title: First molecular typing of cryptococcemia-causing cryptococcus in central-west Brazil.
abstract: Molecular epidemiology studies on cryptococcemia are limited. This study aimed to describe the clinical features of patients with bloodstream infections by Cryptococcus sp. in a public tertiary hospital in Mato Grosso do Sul, as well as identify the fungus' molecular type and determine its antifungal susceptibility. Molecular typing was performed using URA5 restriction fragment length polymorphism PCR, and antifungal susceptibility was determined by microdilution method standardized by the Clinical and Laboratory Standards Institute. Over 14 years, 48 patients were diagnosed with cryptococcemia. The majority (72.9 %) was male with a median age of 40 years; 81.3 % of the patients had HIV/AIDS and 72.9 % died. Cryptococcus neoformans was the most commonly isolated species (97.9 %). Molecular analysis identified the genotypes C. neoformans VNI (93.7 %), C. neoformans VNII (4.2 %), and Cryptococcus gattii VGII (2.1 %). In vitro, these fungi were not resistant to fluconazole, itraconazole, voriconazole, and amphotericin B. This is the first description of the molecular types of cryptococcemia agents in central-west Brazil. Its high lethality, especially in HIV-negative patients, suggests that early diagnosis and prompt antifungal therapy are crucial for a good clinical outcome.
authors.affiliation: Microbiological Research Laboratory, Biology and Health Sciences Center, Federal University of Mato Grosso do Sul, Cidade Universitária, Campo Grande, Mato Grosso do Sul, CEP 79070-900, Brazil.
authors.forename: Rosianne Assis de Sousa
authors.initials: RA
authors.lastname: Tsujisaki
authors.forename: Anamaria Mello Miranda
authors.initials: AM
authors.lastname: Paniago
authors.forename: Manoel Sebastião da Costa
authors.initials: MS
authors.lastname: Lima Júnior
authors.forename: Débora de Souza Olartechea de
authors.initials: Dde S
authors.lastname: Alencar
authors.forename: Fernanda Luíza Espinosa
authors.initials: FL
authors.lastname: Spositto
authors.forename: Maína de Oliveira
authors.initials: Mde O
authors.lastname: Nunes
authors.forename: Luciana
authors.initials: L
authors.lastname: Trilles
authors.forename: Marilene Rodrigues
authors.initials: MR
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D001938:Brazil; D002648:Child; D003453:Cryptococcosis / Q000382:microbiology*; D056285:Cryptococcus gattii / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D003455:Cryptococcus neoformans / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005656:Fungal Proteins / Q000235:genetics; D016469:Fungemia / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology / Q000379:methods; D058889:Molecular Typing / Q000379:methods*; D016533:Mycological Typing Techniques / Q000379:methods*; D012150:Polymorphism, Restriction Fragment Length; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D005656:Fungal Proteins