title: Autochthonous and dormant Cryptococcus gattii infections in Europe.
abstract: Until recently, Cryptococcus gattii infections occurred mainly in tropical and subtropical climate zones. However, during the past decade, C. gattii infections in humans and animals in Europe have increased. To determine whether the infections in Europe were acquired from an autochthonous source or associated with travel, we used multilocus sequence typing to compare 100 isolates from Europe (57 from 40 human patients, 22 from the environment, and 21 from animals) with 191 isolates from around the world. Of the 57 human patient isolates, 47 (83%) were obtained since 1995. Among the 40 patients, 24 (60%) probably acquired the C. gattii infection outside Europe; the remaining 16 (40%) probably acquired the infection within Europe. Human patient isolates from Mediterranean Europe clustered into a distinct genotype with animal and environmental isolates. These results indicate that reactivation of dormant C. gattii infections can occur many years after the infectious agent was acquired elsewhere.
authors.affiliation: Royal Netherlands Academy of Arts and Sciences Fungal Biodiversity Centre, Utrecht, the Netherlands. f.hagen@gmail.com
authors.forename: Ferry
authors.initials: F
authors.lastname: Hagen
authors.forename: M Francisca
authors.initials: MF
authors.lastname: Colom
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Swinne
authors.forename: Kathrin
authors.initials: K
authors.lastname: Tintelnot
authors.forename: Roberta
authors.initials: R
authors.lastname: Iatta
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Montagna
authors.forename: Josep M
authors.initials: JM
authors.lastname: Torres-Rodriguez
authors.forename: Massimo
authors.initials: M
authors.lastname: Cogliati
authors.forename: Aristea
authors.initials: A
authors.lastname: Velegraki
authors.forename: Arjan
authors.initials: A
authors.lastname: Burggraaf
authors.forename: Alwin
authors.initials: A
authors.lastname: Kamermans
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Sweere
authors.forename: Jacques F
authors.initials: JF
authors.lastname: Meis
authors.forename: Corné H W
authors.initials: CH
authors.lastname: Klaassen
authors.forename: Teun
authors.initials: T
authors.lastname: Boekhout
mesh_terms: D000818:Animals; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology; D003453:Cryptococcosis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D056285:Cryptococcus gattii / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D014195:Travel