Skip to main content

Advertisement

SpringerLink
Log in

Molecular characterisation and antifungal susceptibility of clinical Cryptococcus deuterogattii (AFLP6/VGII) isolates from Southern Brazil

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Cryptococcosis, caused by Cryptococcus gattii sensu lato, is an emerging disease that was initially found in (sub)tropical regions but recently expanded to temperate regions. Cryptococcus gattii s.l. infections are mostly encountered in healthy individuals, frequently affecting both lungs and the central nervous system (CNS). Usually, C. gattii s.l. is less susceptible to antifungal compounds than its counterpart, C. neoformans s.l. We studied 18 clinical C. gattii s.l. isolates with amplified fragment length polymorphism (AFLP) fingerprinting, mating-typing, multi-locus sequence typing (MLST) and antifungal susceptibility testing. All isolates were C. deuterogattii (genotype AFLP6/VGII), 14 were mating-type α and four were type a. Amphotericin B, itraconazole, voriconazole, posaconazole and isavuconazole showed high activity, with minimum inhibitory concentration (MIC) ranges of 0.063–0.25, 0.031–0.25, 0.031–0.25, 0.031–0.25 and <0.016–0.25 μg mL−1, respectively. Fluconazole and flucytosine had high geometric mean MICs of 2.07 and 3.7 μg mL−1, respectively. Most cases occurred in immunocompetent patients (n = 10; 55.6 %) and CNS involvement was the most common clinical presentation (n = 14; 77.8 %). Three patients (16.7 %) showed sequelae, hyperreflexia, dysarthria, diadochokinesia, anosmia and upper limb weakness. In conclusion, all infections were caused by C. deuterogattii (AFLP6/VGII) and the majority of patients were immunocompetent, with the CNS as the most affected site. All antifungal drugs had high in vitro activity against C. deuterogattii isolates, except fluconazole and flucytosine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kwon-Chung KJ, Fraser JA, Doering TL, Wang Z, Janbon G, Idnurm A et al (2014) Cryptococcus neoformans and Cryptococcus gattii, the etiologic agents of cryptococcosis. Cold Spring Harb Perspect Med 4(7):a019760. doi:10.1101/cshperspect.a019760

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hagen F, Khayhan K, Theelen B, Kolecka A, Polacheck I, Sionov E et al (2015) Recognition of seven species in the Cryptococcus gattii/Cryptococcus neoformans species complex. Fungal Genet Biol 78:16–48. doi:10.1016/j.fgb.2015.02.009

    Article  CAS  PubMed  Google Scholar 

  3. Liu XZ, Wang QM, Göker M, Groenewald M, Kachalkin AV, Lumbsch HT et al (2015) Towards an integrated phylogenetic classification of the Tremellomycetes. Stud Mycol 81:85–147. doi:10.1016/j.simyco.2015.12.001

    Article  PubMed  Google Scholar 

  4. Liu XZ, Wang QM, Theelen B, Groenewald M, Bai FY, Boekhout T (2015) Phylogeny of tremellomycetous yeasts and related dimorphic and filamentous basidiomycetes reconstructed from multiple gene sequence analyses. Stud Mycol 81:1–26. doi:10.1016/j.simyco.2015.08.001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Kidd SE, Hagen F, Tscharke RL, Huynh M, Bartlett KH, Fyfe M et al (2004) A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). Proc Natl Acad Sci U S A 101:17258–17263. doi:10.1073/pnas.0402981101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Byrnes EJ 3rd, Bartlett KH, Perfect JR, Heitman J (2011) Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals. Microbes Infect 13:895–907. doi:10.1016/j.micinf.2011.05.009

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Springer DJ, Billmyre RB, Filler EE, Voelz K, Pursall R, Mieczkowski PA et al (2014) Cryptococcus gattii VGIII isolates causing infections in HIV/AIDS patients in Southern California: identification of the local environmental source as arboreal. PLoS Pathog 10, e1004285. doi:10.1371/journal.ppat.1004285

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nyazika TK, Hagen F, Meis JF, Robertson VJ (2016) Cryptococcus tetragattii as a major cause of cryptococcal meningitis among HIV-infected individuals in Harare, Zimbabwe. J Infect 72:745–752. doi:10.1016/j.jinf.2016.02.018

