Molecular diversity of serial Cryptococcus neoformans isolates from AIDS patients in the city of São Paulo, Brazil.
Despite highly active anti-retroviral therapy, cryptococcal meningoencephalitis is the second most prevalent neurological disease in Brazilian AIDS patients, being frequently a defining condition with several episodes. As knowledge of Cryptococcus neoformans isolates in the same episode is critical for understanding why some patients develop several episodes, we investigated the genotype characteristics of C. neoformans isolates in two different situations. By pulsed field gel electrophoresis and random amplified polymorphic DNA analysis, 54 isolates from 12 patients with AIDS and cryptococcosis were analyzed. Group 1 comprised 39 isolates from nine patients with a single episode and hospitalization. Group 2 comprised 15 isolates from three patients with two episodes and hospitalizations. Except for three patients from group 1 probably infected with a single C. neoformans isolate, the other nine patients probably were infected with multiple isolates selected in different collection periods, or the infecting isolate might have underwent mutation to adapt and survive the host immune system and/or the antifungal therapy. However, the three patients from group 2 presented genetic diversity among isolates collected in both hospitalizations, possibly having hosted the initial isolate in both periods. These data, emphasize that Cryptococcus diversity in infection can contribute to strategies of treatment and prevention of cryptococcosis.
Martins
Marilena A
MA
Laboratório de Biologia Molecular de Parasitas e Fungos de Interesse em Saúde Pública, Serviço de Parasitologia, Instituto Adolfo Lutz, São Paulo, SP, 01246-902, Brazil.
Pappalardo
Mara C S M
MC
Melhem
Márcia S C
MS
Pereira-Chioccola
Vera L
VL
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000208:Acute Disease; D001938:Brazil; D003455:Cryptococcus neoformans / Q000235:genetics* / Q000302:isolation & purification; D004271:DNA, Fungal / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008590:Meningoencephalitis / Q000382:microbiology*; D016533:Mycological Typing Techniques; D019105:Random Amplified Polymorphic DNA Technique
D004271:DNA, Fungal