title: Diversity and Antifungal Drug Susceptibility of Cryptococcus Isolates in Thailand.
abstract: Yeasts of the Cryptococcus species complex are the causative agent of cryptococcosis, especially in human immunodeficiency virus (HIV) positive individuals. Cerebral or disseminated cryptococcosis has a very high mortality rate worldwide, including in Thailand. Additionally, an increasing rate of antifungal drug resistant cryptococcal isolates has been reported in several neighboring countries, complicating therapeutic approaches. To understand the situation of this infection in Thailand, we retrospectively investigated the molecular epidemiology and antifungal drug resistance in a collection of 74 clinical, 52 environmental and two veterinary isolates using the URA5-RFLP for typing and the EUCAST guideline for susceptibility testing. Where no EUCAST breakpoints (AMB and 5FC) were available, CLSI epidemiologic cutoff values were used for interpretation. Cryptococcal molecular type diversity showed most isolates were C. grubii, molecular type VNI. One clinical isolate was C. deuterogattii (mol. type VGII) and another C. grubii (mol. type VNII). One strain from environment was classified as C. grubii (mol. type VNII). No resistant strains were detected in this retrospective study for either of the antimycotics tested; however, monitoring of the epidemiology of Cryptococcus species in infected patients in Thailand needs to be continued to detect emergence of resistance.
authors.affiliation: Interdisciplinary Program, Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Navaporn
authors.initials: N
authors.lastname: Worasilchai
authors.affiliation: Faculty of Allied Health Sciences, Burapha University, Chon Buri, Thailand.
authors.forename: Marut
authors.initials: M
authors.lastname: Tangwattanachuleeporn
authors.affiliation: Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Kornvalee
authors.initials: K
authors.lastname: Meesilpavikkai
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Folba
authors.affiliation: Department of Medical Microbiology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
authors.forename: Mourine
authors.initials: M
authors.lastname: Kangogo
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Groß
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Weig
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bader
authors.affiliation: Interdisciplinary Program, Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Ariya
authors.initials: A
authors.lastname: Chindamporn
mesh_terms: D054458:Amplified Fragment Length Polymorphism Analysis; D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology*; D002415:Cats; D010856:Columbidae / Q000382:microbiology; D003453:Cryptococcosis / Q000453:epidemiology / Q000382:microbiology*; D003454:Cryptococcus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004271:DNA, Fungal / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000187:drug effects; D004783:Environmental Microbiology; D005243:Feces / Q000382:microbiology; D015725:Fluconazole / Q000494:pharmacology*; D014644:Genetic Variation; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D016533:Mycological Typing Techniques; D013785:Thailand / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D015725:Fluconazole
keywords: Cryptococcus; Thailand; clinical; molecular diversity; susceptibility profile