Molecular epidemiology and antifungal susceptibility of Cryptococcus neoformans isolates from Ugandan AIDS patients.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Molecular epidemiology and antifungal susceptibility of Cryptococcus neoformans isolates from Ugandan AIDS patients.

Diagn Microbiol Infect Dis. 1998 Nov;32(3):191-9. Unique Identifier : AIDSLINE MED/99100573
Pfaller M; Zhang J; Messer S; Tumberland M; Mbidde E; Jessup C; Ghannoum M; Department of Pathology, University of Iowa College of Medicine,; Iowa City 52242, USA.

Abstract: Little is known of the antifungal susceptibility patterns and molecular epidemiology of Cryptococcus neoformans from tropical regions. We studied 164 clinical isolates of C. neofomans from 120 Ugandan AIDS patients with cryptococcal meningitis by analyzing their electrophoretic karyotypes and antifungal susceptibility profiles. Computer-assisted analysis of karyotype patterns was performed to generate dendrograms. MICs of fluconazole and flucytosine were determined by reference methods. A total of 43 distinguishable DNA types were identified among the 164 isolates. Only 30 patients (25%) were infected with their own unique strain of c. neoformans, whereas 75% of the patients shared their infecting strain with at least one other patient. Among 17 patients with more than one CSF isolate of C. neoformans, sequential isolates were identical or highly related in 12 (71%) and were different in five patients (29%). The isolates were susceptible to both fluconazole and flucytosine and there were no instances in which a stepwise increase in either fluconazole or flucytosine MICs was observed among serial isolates. These findings suggest that the epidemiology of cryptococcal disease in AIDS patients from tropical regions may be somewhat different from that observed in more temperate climates.

Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Antifungal Agents/*PHARMACOLOGY/THERAPEUTIC USE Cluster Analysis Cryptococcus neoformans/CLASSIFICATION/*DRUG EFFECTS/GENETICS Drug Resistance, Microbial/GENETICS DNA, Fungal/CEREBROSPINAL FLUID Electrophoresis, Gel, Pulsed-Field Fluconazole/PHARMACOLOGY/THERAPEUTIC USE Flucytosine/PHARMACOLOGY/THERAPEUTIC USE Human Image Processing, Computer-Assisted Karyotyping Meningitis, Cryptococcal/DRUG THERAPY/*EPIDEMIOLOGY/MICROBIOLOGY Microbial Sensitivity Tests Phylogeny Support, Non-U.S. Gov't Uganda/EPIDEMIOLOGY
990630
A9960942

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