Genotypic diversity and clinical outcome of cryptococcosis in renal transplant recipients in Brazil.

Journal Article (Journal Article)

Genotypic diversity and fluconazole susceptibility of 82 Cryptococcus neoformans and Cryptococcus gattii isolates from 60 renal transplant recipients in Brazil were characterized. Clinical characteristics of the patients and prognostic factors were analysed. Seventy-two (87.8%) isolates were C. neoformans and 10 (12.2%) were C. gattii. VNI was the most common molecular type (40 cases; 66.7%), followed by VNII (9 cases; 15%), VGII (6 cases; 10%), VNB (4 cases; 6.7%) and VNI/II (1 case; 1.7%). The isolates showed a high genetic diversity in the haplotype network and six new sequence types were described, most of them for VNB. There was a bias towards skin involvement in the non-VNI population (P = .012). VGII isolates exhibited higher fluconazole minimum inhibitory concentrations compared to C. neoformans isolates (P = 0.008). The 30-day mortality rate was 38.3%, and it was significantly associated with fungemia and absence of headache. Patients infected with VGII had a high mortality rate at 90 days (66.7%). A variety of molecular types produce disease in renal transplant recipients in Brazil and highlighted by VGII and VNB. We report the clinical appearance and impact of the molecular type, fluconazole susceptibility of the isolates, and clinical characteristics on patient outcome in this population.

Full Text

Duke Authors

Cited Authors

  • Ponzio, V; Chen, Y; Rodrigues, AM; Tenor, JL; Toffaletti, DL; Medina-Pestana, JO; Colombo, AL; Perfect, JR

Published Date

  • 2019

Published In

Volume / Issue

  • 8 / 1

Start / End Page

  • 119 - 129

PubMed ID

  • 30866766

Pubmed Central ID

  • PMC6455115

Electronic International Standard Serial Number (EISSN)

  • 2222-1751

Digital Object Identifier (DOI)

  • 10.1080/22221751.2018.1562849


  • eng

Conference Location

  • United States