Cryptococcus tetragattii as a major cause of cryptococcal meningitis among HIV-infected individuals in Harare, Zimbabwe

  • Tinashe K Nyazika
  • , Ferry Hagen*
  • , Jacques F Meis
  • , Valerie J Robertson
  • *Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: HIV-associated cryptococcal meningitis is commonly caused by Cryptococcus neoformans, whilst infections with Cryptococcus gattii sensu lato are historically rare. Despite available studies, little is known about the occurrence of C. gattii sensu lato infections among HIV-infected individuals in Zimbabwe.

METHODS: In a prospective cohort, we investigated the prevalence of C. gattii sensu lato meningitis among HIV-infected patients (n = 74) in Harare, Zimbabwe.

RESULTS: Of the 66/74 isolates confirmed by molecular characterization, 16.7% (11/66) were found to be C. gattii sensu lato and 83.3% (55/66) C. neoformans sensu stricto. From one patient two phenotypically different C. gattii sensu lato colonies were cultured. The majority (n = 9/12; 75%) of the C. gattii sensu lato isolates were Cryptococcus tetragattii (AFLP7/VGIV), which has been an infrequently reported pathogen. In-hospital mortality associated with C. gattii sensu lato was 36.4%.

CONCLUSIONS: Our data suggests that C. tetragattii (AFLP7/VGIV) is a more common cause of disease than C. gattii sensu stricto (genotype AFLP4/VGI) among patients with HIV-associated cryptococcal meningitis in Harare, Zimbabwe and possibly underreported in sub-Saharan Africa.

Original languageEnglish
Pages (from-to)745-752
Number of pages8
JournalThe Journal of Infection
Volume72
Issue number6
DOIs
Publication statusPublished - Jun 2016
Externally publishedYes

Keywords

  • AIDS-Related Opportunistic Infections/microbiology
  • Adult
  • Cerebrospinal Fluid/microbiology
  • Cryptococcosis/epidemiology
  • Cryptococcus gattii/genetics
  • Cryptococcus neoformans/genetics
  • DNA, Fungal/genetics
  • Female
  • Genotype
  • Hospital Mortality
  • Humans
  • Male
  • Meningitis, Cryptococcal/epidemiology
  • Middle Aged
  • Multilocus Sequence Typing
  • Mycological Typing Techniques
  • Prevalence
  • Prospective Studies
  • Zimbabwe/epidemiology

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