    Article  PubMed  Google Scholar 

  9. Datta K, Bartlett KH, Baer R, Byrnes E, Galanis E, Heitman J et al (2009) Spread of Cryptococcus gattii into Pacific Northwest region of the United States. Emerg Infect Dis 15:1185–1191. doi:10.3201/eid1508.081384

    Article  PubMed  PubMed Central  Google Scholar 

  10. Galanis E, Macdougall L, Kidd S, Morshed M; British Columbia Cryptococcus gattii Working Group (2010) Epidemiology of Cryptococcus gattii, British Columbia, Canada, 1999–2007. Emerg Infect Dis 16:251–257. doi:10.3201/eid1602.090900

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hagen F, Boekhout T (2010) The search for the natural habitat of Cryptococcus gattii. Mycopathologia 170:209–211. doi:10.1007/s11046-010-9313-6

    Article  PubMed  Google Scholar 

  12. Kidd SE, Bach PJ, Hingston AO, Mak S, Chow Y, MacDougall L et al (2007) Cryptococcus gattii dispersal mechanisms, British Columbia, Canada. Emerg Infect Dis 13:51–57. doi:10.3201/eid1301.060823

    Article  PubMed  PubMed Central  Google Scholar 

  13. Springer DJ, Chaturvedi V (2010) Projecting global occurrence of Cryptococcus gattii. Emerg Infect Dis 16:14–20. doi:10.3201/eid1601.090369

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ellis DH, Pfeiffer TJ (1990) Natural habitat of Cryptococcus neoformans var. gattii. J Clin Microbiol 28:1642–1644

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Kidd SE, Chow Y, Mak S, Bach PJ, Chen H, Hingston AO et al (2007) Characterization of environmental sources of the human and animal pathogen Cryptococcus gattii in British Columbia, Canada, and the Pacific Northwest of the United States. Appl Environ Microbiol 73:1433–1443. doi:10.1128/AEM.01330-06

    Article  CAS  PubMed  Google Scholar 

  16. Chowdhary A, Rhandhawa HS, Prakash A, Meis JF (2012) Environmental prevalence of Cryptococcus neoformans and Cryptococcus gattii in India: an update. Crit Rev Microbiol 38:1–16. doi:10.3109/1040841X.2011.606426

    Article  PubMed  Google Scholar 

  17. Hagen F, Chowdhary A, Prakash A, Yntema J-B, Meis JF (2014) Molecular characterization of Cryptococcus gattii genotype AFLP6/VGII isolated from woody debris of divi-divi (Caesalpinia coriaria), Bonaire, Dutch Caribbean. Rev Iberoam Micol 31:193–196. doi:10.1016/j.riam.2013.10.007

    Article  PubMed  Google Scholar 

  18. Anzai MC, Lazéra MDS, Wanke B, Trilles L, Dutra V, de Paula DAJ et al (2014) Cryptococcus gattii VGII in a Plathymenia reticulata hollow in Cuiabá, Mato Grosso, Brazil. Mycoses 57:414–418. doi:10.1111/myc.12177

    Article  PubMed  Google Scholar 

  19. Linares C, Colom MF, Torreblanca M, Esteban V, Romera Á, Hagen F (2015) Environmental sampling of Ceratonia siliqua (carob) trees in Spain reveals the presence of the rare Cryptococcus gattii genotype AFLP7/VGIV. Rev Iberoam Micol 32:269–272. doi:10.1016/j.riam.2014.11.002

    Article  PubMed  Google Scholar 

  20. Hagen F, van Assen S, Luijckx GJ, Boekhout T, Kampinga GA (2010) Activated dormant Cryptococcus gattii infection in a Dutch tourist who visited Vancouver Island (Canada): a molecular epidemiological approach. Med Mycol 48:528–531. doi:10.3109/13693780903300319

    Article  PubMed  Google Scholar 

  21. Hagen F, Colom MF, Swinne D, Tintelnot K, Iatta R, Montagna MT et al (2012) Autochthonous and dormant Cryptococcus gattii infections in Europe. Emerg Infect Dis 18:1618–1624. doi:10.3201/eid1810.120068

