Autochthonous and dormant Cryptococcus gattii infections in Europe

Area of Science:

• Medical Mycology
• Infectious Diseases
• Epidemiology

Background:

• Cryptococcus gattii (C. gattii) infections traditionally occurred in tropical/subtropical regions.
• Recent years show a rise in C. gattii cases in humans and animals across Europe.

Purpose of the Study:

• To investigate the origin of C. gattii infections in Europe.
• To differentiate between travel-associated and autochthonous (local) C. gattii acquisition.
• To understand the genetic diversity and transmission patterns of C. gattii in Europe.

Main Methods:

• Multilocus sequence typing (MLST) was employed.
• Comparison of 100 European C. gattii isolates (human, animal, environmental) with 191 global isolates.
• Genotyping of isolates to identify distinct clusters and origins.

Main Results:

• A significant proportion of European human C. gattii infections (60%) were likely acquired outside Europe.
• A distinct C. gattii genotype was identified in Mediterranean Europe, clustering with local animal and environmental isolates.
• Evidence suggests that dormant C. gattii infections can reactivate years after initial acquisition.

Conclusions:

• C. gattii is increasingly found in Europe, with both travel-related and local transmission occurring.
• The emergence of a distinct genotype in Mediterranean Europe suggests local adaptation or spread.
• Reactivation of latent C. gattii infections is a significant factor in the epidemiology of cryptococcosis.