title: Molecular epidemiology reveals genetic diversity among 363 isolates of the Cryptococcus neoformans and Cryptococcus gattii species complex in 61 Ivorian HIV-positive patients.
abstract: Cryptococcal meningitis is a severe opportunistic infection in HIV-infected patients. In Ivory Coast, despite the availability of antiretroviral treatment (ART), this infection is still prevalent. The study investigates the genetic diversity of 363 clinical isolates of Cryptococcus from 61 Ivorian HIV-positive patients, the occurrence of mixed infections and the in vitro antifungal susceptibility of the isolates. Serotyping was performed via LAC1 and CAP64 gene amplification. Genotyping was performed using the phage M13 core (GACA)4and (GTG)5primers and restriction fragment length polymorphism analysis of the URA5 gene. By PCR fingerprinting, the presence of the three serotypes were demonstrated among the 363 isolates in the population studied: A (n=318; 87.6%), AD (n=40; 11%) and B (n=4; 1.1%). Using PCR fingerprinting with primers M13 (GACA)4and (GTG)5, we grouped the isolates into 56 molecular subtypes. We observed a high frequency (39.3%) of mixed infections, with up to two different genotypes per sample. None of the isolates were resistant to amphotericin B. Only 0.3% and 1.1% of the isolates were resistant to fluconazole and flucytosine respectively. This study revealed the high genetic diversity among Cryptococcus isolates, the occurrence of mixed infections and a high antifungal susceptibility for the majority of Ivorian cryptococcal isolates.
authors.affiliation: Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les autres maladies infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.|UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Fulgence K
authors.initials: FK
authors.lastname: Kassi
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Drakulovski
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Bellet
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Donika
authors.initials: D
authors.lastname: Krasteva
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: François
authors.initials: F
authors.lastname: Gatchitch
authors.affiliation: Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire.
authors.forename: Adama
authors.initials: A
authors.lastname: Doumbia
authors.affiliation: Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire.
authors.forename: Gisèle A
authors.initials: GA
authors.lastname: Kouakou
authors.affiliation: UMI 233 Service des Maladies Infectieuses et Tropicales, CHU Gui de Chauliac, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.affiliation: UMI 233 Service des Maladies Infectieuses et Tropicales, CHU Gui de Chauliac, Montpellier, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Reynes
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Mallié
authors.affiliation: Laboratoire de Parasitologie et de Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les autres maladies infectieuses), UFR Pharmacie, CHU de Treichville, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.
authors.forename: Hervé I E
authors.initials: HIE
authors.lastname: Menan
authors.affiliation: UMI 233 IRD-UM INSERM U1175 Laboratoire de Parasitologie et de Mycologie, UFR Pharmacie, Montpellier Cedex 5, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Bertout
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D007560:Cote d'Ivoire / Q000453:epidemiology; D003453:Cryptococcosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D056285:Cryptococcus gattii / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D003455:Cryptococcus neoformans / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D005260:Female; D014644:Genetic Variation; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D016533:Mycological Typing Techniques; D012150:Polymorphism, Restriction Fragment Length; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B
keywords: antifungal susceptibility; cryptococcosis; genetic diversity; genotyping; mixed infection