    Article  PubMed  PubMed Central  Google Scholar 

  22. Colom MF, Hagen F, Gonzalez A, Mellado A, Morera N, Linares C et al (2012) Ceratonia siliqua (carob) trees as natural habitat and source of infection by Cryptococcus gattii in the Mediterranean environment. Med Mycol 50:67–73. doi:10.3109/13693786.2011.574239

    Article  PubMed  Google Scholar 

  23. Cogliati M (2013) Global molecular epidemiology of Cryptococcus neoformans and Cryptococcus gattii: an atlas of the molecular types. Scientifica (Cairo) 2013:675213. doi:10.1155/2013/675213

    Google Scholar 

  24. Chowdhary A, Prakash A, Randhawa HS, Kathuria S, Hagen F, Klaassen CH et al (2013) First environmental isolation of Cryptococcus gattii, genotype AFLP5, from India and a global review. Mycoses 56:222–228. doi:10.1111/myc.12039

    Article  CAS  PubMed  Google Scholar 

  25. Hagen F, Ceresini PC, Polacheck I, Ma H, van Nieuwerburgh F, Gabaldón T et al (2013) Ancient dispersal of the human fungal pathogen Cryptococcus gattii from the amazon rainforest. PLoS One. doi:10.1371/journal.pone.0071148

    Google Scholar 

  26. Espinel-Ingroff A, Aller AI, Canton E, Castañón-Olivares LR, Chowdhary A, Cordoba S et al (2012) 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 56:5898–5906. doi:10.1128/AAC.01115-12

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Espinel-Ingroff A, Chowdhary A, Cuenca-Estrella M, Fothergill A, Fuller J, Hagen F et al (2012) 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 56:3107–3113. doi:10.1128/AAC.06252-11

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Espinel-Ingroff A, Chowdhary A, Gonzalez GM, Guinea J, Hagen F, Meis JF et al (2015) Multicenter study of isavuconazole MIC distributions and epidemiological cutoff values for the Cryptococcus neoformans–Cryptococcus gattii species complex using the CLSI M27-A3 broth microdilution method. Antimicrob Agents Chemother 59:666–668. doi:10.1128/AAC.04055-14

    Article  CAS  PubMed  Google Scholar 

  29. Sionov E, Chang YC, Garraffo HM, Kwon-Chung KJ (2009) Heteroresistance to fluconazole in Cryptococcus neoformans is intrinsic and associated with virulence. Antimicrob Agents Chemother 53:2804–2815. doi:10.1128/AAC.00295-09

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Varma A, Kwon-Chung KJ (2010) Heteroresistance of Cryptococcus gattii to fluconazole. Antimicrob Agents Chemother 54:2303–2311. doi:10.1128/AAC.00153-10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Illnait-Zaragozí MT, Martínez-Machín GF, Fernández-Andreu CM, Perurena-Lancha MR, Theelen B, Boekhout T et al (2012) Environmental isolation and characterisation of Cryptococcus species from living trees in Havana city, Cuba. Mycoses 55:e138–e144. doi:10.1111/j.1439-0507.2012.02168.x

    Article  PubMed  Google Scholar 

  32. Katoh K, Misawa K, Kuma K, Miyata T (2002) MAFFT: a novel method for rapid multiple sequence alignment based on fast Fourier transform. Nucleic Acids Res 30:3059–3066

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kumar S, Stecher G, Tamura K (2016) MEGA7: Molecular Evolutionary Genetics Analysis version 7.0 for bigger datasets. Mol Biol Evol 33:1870–1874. doi:10.1093/molbev/msw054

    Article  CAS  PubMed  Google Scholar 

  34. Clinical and Laboratory Standards Institute (CLSI) (2008) Reference method for broth dilution antifungal susceptibility testing of yeasts; Approved standard—Third edition. CLSI document M27-A3 (ISBN 1-56238-666-2). Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898, USA

  35. Marques SA, Bastazini I Jr, Martins ALGP, Barreto JA, Barbieri D’Elia MP, Lastória JC et al (2012) Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients. Int J Dermatol 51:780–784. doi:10.1111/j.1365-4632.2011.05298.x

    Article  PubMed  Google Scholar 

  36. Cicora F, Petroni J, Formosa P, Roberti J (2015) A rare case of Cryptococcus gattii pneumonia in a renal transplant patient. Transpl Infect Dis 17:463–466. doi:10.1111/tid.12371

