First Isolation, Antifungal Susceptibility, and Molecular Characterization of Cryptococcus neoformans from the Environment in Croatia.

Pllana-Hajdari Pllana-Hajdari,Mareković Mareković,Čičmak Čičmak,Mlinarić-Missoni Mlinarić-Missoni,Cogliati Cogliati,Pleško Pleško

doi:10.3390/jof5040099

Abstract

The purpose of this study was to investigate the presence of Cryptococcus neoformans species complex isolates from environmental sources in Croatia and to determine their molecular types and antifungal susceptibility. Swab samples of tree hollows and bird excreta in the soil beneath trees were collected. Samples included 472 (92.73%) samples obtained from tree hollows and 37 (7.27%) samples from bird excreta. Four C. neoformans species complex isolates were recovered from tree hollow swabs along the Mediterranean coast, while there were no isolates recovered from bird excreta or from the continental area. Three isolates were identified as molecular types VNI and one as VNIV. All tested antifungals showed high in vitro activity against the four isolates. This is the first report proving the presence of C. neoformans species complex in the environment of Croatia. The results of the study suggest a major risk of exposure for inhabitants living along the Croatian coast and that both VNI and VNIV molecular types can be expected in clinical cases of cryptococcosis. Susceptibility to antifungals confirmed that no resistance should be expected in patients with cryptococcosis at the present time.

Highlights

The encapsulated basidiomycetous yeasts of Cryptococcus neoformans and C. gattii species complexes are infectious agents of cryptococcosis, a life-threatening infection primarily affecting immunocompromised hosts [1]
The purpose of this study was to investigate the presence of C. neoformans species complex isolates from environmental sources in Croatia and to determine their molecular types and antifungal susceptibility
Antifungal susceptibility according to the CLSI broth microdilution method, performed for one VNI and one VNIV isolate, confirmed the ATB FUNGUS 3 results (Table 1)

Summary

Introduction

The encapsulated basidiomycetous yeasts of Cryptococcus neoformans and C. gattii species complexes are infectious agents of cryptococcosis, a life-threatening infection primarily affecting immunocompromised hosts [1]. While the C. neoformans species complex mainly affects patients with acquired immunodeficiency syndrome (AIDS) and those who are immunosuppressed (transplant patients, those on long-term corticosteroids, and those prescribed monoclonal antibodies), one-quarter of patients with C. gattii species complex infections are immunocompetent and healthy. Infection of the brain and meninges by the C. neoformans species complex is the most important clinical manifestation in immunosuppressed individuals [2,3]. An estimated 220,000 cases of cryptococcal meningitis complicate. Infections by Cryptococcus species are acquired from environmental sources and are a consequence of the inhalation of dehydrated blastoconidia or basidiospores into the lungs.

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