Molecular analysis of 311 Cryptococcus neoformans isolates from a 30-month ECMM survey of cryptococcosis in Europe
Molecular analysis of 311 Cryptococcus neoformans isolates from a 30-month ECMM survey of cryptococcosis in Europe
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DOI：
10.1111/j.1567-1364.2006.00081.x
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发表时间：
2006-06-01
影响因子：
3.2
通讯作者：
Velho, Rosa
中科院分区：
文献类型：
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作者：
Viviani, Maria Anna;Cogliati, Massimo;Velho, Rosa
在欧洲医学真菌学联合会(ECMM)对欧洲隐球菌病的前瞻性调查期间(1997年7月至1999年12月)，来自17个国家的655例病例被报告；完成的问卷中有565份是可评估的。77%的病例(57.5-94%)与隐球菌病有关。对实验室数据的评估突出了缺乏确定的诊断隐球菌病的标准程序：通常不使用抗原试验进行筛查，主要在脑膜炎发生时(65%的患者)识别这种疾病，除了少数病例外，没有调查感染的程度。除6例由加蒂亚氏隐球菌和4例其他隐球菌引起外，所有病例的病原菌均为新生隐球菌。对311株新生隐球菌进行乳胶凝集试验，以(GACA)(4)寡核苷酸为单一引物进行聚合酶链式反应-指纹分型，并通过STE20等位基因的聚合酶链式反应确定其交配型。最常见的是A型(51%)，其次是D型(30%)和AD型(19%)。聚合酶链式反应-指纹图谱分析显著提高了杂交株的比例至30%，因为6%的血清A型和28%的血清D型分离株属于VN3或VN4杂交型。此外，交配型测定表明，在1个单倍体品系和28个杂交种中存在MATA血清型A等位基因，并鉴定出具有单一交配型的杂交株(4个Aα和2个Dα)。这是第一次在欧洲进行的前瞻性调查，试图调查隐球菌病的流行病学和新生隐球菌的种群结构，到目前为止所获得的结果表明，AD杂交菌株广泛参与了新生隐球菌的感染。
During a European Confederation of Medical Mycology (ECMM) prospective survey of cryptococcosis in Europe (from July 1997 to December 1999) 655 cases were reported from 17 countries; 565 of the completed questionnaires were evaluable. Cryptococcosis was associated with HIV infection in 77% of cases (range 57.5-94%). Assessment of the laboratory data highlighted the lack of defined standard procedures for the diagnosis of cryptococcosis: the antigen test was not usually used for screening, the disease was mainly recognised when meningitis occurred (65% of patients) and, with the exception of a few cases, the extent of the infection was not investigated. Cryptococcus neoformans was the etiological agent in all of the cases except for six caused by C. gattii and four by other Cryptococcus species. A total of 311 C. neoformans strains were serotyped by Crypto Check latex agglutination, genotyped by PCR-fingerprinting using the (GACA)(4) oligonucleotide as a single primer, and their mating type was determined by PCR of the STE20 alleles. Serotype A was the most represented (51% of the isolates), followed by serotype D (30%) and serotype AD (19%). PCR-fingerprinting analysis significantly increased the percentage of hybrid strains to 30%, as 6% of the serotype A and 28% of the serotype D isolates were of the VN3 or VN4 hybrid genotype. In addition, the mating type determinations revealed the MATa serotype A allele in one haploid strain and 28 hybrids, and hybrid isolates with a single mating type (four A alpha and two D alpha) were also identified. This is the first prospective survey to be carried out in Europe which has attempted to investigate the epidemiology of cryptococcosis and the population structure of C. neoformans, and the results obtained thus far show the widespread involvement of AD hybrid strains in C. neoformans infections.