susceptibility to antifungal therapy [14]. However, the level of laccase activity expressed in these non-neoformans cryptococci is lower than that seen in C. neoformans [3,14]. Once the yeast enters the human host, macrophages are responsible for phagocytosis and the production of proinflammatory cytokines for recruitment of inflammatory cells [13,15].…”

Section: Transmission Virulence Factors and Host Immune Responsementioning

confidence: 99%

“…Other cryptococcal species have traditionally been considered non-pathogenic; however, there has been an incremental rise in non-neoformans cryptococcal infections over the past four decades [2][3][4][5]. This increase may reflect enhanced awareness of such infections, improved laboratory detection of non-neoformans species in the Cryptococcus genus and a rise in the number of at-risk patients.…”

Section: Introductionmentioning

confidence: 99%

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Non-neoformans Cryptococcal Infections: a Systematic Review

2007

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Non-neoformans cryptococci have been generally regarded as saprophytes and rarely reported as human pathogens. However, the incidence of infection due to these organisms has increased over the past 40 years, with Cryptococcus laurentii and Cryptococcus albidus, together, responsible for 80% of reported cases. Conditions associated with impaired cell-mediated immunity are important risks for non-neoformans cryptococcal infections and prior azole prophylaxis has been associated with antifungal resistance. The presence of invasive devices was a significant risk factor for Cryptococcus laurentii infection (adjusted OR = 8.7; 95% CI = 1.48-82.9; p = 0.003), while predictors for mortality included age > or =45 years (aOR = 8.4; 95% CI = 1.18-78.82; p = 0.004) and meningeal presentation (aOR = 7.0; 95% CI = 1.85-60.5; p= 0.04). Because clinical manifestations of non-neoformans cryptococcal infections are most often indistinguishable from Cryptococcus neoformans, a high index of suspicion remains important to facilitate early diagnosis and prompt treatment for such infections.

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“…Some non-neoformans species, such as Cryptococcus laurentii and Cryptococcus uniguttulatus, had been reported to colonize humans [3,6].…”

Section: Epidemiologymentioning

confidence: 99%

Section: Transmission Virulence Factors and Host Immune Responsementioning

confidence: 99%

Section: Transmission Virulence Factors and Host Immune Responsementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-neoformans Cryptococcal Infections: a Systematic Review

2007

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“…ryptococcus laurentii is one of the very rare non-neoformans Cryptococcus species that cause human infections (1)(2)(3). The clinical presentation of C. laurentii is similar to that of C. neoformans, but the cryptococcal antigen test is often negative (4), and the organism exhibits decreased fluconazole susceptibility (5,6).…”

mentioning

confidence: 99%

Misidentification of a Rare Species, Cryptococcus laurentii, by Commonly Used Commercial Biochemical Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Systems: Challenges for Clinical Mycology Laboratories

et al. 2016

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c Forty-two putative Cryptococcus laurentii isolates identified by the Vitek 2 system were collected in China. The gold standard, internal transcribed spacer (ITS) sequencing, confirmed that only two isolates were genuine C. laurentii. Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry was able to identify the C. laurentii isolates with an expanded custom database. Cryptococcus laurentii is one of the very rare non-neoformans Cryptococcus species that cause human infections (1-3). The clinical presentation of C. laurentii is similar to that of C. neoformans, but the cryptococcal antigen test is often negative (4), and the organism exhibits decreased fluconazole susceptibility (5, 6). Therefore, accurate identification of the species is essential for treatment drug selection.China Hospital Invasive Fungal Surveillance Net (CHIF-NET) is a nationwide surveillance program for invasive fungal diseases (IFDs) in China (7). During a recent 5-year study period (2009 to 2014), 9,673 yeast isolates were collected, with 42 (0.4%) isolates initially identified as C. laurentii by Vitek 2 at participating hospitals. This unexpectedly high prevalence of C. laurentii than previously reported (e.g., ARTEMIS [1997 to 2007], 0.04%; SENTRY [2008 to 2012], 0%) (3, 8-10) prompted us to investigate further the identity of the isolates.The 42 putative C. laurentii isolates originated from 16 different hospitals, and the identity of the isolates was confirmed at the coordinating central laboratory by sequencing of the internal transcribed spacer (ITS) region, with results queried against the Centraalbureau voor Schimmelcultures (CBS) Fungal Biodiversity Center database (http://www.cbs.knaw.nl/Collections/Biolo MICSSequences.aspx) as previously described (7, 11). Furthermore, the isolates were reidentified by the Vitek 2 (bioMérieux, Marcy l'Etoile, France) yeast identification card and API 20C AUX method (bioMérieux) at the coordinating lab, with testing staff blinded to previous Vitek 2 and sequencing results.Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis was performed on all isolates by both the Vitek MS system (IVD Knowledgebase version 2.0; bioMérieux) and the Bruker Autoflex Speed TOF/TOF MS system (Biotyper version 3.1 software; Bruker Daltonics, Billerica, MA, USA), according to the manufacturer's instructions. Mass spectral profiles of the two C. laurentii clinical isolates confirmed by ITS sequencing were used to construct a main spectrum profile (MSP) dendrogram along with reference spectra of C. laurentii and other Cryptococcus species provided in the Bruker database, for fingerprint relatedness analysis. These data were subsequently used to expand the Bruker MALDI-TOF MS database following the manufacturer's instructions (12).Among 42 putative C. laurentii isolates identified by the Vitek 2 system at local hospitals, only two isolates (4.8%) were confirmed as C. laurentii by sequencing of the ITS region. Of the remaining 40 isolat...

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Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment

Gullo

Rossi

Sardi

et al. 2013

Eur J Clin Microbiol Infect Dis

117

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Cryptococcosis is an important systemic mycosis and the third most prevalent disease in human immunodeficiency virus (HIV)-positive individuals. The incidence of cryptococcosis is high among the 25 million people with HIV/acquired immunodeficiency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. In Cryptococcus neoformans, resistance to azoles may be associated with alterations in the target enzyme encoded by the gene ERG11, lanosterol 14α-demethylase. These alterations are obtained through mutations, or by overexpressing the gene encoding. In addition, C. gattii and C. neoformans present a heteroresistance phenotype, which may be related to increased virulence. Other species beyond C. neoformans and C. gattii, such as C. laurentii, have been diagnosed mainly in patients with immunosuppression. Infections of C. albidus have been isolated in cats and marine mammals. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth, which is also related with increased resistance to antifungal agents. Therefore, there is a great need to search for alternative antifungal agents for these fungi. The search for new molecules is currently occurring from nanoparticle drugs of plant peptide origin. This article presents a brief review of the literature regarding the epidemiology of cryptococcosis, as well as fungal resistance and new alternatives for treatment.

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Infections due to non-neoformans cryptococcal species

Cited by 21 publications

References 54 publications

Non-neoformans Cryptococcal Infections: a Systematic Review

Non-neoformans Cryptococcal Infections: a Systematic Review

Misidentification of a Rare Species, Cryptococcus laurentii, by Commonly Used Commercial Biochemical Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Systems: Challenges for Clinical Mycology Laboratories

Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment

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