Molecular characterization and antifungal susceptibility testing of Cryptococcus neoformans sensu stricto from southern Brazil

Herkert, Patricia Fernanda; Meis, Jacques F.; Salvador, Gabriel Lucca de Oliveira; Gomes, Renata Rodrigues; Vicente, Vânia A.; Muro, Marisol Dominguez; Pinheiro, Rosângela Lameira; Colombo, Arnaldo Lopes; Schwarzbold, Alexandre Vargas; Oliveira, Carla Sakuma de; Ferreira, Marcelo Simão; Queiroz‐Telles, Flávio; Hagen, Ferry

doi:10.1099/jmm.0.000698

Cited by 18 publications

(25 citation statements)

References 59 publications

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“…Genomic DNA was extracted with the MagNA Pure 96 platform (Roche Diagnostics, Almere, The Netherlands) from 2 days old cultures, as described before . Typing of 58 C. auris isolates (41 blood and 17 surveillance samples) was carried out by Amplified Fragment Length Polymorphisms (AFLP) fingerprinting to distinguish C. auris from closely related species as described previously .…”

Section: Methodsmentioning

confidence: 99%

An outbreak due to Candida auris with prolonged colonisation and candidaemia in a tertiary care European hospital

Ruiz-Gaitán

Moret

Tasias-Pitarch

et al. 2018

Mycoses

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285

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Multidrug-resistant Candida auris has emerged as a cause of insidious hospital outbreaks and complicated infections. We present the analysis of an ongoing C. auris outbreak including the largest published series of C. auris bloodstream infection. All C. auris-positive patients from April-2016 to January-2017 were included. Environmental, clinical and microbiological data were recorded. Definitive isolate identification was performed by ITS-rDNA sequencing, and typing by amplified fragment length polymorphism fingerprinting. One hundred and forty patients were colonised by C. auris during the studied period (68% from surgical intensive care). Although control measures were implemented, we were not able to control the outbreak. Forty-one invasive bloodstream infections (87.8% from surgical intensive care) were included. Clinical management included prompt intravascular catheter removal and antifungal therapy with echinocandins. All isolates were fluconazole- and voriconazole-resistant, but echinocandin- and amphotericin B-susceptible. Thirty-day mortality rate was 41.4%, and severe septic metastasis as spondylodiscitis and endocarditis were observed in 5 patients (12%). C. auris was also recovered from inanimate patient surroundings and medical equipment. Despite antifungal treatment, high mortality and late complication rates were recorded. Molecular typing suggested a clonal outbreak different from those previously published.

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Section: Methodsmentioning

confidence: 99%

An outbreak due to Candida auris with prolonged colonisation and candidaemia in a tertiary care European hospital

Ruiz-Gaitán

Moret

Tasias-Pitarch

et al. 2018

Mycoses

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277

285

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“…This is similar to one study reported that no significant differences were detected among the genotypes AFLP1/VNI, AFLP1A/ VNII and AFLP1B/VNII and their respective antifungal susceptibility profiles. 41 These results highlight that the interpretation of cryptococcal antifungal susceptibility among different molecular type/species should be done with caution. 39,[42][43][44]…”

Section: Discussionmentioning

confidence: 92%

<p><em>Cryptococcus neoformans/gattii</em> Species Complexes from Pre-HIV Pandemic Era Contain Unusually High Rate of Non-Wild-Type Isolates for Amphotericin B</p>

