Fungal infections are responsible for high morbidity and mortality in neonatal patients, especially in premature newborns. Infections in neonates caused by Cryptococcus spp. are rare, but it has occurred in an immunocompromised population. This study aims to describe the isolation of Cryptococcus liquefaciens from the hands of a health professional in a neonatal intensive care unit, and to evaluate the production of biofilm and virulence factors and susceptibility to antifungals. Antifungal susceptibility tests were performed according to Clinical and Laboratory Standard Institute document M27-A3. Thermotolerance virulence factors and DNase, phospholipase, proteinase, and hemolytic activities were verified through phenotypic tests; biofilm was evaluated by determining the metabolic activity and biomass. The isolate did not produce any of the tested enzymes and was susceptible to all antifungals (amphotericin B, fluconazole, and micafungin). The growth at 37 °C was very weak; however, the isolate showed a strong biomass production and low metabolic activity. This is the first report of C. liquefaciens isolated from the hands of a health professional. The isolate did not express any of the studied virulence factors in vitro, except for the low growth at 37 °C in the first 48 h, and the strong production of biofilm biomass. Cryptococcus liquefaciens can remain in the environment for a long time and is a human pathogen because it tolerates temperature variations. This report draws attention to the circulation of rare species in critical locations, information that may help in a fast and correct diagnosis and, consequently, implementation of an appropriate treatment.
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The authors are grateful to the neonatal intensive care unit of the University Hospital of Uberlândia, the Technical Course in Clinical Analysis, and the Technical School of Health of the Federal University of Uberlândia (ESTES-UFU) for the research space. We thank Meliza Arantes de Souza Bessa for her collaboration in the registration of the photos and we also thank Rodrigo Augusto Machado de Moraes for helping in translating the article into English.
This study was funded by the Research Support Foundation of the State of Minas Gerais (FAPEMIG) (grant number APQ-00965–18). Priscila Guerino Vilela Alves and Nagela Bernadelli Souza e Silva received research grants from the Coordination for the Improvement of Higher Education Personnel (CAPES), and Renner Soares Cruvinel received a research grant from the National Council for Scientific and Technological Development (CNPQ). This study was financed in part by the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Finance Code 001.
This study was approved by the Research Ethics Committee of the Federal University of Uberlândia, under no. 2.645.323/2018.
The professional was informed about the research, and the collection was only carried out after he/she signed the informed consent form.
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Alves, P.G.V., de Paula Menezes, R., de Oliveira Brito, M. et al. Cryptococcus liquefaciens isolated from the hand of a healthcare professional in a neonatal intensive care unit. Braz J Microbiol (2021). https://doi.org/10.1007/s42770-021-00601-4
- Cryptococcus liquefaciens
- Fungal infections
- Virulence factors