Clinical and Microbiological Characteristics of Cryptococcus Gattii Isolated from 7 Hospitals in China

Overview

Journal BMC Microbiol

Publisher Biomed Central

Specialty Microbiology

Date 2020 Apr 2

PMID 32228457

Citations 9

Authors

Liang Jin

Jing-Rong Cao

Xin-Ying Xue

Hua Wu

Li-Feng Wang

Ling Guo

Ding-Xia Shen

Affiliations

Soon will be listed here.

Abstract

Background: Infection, even outbreak, caused by Cryptococcus gattii (C. gattii) has been reported in Canada and the United States, but there were sparsely-reported cases of C. gattii in China. Our interest in occurrence, clinical manifestation, laboratory identification and molecular characterization of Chinese C. gattii strains leads us to this research.

Results: Out of 254 clinical isolates, initially identified as Cryptococcus neoformans (C. neoformans), eight strains were re-identified as C. gattii. Multi-locus sequence typing (MLST) showed genotype VGI accounted for the most (6 / 8), the other two strains were genotype VGII (VGIIa and VGIIb respectively) with 3 specific spectra of molecular weight about 4342, 8686, 9611 Da by MALDI-TOF MS. The minimal inhibitory concentrations (MICs) of Fluconazole with Yeast one was 2~4 times higher than that with ATB fungus 3 and MICs of antifungal agents against VGII strains were higher than against VGI strains. Comparative proteome analysis showed that 329 and 180 proteins were highly expressed by C. gattii VGI and VGII respectively. The enrichment of differentially expressed proteins was directed to Golgi complex.

Conclusions: Infection by C. gattii in China occurred sparsely. Genotype VGI was predominant but VGII was more resistant to antifungal agents. There was significant difference in protein expression profile between isolates of VGI and VGII C. gattii.

Citing Articles

The First of Us? Meningitis Complicated by Hydrocephalus in an Otherwise Immunocompetent Host: A Case Report.

Bennett S, Lopez J, Glover P, Steinberg R, Saldana C, Terwilliger T J Investig Med High Impact Case Rep. 2024; 12:23247096241292230.

PMID: 39432437 PMC: 11528583. DOI: 10.1177/23247096241292230.

Pan-omics-based characterization and prediction of highly multidrug-adapted strains from an outbreak fungal species complex.

Fan X, Chen L, Chen M, Zhang N, Chang H, He M Innovation (Camb). 2024; 5(5):100681.

PMID: 39228856 PMC: 11369464. DOI: 10.1016/j.xinn.2024.100681.

Post-infectious inflammatory response syndrome in an HIV-negative patient after Cryptococcus gattii meningoencephalitis: a case report and review of the literature.

Lan J, Lv L, Ye L, Wang T, Wu Z, Wu S J Med Case Rep. 2023; 17(1):332.

PMID: 37542340 PMC: 10403845. DOI: 10.1186/s13256-023-04066-x.

Global Analyses of Multi-Locus Sequence Typing Data Reveal Geographic Differentiation, Hybridization, and Recombination in the Species Complex.

Hitchcock M, Xu J J Fungi (Basel). 2023; 9(2).

PMID: 36836390 PMC: 9967412. DOI: 10.3390/jof9020276.

Application of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry for the Rapid Identification of Yeast Species From Polar Regions.

He C, Feng J, Su J, Zhang T, Yu L Front Microbiol. 2022; 13:832893.

PMID: 35283859 PMC: 8905632. DOI: 10.3389/fmicb.2022.832893.

References

Espinel-Ingroff A, Chowdhary A, Cuenca-Estrella M, Fothergill A, Fuller J, Hagen F . Cryptococcus neoformans-Cryptococcus gattii species complex: an international study of wild-type susceptibility endpoint distributions and epidemiological cutoff values for amphotericin B and flucytosine. Antimicrob Agents Chemother. 2012; 56(6):3107-13. PMC: 3370763. DOI: 10.1128/AAC.06252-11. View

Fraser J, Giles S, Wenink E, Geunes-Boyer S, Wright J, Diezmann S . Same-sex mating and the origin of the Vancouver Island Cryptococcus gattii outbreak. Nature. 2005; 437(7063):1360-4. DOI: 10.1038/nature04220. View

Klein K, Hall L, Deml S, Rysavy J, Wohlfiel S, Wengenack N . Identification of Cryptococcus gattii by use of L-canavanine glycine bromothymol blue medium and DNA sequencing. J Clin Microbiol. 2009; 47(11):3669-72. PMC: 2772631. DOI: 10.1128/JCM.01072-09. View

Lockhart S, Iqbal N, Bolden C, DeBess E, Marsden-Haug N, Worhle R . Epidemiologic cutoff values for triazole drugs in Cryptococcus gattii: correlation of molecular type and in vitro susceptibility. Diagn Microbiol Infect Dis. 2012; 73(2):144-8. PMC: 11907737. DOI: 10.1016/j.diagmicrobio.2012.02.018. View

