title: Cryptococcus tetragattii as a major cause of cryptococcal meningitis among HIV-infected individuals in Harare, Zimbabwe.
abstract: HIV-associated cryptococcal meningitis is commonly caused by Cryptococcus neoformans, whilst infections with Cryptococcus gattii sensu lato are historically rare. Despite available studies, little is known about the occurrence of C. gattii sensu lato infections among HIV-infected individuals in Zimbabwe.
  
  
  
  In a prospective cohort, we investigated the prevalence of C. gattii sensu lato meningitis among HIV-infected patients (n = 74) in Harare, Zimbabwe.
  
  
  
  Of the 66/74 isolates confirmed by molecular characterization, 16.7% (11/66) were found to be C. gattii sensu lato and 83.3% (55/66) C. neoformans sensu stricto. From one patient two phenotypically different C. gattii sensu lato colonies were cultured. The majority (n = 9/12; 75%) of the C. gattii sensu lato isolates were Cryptococcus tetragattii (AFLP7/VGIV), which has been an infrequently reported pathogen. In-hospital mortality associated with C. gattii sensu lato was 36.4%.
  
  
  
  Our data suggests that C. tetragattii (AFLP7/VGIV) is a more common cause of disease than C. gattii sensu stricto (genotype AFLP4/VGI) among patients with HIV-associated cryptococcal meningitis in Harare, Zimbabwe and possibly underreported in sub-Saharan Africa.
authors.affiliation: Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Tinashe K
authors.initials: TK
authors.lastname: Nyazika
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Electronic address: f.hagen@gmail.com.
authors.forename: Ferry
authors.initials: F
authors.lastname: Hagen
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Jacques F
authors.initials: JF
authors.lastname: Meis
authors.affiliation: Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Robertson
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000328:Adult; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003453:Cryptococcosis / Q000453:epidemiology / Q000382:microbiology; D056285:Cryptococcus gattii / Q000235:genetics / Q000302:isolation & purification*; D003455:Cryptococcus neoformans / Q000235:genetics / Q000302:isolation & purification; D004271:DNA, Fungal / Q000235:genetics; D005260:Female; D005838:Genotype; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000453:epidemiology / Q000382:microbiology*; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D016533:Mycological Typing Techniques; D015995:Prevalence; D011446:Prospective Studies; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D004271:DNA, Fungal
keywords: AFLP genotyping; Cryptococcal meningitis; Cryptococcus gattii; Cryptococcus neoformans; Cryptococcus tetragattii; HIV infections; Multilocus sequence typing; Mycological biotyping