Pharkjaksu

Chongtrakool

Chayakulkeeree

et al. 2020

IDR

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Introduction: The Cryptococcus neoformans/gattii species complexes are a leading cause of fatality among HIV-infected patients. Despite the unavailability of clinical breakpoints (CBPs) for antifungal agents, epidemiological cutoff values (ECVs) were recently proposed, and non-wild-type isolates for polyenes and azoles are being increasingly reported. However, the distributions of the susceptibility patterns for pre-HIV-era isolates have not been studied. Methods: We determined the in vitro antifungal susceptibility patterns of 233 Cryptococcus isolates, collected at the National Institutes of Health, USA, in pre-HIV pandemic era, to study minimum inhibitory concentrations (MICs) to the important drugs for cryptococcosis and to compare the results with strain genotypes. Amphotericin B susceptibility was compared to published ECV of C. neoformans. Results: The 233 Cryptococcus strains consisted of 89.7% C. neoformans species complex and 10.3% C. gattii species complex. Most were from clinical sources (189, 81.1%), and the major molecular type was VNI (146, 62.7%). The highest geometric mean (GM) was observed for fluconazole (GM = 0.96 µg/mL) while the lowest was for itraconazole (GM = 0.10 µg/mL). MICs to fluconazole in C. gattii species complex were significantly higher than C. neoformans species complex (p < 0.001). Moreover, C. neoformans/VNI strains showed significantly higher MICs than others such as C. neoformans/VNII to fluconazole (p < 0.0001) and C. deneoformans/VNIV to amphotericin B (p = 0.022) and fluconazole (p = 0.008). In our collection of 167 clinical C. neoformans species complex strains, 85 (50.9%), 24 (14.4%), and 3 (1.8%) strains had an amphotericin B (AMB)-MIC of 1, 2, and 4 µg/mL, respectively. The high percentage (66.9%, 79/118 strains) of non-wild-type clinical C. neoformans VNI strains, using an AMB-ECV of 0.5 µg/mL, was found. Moreover, 25 of 28 (89.3%) C. neoformans VNI strains from environmental and veterinary sources also had AMB-MICs above 0.5 µg/mL. In general, there was no significant difference in GM AMB-MIC of the clinical strains isolated from patients with (35 patients) and without (78 patients) prior AMB treatment (0.85 vs 0.76; p = 0.624). GM MIC of the environmental strains was not significantly different from that of the prior AMB-treatment strains (0.98 vs 0.76, p = 0.159) and the post-AMB-treatment strains (0.98 vs 0.85, p = 0.488). Conclusion: The high rate of non-wild-type among these otherwise naive isolates to amphotericin B is unexpected. Confirmation with more strains from a later era is needed.

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“…gattii (BYRNES et al, 2009;CHEN et al, 2013;FIRACATIVE;DUAN;, Candida albicans (BRENNAN et al, 2002;DUNPHY et al, 2003), Candida krusei (SCORZONI et al, 2013) -INGROFF et al, 2012b;KIDD et al, 2016). Já para o VOR é observado na literatura que este antifúngico ainda se demonstra eficaz contra as espécies de Cryptococcus (ESPINEL-INGROFF et al, 2012b;HERKERT et al, 2016;KIDD et al, 2016;HERKERT et al, 2018).…”

Section: Lista De Símbolosunclassified

“…Para o antifúngico VOR, os dados de nosso estudo corroboram com os dados da literatura, onde C. neoformans e C. gattii demonstram-se sensíveis a este antifúngico (ESPINEL-INGROFF et al, 2012b;HERKERT et al, 2016;HERKERT et al, 2018). Em um estudo realizado na Austrália foi observado que as espécies C.…”

Section: Antifúngicosunclassified

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Caracterização molecular, susceptibilidade a antifúngicos e virulência de isolados clínicos de Cryptococcus spp

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Molecular characterization and antifungal susceptibility testing of Cryptococcus neoformans sensu stricto from southern Brazil

Cited by 18 publications

References 59 publications

An outbreak due to Candida auris with prolonged colonisation and candidaemia in a tertiary care European hospital

An outbreak due to Candida auris with prolonged colonisation and candidaemia in a tertiary care European hospital

<p><em>Cryptococcus neoformans/gattii</em> Species Complexes from Pre-HIV Pandemic Era Contain Unusually High Rate of Non-Wild-Type Isolates for Amphotericin B</p>

Caracterização molecular, susceptibilidade a antifúngicos e virulência de isolados clínicos de Cryptococcus spp

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