    Article  CAS  PubMed  Google Scholar 

  37. Franco-Paredes C, Womack T, Bohlmeyer T, Sellers B, Hays A, Patel K et al (2015) Management of Cryptococcus gattii meningoencephalitis. Lancet Infect Dis 15:348–355. doi:10.1016/S1473-3099(14)70945-4

    Article  PubMed  Google Scholar 

  38. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ et al (2010) Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 50:291–322. doi:10.1086/649858

    Article  PubMed  Google Scholar 

  39. Chen SC-A, Slavin MA, Heath CH, Playford EG, Byth K, Marriott D et al (2012) Clinical manifestations of Cryptococcus gattii infection: determinants of neurological sequelae and death. Clin Infect Dis 55:789–798. doi:10.1093/cid/cis529

    Article  PubMed  Google Scholar 

  40. Chen SC-A, Korman TM, Slavin MA, Marriott D, Byth K, Bak N et al (2013) Antifungal therapy and management of complications of cryptococcosis due to Cryptococcus gattii. Clin Infect Dis 57:543–551. doi:10.1093/cid/cit341

    Article  CAS  PubMed  Google Scholar 

  41. dos Santos WRA, Meyer W, Wanke B, Costa SPSE, Trilles L, dos Nascimento JLM et al (2008) Primary endemic Cryptococcosis gattii by molecular type VGII in the state of Pará, Brazil. Mem Inst Oswaldo Cruz 103:813–818

    PubMed  Google Scholar 

  42. do Costa PSE, do Lazéra M, Santos WRA, Morales BP, Bezerra CCF, Nishikawa MM et al (2009) First isolation of Cryptococcus gattii molecular type VGII and Cryptococcus neoformans molecular type VNI from environmental sources in the city of Belém, Pará, Brazil. Mem Inst Oswaldo Cruz 104:662–664

    Article  CAS  Google Scholar 

  43. Martins LMS, Wanke B, dos Lazéra M, Trilles L, Barbosa GG, de Macedo RCL et al (2011) Genotypes of Cryptococcus neoformans and Cryptococcus gattii as agents of endemic cryptococcosis in Teresina, Piauí (northeastern Brazil). Mem Inst Oswaldo Cruz 106:725–730

    Article  CAS  PubMed  Google Scholar 

  44. Freire AKL, dos Santos BA, de Lima SI, Matsuura ABJ, Ogusku MM, Salem JI et al (2012) Molecular characterisation of the causative agents of cryptococcosis in patients of a tertiary healthcare facility in the state of Amazonas-Brazil. Mycoses 55:e145–e150. doi:10.1111/j.1439-0507.2012.02173.x

    Article  PubMed  Google Scholar 

  45. Matos CS, de Souza Andrade A, Oliveira NS, Barros TF (2012) Microbiological characteristics of clinical isolates of Cryptococcus spp. in Bahia, Brazil: molecular types and antifungal susceptibilities. Eur J Clin Microbiol Infect Dis 31:1647–1652. doi:10.1007/s10096-011-1488-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Silva DC, Martins MA, Szeszs MW, Bonfietti LX, Matos D, Melhem MSC (2012) Susceptibility to antifungal agents and genotypes of Brazilian clinical and environmental Cryptococcus gattii strains. Diagn Microbiol Infect Dis 72:332–339. doi:10.1016/j.diagmicrobio.2011.11.016

    Article  CAS  PubMed  Google Scholar 

  47. Cardoso PHM, de Baroni F, Silva EG, Nascimento DC, Martins MDA, Szezs W et al (2013) Feline nasal granuloma due to Cryptoccocus gattii type VGII. Mycopathologia 176:303–307. doi:10.1007/s11046-013-9686-4

    Article  PubMed  Google Scholar 

  48. Favalessa OC, de Paula DAJ, Dutra V, Nakazato L, Tadano T, dos Lazera M et al (2014) Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil. J Infect Dev Ctries 8:1037–1043

    Article  CAS  PubMed  Google Scholar 

  49. Brito-Santos F, Barbosa GG, Trilles L, Nishikawa MM, Wanke B, Meyer W et al (2015) Environmental isolation of Cryptococcus gattii VGII from indoor dust from typical wooden houses in the deep Amazonas of the Rio Negro basin. PLoS One 10, e0115866. doi:10.1371/journal.pone.0115866

