The need for environmental surveillance to understand the ecology, epidemiology and impact of Cryptococcus infection in Africa.
The need for environmental surveillance to understand the ecology, epidemiology and impact of Cryptococcus infection in Africa.
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需要进行环境监测，以了解非洲隐球菌感染的生态学、流行病学和影响。
DOI：
10.1093/femsec/fiab093
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发表时间：
2021-07-07
影响因子：
4.2
通讯作者：
Fisher MC
中科院分区：
文献类型：
--
作者：
Edwards HM;Cogliati M;Kwenda G;Fisher MC
利用基因组测序技术，我们对致病性酵母菌新型隐球菌和加蒂隐球菌的认识得到了极大的提高。在环境中无处不在的腐生菌，吸入这些病原体的感染性孢子可导致隐球菌病。免疫系统受损的个体尤其危险，尤其是那些感染了艾滋病毒/艾滋病的人。基因组测序与实验室和临床研究相结合，揭示了不同谱系在其观察到的频率、毒力和临床结果方面存在重要差异。然而，迄今为止，基因组分析主要集中在临床分离株上，这些分离株仅代表环境中多样性的一个子集。为了了解这些酵母菌的生态学、生物学和进化，以及它们如何影响临床疾病的流行病学和病理生理学，需要在其原生环境中加强对这些酵母菌的基因组监测。这在非洲大陆尤其重要，因为全球隐球菌多样性可能起源于非洲大陆，尽管那里有最大的隐球菌感染风险，但环境采样和测序却很少。在这里，我们回顾了迄今为止通过对环境隐球菌分离物的分析所提供的科学和临床相关的见解，并认为通过进一步的采样，特别是在非洲，等待着更多重要的发现。我们总结了病原真菌隐球菌的环境采样和基因组学揭示的重要见解，但认为在这一领域仍有很多需要学习的地方。
Our understanding of the pathogenic yeasts Cryptococcus neoformans and Cryptococcus gattii has been greatly enhanced by use of genome sequencing technologies. Found ubiquitously as saprotrophs in the environment, inhalation of infectious spores from these pathogens can lead to the disease cryptococcosis. Individuals with compromised immune systems are at particular risk, most notably those living with HIV/AIDS. Genome sequencing in combination with laboratory and clinical studies has revealed diverse lineages with important differences in their observed frequency, virulence and clinical outcomes. However, to date, genomic analyses have focused primarily on clinical isolates that represent only a subset of the diversity in the environment. Enhanced genomic surveillance of these yeasts in their native environments is needed in order to understand their ecology, biology and evolution and how these influence the epidemiology and pathophysiology of clinical disease. This is particularly relevant on the African continent from where global cryptococcal diversity may have originated, yet where environmental sampling and sequencing has been sparse despite harbouring the largest population at risk from cryptococcosis. Here, we review what scientifically and clinically relevant insights have been provided by analysis of environmental Cryptococcus isolates to date and argue that with further sampling, particularly in Africa, many more important discoveries await. We summarise important insights unveiled by environmental sampling and genomics of the pathogenic fungi, Cryptococcus, but argue there is still much to learn with increased focus in this area.
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