Abstract
Cryptococcosis is a globally distributed infectious fungal disease. However, much remains unknown about its molecular epidemiology in many parts of the world. In this study, we analyzed 86 clinical Cryptococcus neoformans isolates from 14 regions in Jiangxi Province in south central China. Each isolate was from a different patient and 35 of the 86 (40.7%) patients were infected with HIV. All strains belonged to serotype A and mating type α (MATα). Genotyping based on DNA sequences at seven nuclear loci revealed eight sequence types (STs) among the 86 isolates, including two novel STs that have not been reported from other parts of the world. ST5 was the dominant genotype and our comparative analyses showed that these genotypes in Jiangxi likely originated by dispersal from other regions within and outside of China and/or mutations from another genotype within Jiangxi. Though none of the isolates was resistant to the five tested antifungal drugs (flucytosine, amphotericin B, fluconazole, itraconazole, and voriconazole), obvious differences in their minimum inhibitory concentrations were observed, even among isolates of the same ST. Our results suggest that continuous monitoring should be conducted to understand the changing dynamics of C. neoformans in this and other regions.
Highlights
Cryptococcus is a genus of basidiomycetous fungi[1]
The isolates were analyzed for their mating types, multilocus genotypes derived based on sequencing at seven nuclear loci, and susceptibilities to five antifungal drugs
Several molecular techniques have been employed for identifying the molecular types and/or genotypes for strains in these two species complexes, including polymerase chain reaction (PCR) fingerprinting, pulsed-field gel electrophoresis (PFGE), amplified fragment length polymorphism (AFLP), multilocus microsatellite typing (MLMT), repetitive-sequence-based PCR, restriction fragment length polymorphism of the URA5 gene (URA5-RFLP), and multilocus sequence typing (MLST)[13]
Summary
Cryptococcus is a genus of basidiomycetous fungi[1]. Two species in this genus, Cryptococcus neoformans and Cryptococcus gattii, are major pathogens of humans and other animals and can cause a diversity of diseases collectively called cryptococcosis[1]. For successful control and prevention of cryptococcosis, it’s critical to understand the molecular epidemiology of cryptococcal infections in these emerging regions Both C. neoformans and C. gattii have broad geographic distributions and they can grow in a diversity of environments. Several molecular techniques have been employed for identifying the molecular types and/or genotypes for strains in these two species complexes, including polymerase chain reaction (PCR) fingerprinting, pulsed-field gel electrophoresis (PFGE), amplified fragment length polymorphism (AFLP), multilocus microsatellite typing (MLMT), repetitive-sequence-based PCR, restriction fragment length polymorphism of the URA5 gene (URA5-RFLP), and multilocus sequence typing (MLST)[13] Among these methods, MLST has become the preferred method by the International Society for Human and Animal Mycology (ISHAM)[11]. The objectives of this study are to analyze the genotypes and antifungal drug susceptibilities of isolates causing cryptococcosis in Jiangxi Province and to compare their genotypes with those from other regions
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