Microsatellite typing and susceptibilities of serial Cryptococcus neoformansisolates from Cuban patients with recurrent cryptococcal meningitis

BMC Infectious Diseases

Research Article

Teun Boekhout¹  Ferry Hagen¹  Gerardo F Martínez-Machín²  Carlos M Fernández-Andreu²  María T Illnait-Zaragozí²  Corné HW Klaassen³  Jacques F Meis³ 

[1] CBS-Fungal Biodiversity Centre, Utrecht, The Netherlands;Department of Bacteriology and Mycology, Instituto Pedro Kourí, Havana, Cuba;Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands;

关键词: Minimum Inhibitory Concentration;    Fluconazole;    Itraconazole;    Voriconazole;    Acquire Immune Deficiency Syndrome;   

DOI  :  10.1186/1471-2334-10-289

 received in 2010-05-20, accepted in 2010-10-04,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundCryptococcus neoformans is commonly associated with meningoencephalitis in immunocompromised patients and occasionally in apparently healthy individuals. Recurrence of infection after initial treatment is not uncommon. We studied C. neoformans isolates from 7 Cuban patients with recurrent cryptococcal meningitis. Antifungal susceptibility and genotyping with microsatellite molecular typing were carried out.MethodsIsolates (n = 19) were recovered from cerebrospinal fluid, blood, urine and semen. Antifungal susceptibilities for amphotericin B, fluconazole, flucytosine, itraconazole, voriconazole, posaconazole and isavuconazole were tested by CLSI M27A3 broth microdilution method. Genotyping was done using a panel of 9 microsatellite (STR) markers: (CT)n, (TG)n, (TA)n, (CTA)n, (TCT)n, (CCA)n, (TTAT)n, (ATCC)n and (TATT)n.ResultsThe average number of isolates/patient was 2.71. The mean time interval between the collection of any two isolates was 52.5 days. All strains were identified as C. neoformans var. grubii (serotype Aα). Although none of the strains were resistant to the studied drugs, in serial isolates from two patients, MICs values of triazoles increased 4-5 log2 dilutions over time. STR patterns showed 14 distinctive profiles. In three patients the recurrent infection was associated with genotypically identical isolates. The four other patients had relapse isolates which were genotypically different from the initial infecting strain.ConclusionRecurrences of cryptococcal meningitis in our series of patients was not associated with development of drug resistance of the original strain but by an initial infection with different strains or a reinfection with a new strain.

【 授权许可】

Unknown   
© Illnait-Zaragozí et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.