MLST揭示了来自巴西北部亚马逊州临床来源的新型隐球菌分子型VNI分离株的克隆种群结构。,PLOS ONE

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MLST揭示了来自巴西北部亚马逊州临床来源的新型隐球菌分子型VNI分离株的克隆种群结构。
PLOS ONE ( IF 2.9 ) Pub Date : 2018-06-09 , DOI: 10.1371/journal.pone.0197841
Diego Fernando Silva Rocha _{1,

2} , Katia Santana Cruz ₁ , Carla Silvana da Silva Santos ₁ , Lizandra Stephanny Fernandes Menescal ₁ , João Ricardo da Silva Neto ₁ , Silviane Bezerra Pinheiro ₂ , Lucyane Mendes Silva ₂ , Luciana Trilles ₃ , João Vicente Braga de Souza ₂

Affiliation

隐球菌病在亚马孙州被认为是地方病，在艾滋病患者中更常见，他们主要是被新隐球菌分子型VNI感染。加迪隐球菌VGII的感染在美洲大陆具有免疫能力的宿主中占主导地位，并且与北美的暴发有关，特别是在巴西亚马逊地区也存在的亚型VGIIa和VGIIb。尽管很少进行环境研究，但仍不清楚该病在亚马逊州的分子流行病学的几个方面，包括有限地使用多基因座序列分型（MLST）来评估临床分离株（主要是新孢子虫）的遗传种群结构。因此，我们使用MLST来鉴定38种新孢梭菌VNI和C的临床分离株的序列类型。gattii VGII并使用系统发育分析来评估其与全球分离株的遗传关系。分析了30名患者的记录，以描述该地区隐球菌病的现状及其与不同亚型的关系。还进行了肉汤微稀释以确定对两性霉素B，氟康唑和伊曲康唑的抗真菌药敏性。MLST确定，HIV患者（n = 26）仅受带有ST93的VNI株感染，在VGII株（n = 4）中，确定了三个ST（ST5，ST172和新的ST445）。HIV组的住院致死率是54％，HIV和非HIV组的患者在疾病的临床方面没有显着差异。此外，所有分离株均对测试的抗真菌药敏感。

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MLST reveals a clonal population structure for Cryptococcus neoformans molecular type VNI isolates from clinical sources in Amazonas, Northern-Brazil.

Cryptococcosis is considered endemic in Amazonas state, occurring more frequently in individuals with AIDS, who are predominantly infected by Cryptococcus neoformans molecular type VNI. Infections by Cryptococcus gattii VGII predominate in immunocompetent hosts from the American continent and are associated with outbreaks in North America, particularly the subtypes VGIIa and VGIIb, which are also present in the Brazilian Amazon region. Despite few environmental studies, several aspects of the molecular epidemiology of this disease in Amazonas remain unclear, including the limited use of multilocus sequence typing (MLST) to evaluate the genetic population structure of clinical isolates, mainly C. neoformans. Therefore, we used MLST to identify the sequence types of 38 clinical isolates of C. neoformans VNI and C. gattii VGII and used phylogenetic analysis to evaluate their genetic relationship to global isolates. Records of 30 patients were analyzed to describe the current scenario of cryptococcosis in the region and their associations with the different subtypes. Broth microdilution was also performed to determine the susceptibility profile to the antifungals amphotericin B, fluconazole and itraconazole. MLST identified that patients with HIV (n = 26) were exclusively affected by VNI strains with ST93, and among the VGII strains (n = 4), three STs (ST5, ST172 and the new ST445) were identified. An in-hospital lethality of 54% was observed in the HIV group, and there were no significant differences in the clinical aspects of the disease between the HIV and non-HIV groups of patients. In addition, all isolates were susceptible to the antifungals tested. Therefore, in Amazonas state, VNI isolates are a genetically monotypic group, with ST93 being highly important in HIV individuals.

更新日期：2019-11-01

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