    Article  PubMed  PubMed Central  Google Scholar 

  50. Headley SA, Di Santis GW, de Alcântara BK, Costa TC, da Silva EO, Pretto-Giordano LG et al (2015) Cryptococcus gattii-induced infections in dogs from Southern Brazil. Mycopathologia 180:265–275. doi:10.1007/s11046-015-9901-6

    Article  PubMed  Google Scholar 

  51. Abegg MA, Cella FL, Faganello J, Valente P, Schrank A, Vainstein MH (2006) Cryptococcus neoformans and Cryptococcus gattii isolated from the excreta of psittaciformes in a southern Brazilian zoological garden. Mycopathologia 161:83–91. doi:10.1007/s11046-005-0186-z

    Article  PubMed  Google Scholar 

  52. Trilles L, dos Lazéra M, Wanke B, Oliveira RV, Barbosa GG, Nishikawa MM et al (2008) Regional pattern of the molecular types of Cryptococcus neoformans and Cryptococcus gattii in Brazil. Mem Inst Oswaldo Cruz 103:455–462

    Article  CAS  PubMed  Google Scholar 

  53. Nascimento E, Bonifácio da Silva MEN, Martinez R, von Zeska Kress MR (2014) Primary cutaneous cryptococcosis in an immunocompetent patient due to Cryptococcus gattii molecular type VGI in Brazil: a case report and review of literature. Mycoses 57:442–447. doi:10.1111/myc.12176

    Article  PubMed  Google Scholar 

  54. Carriconde F, Gilgado F, Arthur I, Ellis D, Malik R, van de Wiele N et al (2011) Clonality and α-a recombination in the Australian Cryptococcus gattii VGII population—an emerging outbreak in Australia. PLoS One 6, e16936. doi:10.1371/journal.pone.0016936

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Fraser JA, Giles SS, Wenink EC, Geunes-Boyer SG, Wright JR, Diezmann S et al (2005) Same-sex mating and the origin of the Vancouver Island Cryptococcus gattii outbreak. Nature 437:1360–1364. doi:10.1038/nature04220

    Article  CAS  PubMed  Google Scholar 

  56. Iqbal N, DeBess EE, Wohrle R, Sun B, Nett RJ, Ahlquist AM et al (2010) Correlation of genotype and in vitro susceptibilities of Cryptococcus gattii strains from the Pacific Northwest of the United States. J Clin Microbiol 48:539–544. doi:10.1128/JCM.01505-09

    Article  CAS  PubMed  Google Scholar 

  57. Pasa CR, Chang MR, Hans-Filho G (2012) Post-trauma primary cutaneous cryptococcosis in an immunocompetent host by Cryptococcus gattii VGII. Mycoses 55:e1–e3. doi:10.1111/j.1439-0507.2011.02058.x

    PubMed  Google Scholar 

  58. Hagen F, Illnait-Zaragozi M-T, Bartlett KH, Swinne D, Geertsen E, Klaassen CHW et al (2010) 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 54:5139–5145. doi:10.1128/AAC.00746-10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Lockhart SR, Iqbal N, Bolden CB, DeBess EE, Marsden-Haug N, Worhle R et al (2012) Epidemiologic cutoff values for triazole drugs in Cryptococcus gattii: correlation of molecular type and in vitro susceptibility. Diagn Microbiol Infect Dis 73:144–148. doi:10.1016/j.diagmicrobio.2012.02.018

    Article  CAS  PubMed  Google Scholar 

  60. Trilles L, Meyer W, Wanke B, Guarro J, Lazéra M (2012) Correlation of antifungal susceptibility and molecular type within the Cryptococcus neoformans/C. gattii species complex. Med Mycol 50:328–332. doi:10.3109/13693786.2011.602126

    Article  PubMed  Google Scholar 

  61. Miceli MH, Kauffman CA (2015) Isavuconazole: a new broad-spectrum triazole antifungal agent. Clin Infect Dis 61:1558–1565. doi:10.1093/cid/civ571

    Article  PubMed  Google Scholar 

  62. Illnait-Zaragozi M-T, Martínez GF, Curfs-Breuker I, Fernández CM, Boekhout T, Meis JF (2008) In vitro activity of the new azole isavuconazole (BAL4815) compared with six other antifungal agents against 162 Cryptococcus neoformans isolates from Cuba. Antimicrob Agents Chemother 52:1580–1582. doi:10.1128/AAC.01384-07

