ABSTRACT
PURPOSE: Cryptococcosis is acquired from the environment by the inhalation of Cryptococcus cells and may establish from an asymptomatic latent infection into pneumonia or meningoencephalitis. The genetic diversity of a Cryptococcus neoformans species complex has been investigated by several molecular tools, such as multi-locus sequence typing, amplified fragment length polymorphism (AFLP), restriction fragment length polymorphism and microsatellite analysis. This study aimed to investigate the genotype distributions and antifungal susceptibility profiles of C. neoformans sensu lato isolates from southern Brazil. METHODOLOGY: We studied 219 C. neoformans sensu lato isolates with mating- and serotyping, AFLP fingerprinting, microsatellite typing and antifungal susceptibility testing.Results/Key findings. Among the isolates, 136 (69â%) were from HIV-positive patients. Only C. neoformans mating-type α and serotype A were observed. AFLP fingerprinting analysis divided the isolates into AFLP1/VNI (n=172; 78.5â%), AFLP1A/VNII (n=19; 8.7â%), AFLP1B/VNII (n=4; 1.8â%) and a new AFLP pattern AFLP1C (n=23; 10.5â%). All isolates were susceptible to tested antifungals and no correlation between antifungal susceptibility and genotypes was observed. Through microsatellite analysis, most isolates clustered in a major microsatellite complex and Simpson's diversity index of this population was D=0.9856. CONCLUSION: The majority of C. neoformans sensu stricto infections occurred in HIV-positive patients. C. neoformans AFLP1/VNI was the most frequent genotype and all antifungal drugs had high in vitro activity against this species. Microsatellite analyses showed a high genetic diversity within the regional C. neoformans sensu stricto population, and correlation between environmental and clinical isolates, as well as a temporal and geographic relationship.
Subject(s)
Antifungal Agents/pharmacology , Cryptococcosis/microbiology , Cryptococcus neoformans/drug effects , Cryptococcus neoformans/isolation & purification , Drug Resistance, Fungal , Amplified Fragment Length Polymorphism Analysis , Brazil , Cryptococcus neoformans/classification , Cryptococcus neoformans/genetics , Genotype , Humans , Microbial Sensitivity Tests , Multilocus Sequence Typing , Phylogeny , Polymorphism, Restriction Fragment LengthABSTRACT
Entre las principales enfermedades oportunistas que aparecen en el paciente VIH-positivo se encuentra la histoplasmosis. Esta micosis sistémica, causada por el hongo Histoplasma capsulatum, tiene la capacidad de diseminarse a partir del pulmón hacia la piel y la mucosa oral. Pueden encontrarse lesiones orales de histoplasmosis con aspecto ulcerado o nodular, pero son siempre muy dolorosas e infiltrantes de la mucosa. Cuando están presentes en la boca son claro indicio de alguna inmunodepresión. Este trabajo muestra la evolución de un paciente VIH-positivo que presentaba varias lesiones ulceradas en la cavidad bucal y la piel facial. La sintomatología y el aspecto clínico de las lesiones no fueron específicos de la enfermedad y por eso el diagnóstico fue obtenido por raspado citológico y biopsia oral. El resultado de los exámenes puso de manifiesto que se trataba de un cuadro sistémico. El plan de tratamiento fue hecho con anfotericina B para la remisión de las lesiones y, seguidamente, con itraconazol en la fase de mantenimiento (AU)
