Robert Koch-Institut, Nordufer 20, 13353, Berlin, Germany.
Med Microbiol Immunol. 2014 Oct;203(5):333-40. doi: 10.1007/s00430-014-0341-6. Epub 2014 May 17.
Cryptococcosis is a fungal infection mostly caused by Cryptococcus neoformans. We identified agents of cryptococcosis diagnosed in Germany from 2004 to 2010. We used multi-locus sequence typing (MLST) to understand the molecular epidemiology of cryptococcosis. Sero- and mating types of individual patient isolates were determined by PCR. MLST was performed using the seven-locus scheme. Allele and nucleotide diversity was calculated for each locus of C. neoformans var. grubii and C. neoformans var. neoformans. Phylogenetic relations were assessed by dendrograms. Clinical data were compared between infections caused by the two variants. We studied 101 isolates. Eight were identified as hybrids (8%). All non-hybrids were of the α mating type. Among 78 C. neoformans var. grubii (77%), 16 sequence types (STs) were identified including three novel STs. They clustered in four groups, previously isolated in Asia, Europe or worldwide. Among 15 C. neoformans var. neoformans (15%), 10 STs were identified, without clustering. These isolates showed higher allele, and nucleotide diversity compared with C. neoformans var. grubii. C. neoformans var. neoformans was more likely to cause soft-tissue infections (3/9, 33 vs. 1/63, 2%, p = 0.005) and to affect non-AIDS patients (7/14, 50 vs. 15/76, 20%, p = 0.036). C. neoformans var. grubii is the predominant agent of cryptococcosis in Germany. MLST suggests that a part of these cases are acquired abroad by immigrants or tourists. C. neoformans var. neoformans isolates represent a greater genetic diversity and are associated with more variable clinical presentations.
隐球菌病是一种真菌感染，主要由新型隐球菌引起。我们鉴定了 2004 年至 2010 年德国诊断出的隐球菌病病原体。我们使用多位点序列分型（MLST）了解隐球菌病的分子流行病学。通过 PCR 确定个体患者分离株的血清型和交配型。使用 7 个基因座方案进行 MLST。计算了新型隐球菌 var. grubii 和新型隐球菌 var. neoformans 每个基因座的等位基因和核苷酸多样性。通过聚类树评估了系统发育关系。比较了两种变体引起的感染的临床数据。我们研究了 101 株分离物。其中 8 株被鉴定为杂种（8%）。所有非杂种均为α交配型。在 78 株新型隐球菌 var. grubii（77%）中，鉴定出 16 种序列型（ST），包括 3 种新的 ST。它们聚集在四个组中，以前在亚洲、欧洲或全球范围内分离出来。在 15 株新型隐球菌 var. neoformans（15%）中，鉴定出 10 种 ST，没有聚类。与新型隐球菌 var. grubii 相比，这些分离株显示出更高的等位基因和核苷酸多样性。新型隐球菌 var. neoformans 更有可能引起软组织感染（3/9，33%比 1/63，2%，p=0.005），并影响非艾滋病患者（7/14，50%比 15/76，20%，p=0.036）。新型隐球菌 var. grubii 是德国隐球菌病的主要病原体。MLST 表明，这些病例中的一部分是移民或游客在国外获得的。新型隐球菌 var. neoformans 分离株代表更大的遗传多样性，与更可变的临床表现相关。
