Genetic diversity among clinical Coccidioides spp. isolates in Arizona.

Increasing coccidioidomycosis rates in Arizona may indicate the development of a hypervirulent strain. One hundred and twenty-one clinical Coccidioides spp. isolates were collected over 16 months from Maricopa, Graham, Yuma, and Pima counties in Arizona. The patient age distribution ranged from 9 to 91 years, with a median age of 58 years; 36% were female, and 64% male. All isolates were analyzed by measuring length polymorphisms in nine distinct microsatellite regions. The three microsatellites found to have the greatest discriminatory power for Coccidioides posadasii were: K03 (0.87), GA37 (0.83), and K01 (0.78). The majority of isolates (n=119) were C. posadasii. Duplicate isolates (n=28) from 13 patients showed single strain infections. Phylogenetic analysis of the microsatellite data showed no dominant microsatellite pattern. We conclude that the increase in reported cases of coccidioidomycosis in Arizona is not linked to a dominant, hypervirulent strain of Coccidioides posadasii.