Da Silva Babbyngttonn Khell, Freire Ana Karla, Bentes Amaury Dos Santos, Sampaio Ivanete De Lima, Santos Lucilaide Oliveira, Dos Santos Mirlane Silva, De Souza João Vicente
Fundação de Medicina Tropical do Amazonas, Manaus, AM, Brazil.
Rev Iberoam Micol. 2012 Jan-Mar;29(1):40-3. doi: 10.1016/j.riam.2011.05.003. Epub 2011 Jun 2.
The differentiation and classification of pathogenic Cryptococcus species provides useful data for epidemiological studies and for the clinical diagnosis and treatment of patients.
The aim of this study was to characterise 40 clinical Cryptococcus isolates obtained from patients at the Tropical Medicine Foundation of Amazonas (FMTAM) from 2006 to 2008.
It was used phenotypic (i.e., enzyme production and antifungal resistance) and molecular biological (URA5-RFLP) experiments.
Patients with HIV/AIDS were most affected with cryptococcosis. Thirty-one (75.5%) of the clinical isolates were classified as Cryptococcus neoformans and 9 (22.5%) as Cryptococcus gattii. High amounts of protease and phospholipase enzymes were produced by most of the isolates. Using the disk diffusion test (CLSI M44-A), 81, 35 and 100% of the C. neoformans isolates were characterized as susceptible to fluconazole, itraconazole and amphotericin B, respectively, whereas 78, 56 and 100% of the C. gattii isolates were susceptible to these antimicrobial agents. The average of Minimal Inhibitory Concentration (MIC) for C. neoformans and C. gattii isolates was 0.26 and 0.58 μg/mL, respectively. The 9 isolates of C. gattii had a fingerprint pattern comparable with the VGII molecular type, while all 31 isolates of C. neoformans presented with a pattern consistent with the VNI type.
This study confirms the importance of HIV/AIDS for the cryptococcosis epidemiology, the susceptibility of the isolates to amphotericin B and the high prevalence of the molecular genotypes VNI and VGII in the north of Brazil.
致病性隐球菌物种的鉴别和分类为流行病学研究以及患者的临床诊断和治疗提供了有用的数据。
本研究的目的是对2006年至2008年从亚马孙热带医学基金会（FMTAM）的患者中分离出的40株临床隐球菌进行特征分析。
采用表型实验（即酶产生和抗真菌药敏）和分子生物学实验（URA5-RFLP）。
艾滋病患者受隐球菌病影响最为严重。31株（75.5%）临床分离株被鉴定为新生隐球菌，9株（22.5%）为格特隐球菌。大多数分离株产生大量的蛋白酶和磷脂酶。使用纸片扩散法（CLSI M44-A），分别有81%、35%和100%的新生隐球菌分离株对氟康唑、伊曲康唑和两性霉素B敏感，而78%、56%和100%的格特隐球菌分离株对这些抗菌药物敏感。新生隐球菌和格特隐球菌分离株的最低抑菌浓度（MIC）平均值分别为0.26和0.58μg/mL。9株格特隐球菌分离株的指纹图谱与VGII分子型相似，而所有31株新生隐球菌分离株的图谱与VNI型一致。
本研究证实了艾滋病在隐球菌病流行病学中的重要性、分离株对两性霉素B的敏感性以及巴西北部VNI和VGII分子基因型的高流行率。
