Cryptococcosis due to Cryptococcus gattii in Germany from 2004-2013
Ilka McCormick Smith1, Christoph Stephan2, Michael Hogardt3
1Robert Koch-Institut, FG 16, Consultant Laboratory for Cryptococcosis, Scedosporiosis and Imported Systemic Mycoses, Berlin, Germany.
International Journal of Medical Microbiology : IJMM
|September 6, 2015
Summary
Cryptococcus gattii infections are rare in Germany but likely underestimated. This deadly fungal pathogen, typically found in tropics, is emerging in temperate regions, posing a public health risk.
Area of Science:
- Medical Mycology
- Infectious Disease Epidemiology
- Public Health Surveillance
Background:
- Cryptococcus gattii, a fungal pathogen, was historically confined to tropical and subtropical regions.
- Recent North American outbreaks in non-immunocompromised individuals highlight its potential public health impact in temperate zones.
- Cryptococcosis surveillance in Germany is challenging due to lack of mandatory reporting and diagnostic differentiation from Cryptococcus neoformans.
Observation:
- Hospital discharge data and reference laboratory records from Germany (2004-2013) were analyzed for Cryptococcus infections.
- An average of 57 hospitalizations for cryptococcosis and 14 C. gattii isolates were reported annually.
- Four C. gattii isolates (3%) were identified from 155 patient samples, including VGI, VGIII types, and an interspecies hybrid, primarily causing meningoencephalitis.
Findings:
- C. gattii infections are rare in Germany, with only 4 cases identified between 2004 and 2013.
- Half of the identified C. gattii infections were likely acquired abroad.
- Mortality rates for C. gattii infections in the study cohort were high, with only one survivor.
Implications:
- Underestimation of C. gattii prevalence in Germany is probable due to diagnostic and surveillance limitations.
- Understanding the environmental niches of C. gattii in Germany is crucial for risk assessment and prevention strategies.
- The emergence of C. gattii in temperate regions necessitates improved diagnostic capabilities and public health awareness.