Lockhart S, Iqbal N, Harris J, Grossman N, DeBess E, Wohrle R . Cryptococcus gattii in the United States: genotypic diversity of human and veterinary isolates. PLoS One. 2013; 8(9):e74737. PMC: 3760847. DOI: 10.1371/journal.pone.0074737. View

Harris J, Lockhart S, Chiller T . Cryptococcus gattii: where do we go from here?. Med Mycol. 2011; 50(2):113-29. DOI: 10.3109/13693786.2011.607854. View

Ngamskulrungroj P, Serena C, Gilgado F, Malik R, Meyer W . Global VGIIa isolates are of comparable virulence to the major fatal Cryptococcus gattii Vancouver Island outbreak genotype. Clin Microbiol Infect. 2010; 17(2):251-8. DOI: 10.1111/j.1469-0691.2010.03222.x. View

Espinel-Ingroff A, Aller A, Canton E, Castanon-Olivares L, Chowdhary A, Cordoba S . Cryptococcus neoformans-Cryptococcus gattii species complex: an international study of wild-type susceptibility endpoint distributions and epidemiological cutoff values for fluconazole, itraconazole, posaconazole, and voriconazole. Antimicrob Agents Chemother. 2012; 56(11):5898-906. PMC: 3486550. DOI: 10.1128/AAC.01115-12. View

Kwon-Chung K, Polacheck I, Bennett J . Improved diagnostic medium for separation of Cryptococcus neoformans var. neoformans (serotypes A and D) and Cryptococcus neoformans var. gattii (serotypes B and C). J Clin Microbiol. 1982; 15(3):535-7. PMC: 272134. DOI: 10.1128/jcm.15.3.535-537.1982. View

10.

Kidd S, Hagen F, Tscharke R, Huynh M, Bartlett K, Fyfe M . A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). Proc Natl Acad Sci U S A. 2004; 101(49):17258-63. PMC: 535360. DOI: 10.1073/pnas.0402981101. View

11.

Chen S, Meyer W, Sorrell T . Cryptococcus gattii infections. Clin Microbiol Rev. 2014; 27(4):980-1024. PMC: 4187630. DOI: 10.1128/CMR.00126-13. View

12.

Meyer W, Aanensen D, Boekhout T, Cogliati M, Diaz M, Esposto M . Consensus multi-locus sequence typing scheme for Cryptococcus neoformans and Cryptococcus gattii. Med Mycol. 2009; 47(6):561-70. PMC: 2884100. DOI: 10.1080/13693780902953886. View

13.

Chen J, Varma A, Diaz M, Litvintseva A, Wollenberg K, Kwon-Chung K . Cryptococcus neoformans strains and infection in apparently immunocompetent patients, China. Emerg Infect Dis. 2008; 14(5):755-62. PMC: 2600263. DOI: 10.3201/eid1405.071312. View

14.

Chen Y, Chang S, Shih C, Hung C, Luhbd K, Pan Y . Clinical features and in vitro susceptibilities of two varieties of Cryptococcus neoformans in Taiwan. Diagn Microbiol Infect Dis. 2000; 36(3):175-83. DOI: 10.1016/s0732-8893(99)00137-6. View

15.

Fang W, Fa Z, Liao W . Epidemiology of Cryptococcus and cryptococcosis in China. Fungal Genet Biol. 2014; 78:7-15. DOI: 10.1016/j.fgb.2014.10.017. View

16.

Kwon-Chung K, Bennett J . Epidemiologic differences between the two varieties of Cryptococcus neoformans. Am J Epidemiol. 1984; 120(1):123-30. DOI: 10.1093/oxfordjournals.aje.a113861. View

17.

Chen S, Sorrell T, Nimmo G, Speed B, Currie B, Ellis D . Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. Australasian Cryptococcal Study Group. Clin Infect Dis. 2000; 31(2):499-508. DOI: 10.1086/313992. View

18.

Ngamskulrungroj P, Chang Y, Sionov E, Kwon-Chung K . The primary target organ of Cryptococcus gattii is different from that of Cryptococcus neoformans in a murine model. mBio. 2012; 3(3). PMC: 3350374. DOI: 10.1128/mBio.00103-12. View

19.

Hagen F, Illnait-Zaragozi M, Bartlett K, Swinne D, Geertsen E, Klaassen C . In vitro antifungal susceptibilities and amplified fragment length polymorphism genotyping of a worldwide collection of 350 clinical, veterinary, and environmental Cryptococcus gattii isolates. Antimicrob Agents Chemother. 2010; 54(12):5139-45. PMC: 2981230. DOI: 10.1128/AAC.00746-10. View

20.

Datta K, Bartlett K, Baer R, Byrnes E, Galanis E, Heitman J . Spread of Cryptococcus gattii into Pacific Northwest region of the United States. Emerg Infect Dis. 2009; 15(8):1185-91. PMC: 2815957. DOI: 10.3201/eid1508.081384. View