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Datta K, Rhee P, Byrnes E 3rd, Garcia-Effron G, Perlin DS, Staab JF et al (2013) Isavuconazole activity against Aspergillus lentulus, Neosartorya udagawae, and Cryptococcus gattii, emerging fungal pathogens with reduced azole susceptibility. J Clin Microbiol 51:3090–3093. doi:10.1128/JCM.01190-13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Thompson GR 3rd, Rendon A, Dos Santos RR, Queiroz-Telles F, Ostrosky-Zeichner L, Azie N et al (2016) Isavuconazole treatment of cryptococcosis and dimorphic mycoses. Clin Infect Dis 63:356–362. doi:10.1093/cid/ciw305

    Article  PubMed  PubMed Central  Google Scholar 

  65. Chen SC-A, Meyer W, Sorrell TC (2014) Cryptococcus gattii infections. Clin Microbiol Rev 27:980–1024. doi:10.1128/CMR.00126-13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Hospenthal DR, Bennett JE (1998) Flucytosine monotherapy for cryptococcosis. Clin Infect Dis 27:260–264

    Article  CAS  PubMed  Google Scholar 

  67. Illnait-Zaragozí MT, Martínez-Machín GF, Fernández-Andreu CM, Hagen F, Boekhout T, Klaassen CHW et al (2010) Microsatellite typing and susceptibilities of serial Cryptococcus neoformans isolates from Cuban patients with recurrent cryptococcal meningitis. BMC Infect Dis 10:289. doi:10.1186/1471-2334-10-289

    Article  PubMed  PubMed Central  Google Scholar 

  68. Chowdhary A, Randhawa HS, Sundar G, Kathuria S, Prakash A, Khan Z et al (2011) In vitro antifungal susceptibility profiles and genotypes of 308 clinical and environmental isolates of Cryptococcus neoformans var. grubii and Cryptococcus gattii serotype B from north-western India. J Med Microbiol 60:961–967. doi:10.1099/jmm.0.029025-0

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The work of Patricia Fernanda Herkert was financially supported by ‘Coordenação de Aperfeiçoamento de Pessoal de Nível Superior’ and ‘Conselho Nacional de Desenvolvimento Científico e Tecnológico’, Brazil.

Author information

Authors and Affiliations

  1. Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, PR, Brazil

    P. F. Herkert, R. R. Gomes & V. A. Vicente

  2. Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands

    P. F. Herkert, F. Hagen & J. F. Meis

  3. Department of Internal Medicine, Federal University of Parana, Curitiba, PR, Brazil

    G. L. de Oliveira Salvador

  4. Department of Biological Science, State University of Parana/Campus Paranagua, Paranagua, PR, Brazil

    R. R. Gomes

  5. Federal University of Uberlandia, Uberlândia, MG, Brazil

    M. S. Ferreira

  6. Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasília, DF, Brazil

    V. A. Vicente

  7. Laboratory of Mycology, Hospital de Clínicas, Federal University of Parana, Curitiba, PR, Brazil

    M. D. Muro & R. L. Pinheiro

  8. Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands

    J. F. Meis

  9. Communitarian Health Department, Hospital de Clínicas, Federal University of Parana, Curitiba, PR, Brazil

    F. Queiroz-Telles

Authors
  1. P. F. Herkert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Hagen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. L. de Oliveira Salvador
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. R. Gomes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. S. Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. A. Vicente
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. D. Muro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R. L. Pinheiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. F. Meis
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. F. Queiroz-Telles
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Hagen.

Ethics declarations

Conflict of interest

JFM served as a consultant to and has received research grants from Astellas, Basilea, Gilead Sciences and Merck. All of the other authors declare no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herkert, P.F., Hagen, F., de Oliveira Salvador, G.L. et al. Molecular characterisation and antifungal susceptibility of clinical Cryptococcus deuterogattii (AFLP6/VGII) isolates from Southern Brazil. Eur J Clin Microbiol Infect Dis 35, 1803–1810 (2016). https://doi.org/10.1007/s10096-016-2731-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-016-2731-8

Keywords

Search

Navigation