Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation

ABSTRACT Cryptococcus neoformans is a human opportunistic fungal pathogen causing severe disseminated meningoencephalitis, mostly in patients with cellular immune defects. This species is divided into three serotypes: A, D, and the AD hybrid. Our objectives were to compare population structures of s...

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Autores principales:	Marie Desnos-Ollivier, Sweta Patel, Dorothée Raoux-Barbot, Joseph Heitman, Françoise Dromer
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2015
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/a501389c55c7488eb5f1eeaff60fd63f
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spelling	oai:doaj.org-article:a501389c55c7488eb5f1eeaff60fd63f2021-11-15T15:49:02ZCryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation10.1128/mBio.00311-152150-7511https://doaj.org/article/a501389c55c7488eb5f1eeaff60fd63f2015-07-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.00311-15https://doaj.org/toc/2150-7511ABSTRACT Cryptococcus neoformans is a human opportunistic fungal pathogen causing severe disseminated meningoencephalitis, mostly in patients with cellular immune defects. This species is divided into three serotypes: A, D, and the AD hybrid. Our objectives were to compare population structures of serotype A and D clinical isolates and to assess whether infections with AD hybrids differ from infections with the other serotypes. For this purpose, we analyzed 483 isolates and the corresponding clinical data from 234 patients enrolled during the CryptoA/D study or the nationwide survey on cryptococcosis in France. Isolates were characterized in terms of ploidy, serotype, mating type, and genotype, utilizing flow cytometry, serotype- and mating type-specific PCR amplifications, and multilocus sequence typing (MLST) methods. Our results suggest that C. neoformans serotypes A and D have different routes of multiplication (primarily clonal expansion versus recombination events for serotype A and serotype D, respectively) and important genomic differences. Cryptococcosis includes a high proportion of proven or probable infections (21.5%) due to a mixture of genotypes, serotypes, and/or ploidies. Multivariate analysis showed that parameters independently associated with failure to achieve cerebrospinal fluid (CSF) sterilization by week 2 were a high serum antigen titer, the lack of flucytosine during induction therapy, and the occurrence of mixed infection, while infections caused by AD hybrids were more likely to be associated with CSF sterilization. Our study provides additional evidence for the possible speciation of C. neoformans var. neoformans and grubii and highlights the importance of careful characterization of causative isolates. IMPORTANCE Cryptococcus neoformans is an environmental fungus causing severe disease, estimated to be responsible for 600,000 deaths per year worldwide. This species is divided into serotypes A and D and an AD hybrid, and these could be considered two different species and an interspecies hybrid. The objectives of our study were to compare population structures of serotype A and serotype D and to assess whether infections with AD hybrids differ from infections with serotype A or D isolates in terms of clinical presentation and outcome. For this purpose, we used clinical data and strains from patients diagnosed with cryptococcosis in France. Our results suggest that, according to the serotype, isolates have different routes of multiplication and high genomic differences, confirming the possible speciation of serotypes A and D. Furthermore, we observed a better prognosis for infections caused by AD hybrid than those caused by serotype A or D, at least for those diagnosed in France.Marie Desnos-OllivierSweta PatelDorothée Raoux-BarbotJoseph HeitmanFrançoise DromerAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 6, Iss 3 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Marie Desnos-Ollivier Sweta Patel Dorothée Raoux-Barbot Joseph Heitman Françoise Dromer Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
description	ABSTRACT Cryptococcus neoformans is a human opportunistic fungal pathogen causing severe disseminated meningoencephalitis, mostly in patients with cellular immune defects. This species is divided into three serotypes: A, D, and the AD hybrid. Our objectives were to compare population structures of serotype A and D clinical isolates and to assess whether infections with AD hybrids differ from infections with the other serotypes. For this purpose, we analyzed 483 isolates and the corresponding clinical data from 234 patients enrolled during the CryptoA/D study or the nationwide survey on cryptococcosis in France. Isolates were characterized in terms of ploidy, serotype, mating type, and genotype, utilizing flow cytometry, serotype- and mating type-specific PCR amplifications, and multilocus sequence typing (MLST) methods. Our results suggest that C. neoformans serotypes A and D have different routes of multiplication (primarily clonal expansion versus recombination events for serotype A and serotype D, respectively) and important genomic differences. Cryptococcosis includes a high proportion of proven or probable infections (21.5%) due to a mixture of genotypes, serotypes, and/or ploidies. Multivariate analysis showed that parameters independently associated with failure to achieve cerebrospinal fluid (CSF) sterilization by week 2 were a high serum antigen titer, the lack of flucytosine during induction therapy, and the occurrence of mixed infection, while infections caused by AD hybrids were more likely to be associated with CSF sterilization. Our study provides additional evidence for the possible speciation of C. neoformans var. neoformans and grubii and highlights the importance of careful characterization of causative isolates. IMPORTANCE Cryptococcus neoformans is an environmental fungus causing severe disease, estimated to be responsible for 600,000 deaths per year worldwide. This species is divided into serotypes A and D and an AD hybrid, and these could be considered two different species and an interspecies hybrid. The objectives of our study were to compare population structures of serotype A and serotype D and to assess whether infections with AD hybrids differ from infections with serotype A or D isolates in terms of clinical presentation and outcome. For this purpose, we used clinical data and strains from patients diagnosed with cryptococcosis in France. Our results suggest that, according to the serotype, isolates have different routes of multiplication and high genomic differences, confirming the possible speciation of serotypes A and D. Furthermore, we observed a better prognosis for infections caused by AD hybrid than those caused by serotype A or D, at least for those diagnosed in France.
format	article
author	Marie Desnos-Ollivier Sweta Patel Dorothée Raoux-Barbot Joseph Heitman Françoise Dromer
author_facet	Marie Desnos-Ollivier Sweta Patel Dorothée Raoux-Barbot Joseph Heitman Françoise Dromer
author_sort	Marie Desnos-Ollivier
title	Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
title_short	Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
title_full	Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
title_fullStr	Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
title_full_unstemmed	Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation
title_sort	cryptococcosis serotypes impact outcome and provide evidence of <named-content content-type="genus-species">cryptococcus neoformans</named-content> speciation
publisher	American Society for Microbiology
publishDate	2015
url	https://doaj.org/article/a501389c55c7488eb5f1eeaff60fd63f
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Cryptococcosis Serotypes Impact Outcome and Provide Evidence of <named-content content-type="genus-species">Cryptococcus neoformans</named-content> Speciation

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