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Cryptococcus neoformans Causing Meningoencephalitis in Adults and a Child from Lima, Peru: Genotypic Diversity and

Carolina Firacative1, Natalia Zuluaga-Puerto2, José Guevara3

  • 1Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia.

Journal of Fungi (Basel, Switzerland)
|December 22, 2022
PubMed

Insights

Cryptococcosis, a fungal infection affecting immunocompromised individuals, shows high genetic diversity in Peru. Most Cryptococcus neoformans isolates were susceptible to antifungals, though some strains exhibited reduced susceptibility.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Molecular Epidemiology

Background:

  • Cryptococcosis, caused by Cryptococcus neoformans, is a severe opportunistic infection, particularly affecting the central nervous system in immunocompromised patients.
  • This mycosis contributes significantly to AIDS-related mortality globally and remains a public health concern in regions like Peru due to rising HIV infections.

Purpose of the Study:

  • To determine the genotypic diversity of Cryptococcus neoformans isolates from meningoencephalitis cases in Lima, Peru.
  • To assess the antifungal susceptibility profiles of these C. neoformans isolates.
  • To investigate the molecular epidemiology and antifungal resistance patterns in a population with HIV and other risk factors, including a rare pediatric case.

Main Methods:

  • Multilocus sequence typing (MLST) was employed to identify the molecular types and sequence types of C. neoformans isolates.
  • YeastOne® broth microdilution assays were performed to evaluate the susceptibility of isolates to six antifungal agents.
  • Isolates were obtained from 26 patients (25 adults, 1 child) diagnosed with cryptococcal meningoencephalitis in Lima, Peru.

Main Results:

  • The study identified 19 Cryptococcus neoformans isolates as molecular type VNI and seven as VNII, distributed across eight and three sequence types, respectively, indicating significant genetic diversity.
  • The majority of the isolates demonstrated susceptibility to all tested antifungals.
  • A statistically significant finding (p < 0.05) indicated that VNI isolates exhibited lower susceptibility to fluconazole, itraconazole, and voriconazole compared to VNII isolates.

Conclusions:

  • This research provides crucial data on the molecular epidemiology and antifungal susceptibility of Cryptococcus neoformans in Peru, highlighting the genetic diversity of circulating strains.
  • While most isolates remain susceptible, the reduced susceptibility of VNI strains to key azole antifungals warrants attention for treatment strategies.
  • The study underscores the importance of molecular characterization in understanding cryptococcosis, particularly noting the rare occurrence of a pediatric case.
Keywords:
Cryptococcus neoformansMLSTPeruantifungal susceptibilitycryptococcosis

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