Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2026
Molecular types, clinical profile, and exploratory virulence-associated phenotypes of clinical Cryptococcus isolates from Amazonas, Brazil.
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Filho Robert Langlady Lira Rosas, Moreira Izabela de Mesquita Bárcia, Lazameth-Diniz Nayara de Fátima, Souza Flávia Fernandes, Bisneto João Flávio Dias do Val, de Sousa Naira Sulany Oliveira, de Almeida Juan Diego Ribeiro, de Souza Érica Simplício, Cruz Kátia Santana, Santos Carla Silvana da Silva, Frickmann Hagen, de Souza João Vicente Braga
Аннотация
BACKGROUND: Cryptococcosis remains a severe systemic mycosis, especially among people living with HIV/AIDS, and culture-based molecular data from Amazonas remain limited.
OBJECTIVES: The aim was to identify which Cryptococcus molecular types circulated among clinical isolates from Amazonas between 2020 and 2024; what were the main clinical characteristics and outcomes of patients infected with Cryptococcus neoformans molecular type VNI and Cryptococcus gattii molecular type VGII; and whether these molecular types differed in selected susceptibility-related and virulence-associated phenotypes.
METHODS: We analyzed 70 culture-confirmed clinical isolates from patients treated at the Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil. Molecular types were assigned by URA5 PCR-RFLP using reference strains. Demographic and clinical variables were retrieved from medical records. A stratified 30-isolate subset comprising 24 VNI and 6 VGII isolates was evaluated for phospholipase activity and melanization. Fluconazole MICs were analyzed for the complete 70-isolate dataset and were determined by broth microdilution according to CLSI M27-A4.
RESULTS: VNI predominated (64/70; 91.4%), whereas VGII accounted for 6/70 isolates (8.6%). The series was predominantly composed of men, young adults, and HIV-positive patients. HIV infection was more frequent among VNI cases, whereas VGII included proportionally more HIV-negative patients. In-hospital death occurred in 17/70 patients (24.3%). Fluconazole MICs, phospholipase activity, and melanization were broadly comparable between VNI and VGII, although the small VGII subgroup precluded robust genotype-associated inference.
CONCLUSION: VNI was the dominant molecular type in this severe reference-center cryptococcosis series from Amazonas. Phenotypic findings should be interpreted as exploratory and hypothesis-generating.
OBJECTIVES: The aim was to identify which Cryptococcus molecular types circulated among clinical isolates from Amazonas between 2020 and 2024; what were the main clinical characteristics and outcomes of patients infected with Cryptococcus neoformans molecular type VNI and Cryptococcus gattii molecular type VGII; and whether these molecular types differed in selected susceptibility-related and virulence-associated phenotypes.
METHODS: We analyzed 70 culture-confirmed clinical isolates from patients treated at the Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil. Molecular types were assigned by URA5 PCR-RFLP using reference strains. Demographic and clinical variables were retrieved from medical records. A stratified 30-isolate subset comprising 24 VNI and 6 VGII isolates was evaluated for phospholipase activity and melanization. Fluconazole MICs were analyzed for the complete 70-isolate dataset and were determined by broth microdilution according to CLSI M27-A4.
RESULTS: VNI predominated (64/70; 91.4%), whereas VGII accounted for 6/70 isolates (8.6%). The series was predominantly composed of men, young adults, and HIV-positive patients. HIV infection was more frequent among VNI cases, whereas VGII included proportionally more HIV-negative patients. In-hospital death occurred in 17/70 patients (24.3%). Fluconazole MICs, phospholipase activity, and melanization were broadly comparable between VNI and VGII, although the small VGII subgroup precluded robust genotype-associated inference.
CONCLUSION: VNI was the dominant molecular type in this severe reference-center cryptococcosis series from Amazonas. Phenotypic findings should be interpreted as exploratory and hypothesis-generating.