A flow cytometry method for testing the susceptibility of Cryptococcus spp. to amphotericin B

Human fungal infections have increased at an alarming rate in recent years, particularly in immunocompromised individuals. Cryptococcosis is the second most prevalent systemic fungal infection worldwide, and the most prevalent systemic infection in immunocompromised individuals, representing more than 70% of cases. The incidence of cryptococcosis is high in people with HIV/acquired immunodeficiency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. The aim of this research was to develop a rapid flow cytometric antifungal susceptibility test and to compare the results with the standard methods. A reference strain and clinical isolates of Cryptococcus neoformans and Cryptococcus gattii were tested for susceptibility to amphotericin B by flow cytometry using propidium iodide as indicator of viability. Flow cytometry (FC) results were compared with the minimum inhibitory concentration (MIC) values determined by microdilution. The antifungal activity of amphotericin B ranged from MICs of 0.06 to 2μg/ml for the 11 isolates studied. The same results were found by FC. The FC method allows same-day results, assisting in the selection of appropriate antifungal therapies. These results demonstrate an excellent correlation between FC and the classic methods of testing for susceptibility to antifungal agents. This rapid diagnosis method makes it possible to quickly administer effective therapeutic interventions, often saving lives.

Sensibilidade à antifúngicos sintéticos e naturais anti-Cryptococcus neoformans determinados por citometria de fluxo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Environmental isolation, biochemical identification, and antifungal drug susceptibility of Cryptococcus species

Introduction The incidence of opportunistic fungal infections has increased in recent years and is considered an important public health problem. Among systemic and opportunistic mycoses, cryptococcosis is distinguished by its clinical importance due to the increased risk of infection in individuals infected by human immunodeficiency virus. Methods To determine the occurrence of pathogenic Cryptococcus in pigeon excrement in the City of Araraquara, samples were collected from nine environments, including state and municipal schools, abandoned buildings, parks, and a hospital. The isolates were identified using classical tests, and susceptibility testing for the antifungal drugs (fluconazole, itraconazole, voriconazole, and amphotericin B) independently was also performed. After collection, the excrement samples were plated on Niger agar and incubated at room temperature. Results A total of 87 bird dropping samples were collected, and 66.6% were positive for the genus Cryptococcus. The following species were identified: Cryptococcus neoformans (17.2%), Cryptococcus gattii (5.2%), Cryptococcus ater (3.5%), Cryptococcus laurentti (1.7%), and Cryptococcus luteolus (1.7%). A total of 70.7% of the isolates were not identified to the species level and are referred to as Cryptococcus spp. throughout the manuscript. Conclusions Although none of the isolates demonstrated resistance to antifungal drugs, the identification of infested areas, the proper control of birds, and the disinfection of these environments are essential for the epidemiological control of cryptococcosis.

Caracterização morfológica e fenotípica de leveduras do gênero Cryptococcus com ênfase na pesquisa de Cryptococcus neoormans isoladas de amostras de água de mar e areia de três ambientes costeiros do estado de São Paulo: Canal de São Sebastião, Baixada Santista e Ubatuba

The yeast Cryptococcus neoformans is the etiologic agent of cryptococcosis, an infectious cosmopolitan disease that affects humans. Although rare, this disease is potentially fatal, especially for immunocompromised hosts. This pathogen is frequently isolated from excrements of pigeons and parrots, with many environmental sources such as birds, pigeon droppings, eucalyptus leaves, decaying trees, towers, churches and places of storage of grain (the port area). The isolation of this microorganism has been obtained also from the aquatic environment. The identification of environmental sources is needed to protect human health, especially susceptible populations such as immunocompromised. Therefore, this study investigated the presence of Cryptococcus neoformans in yeast isolates obtained from samples of sea water and sand from three regions of São Paulo: São Sebastião Channel, Santos and Ubatuba. Isolates were analyzed according to micro-and macroscopic characteristics and biochemical tests: microculture, urease, ink nankin, auxanograma, zymogram and phenol. We analyzed 199 isolates, 175 of which had features suggestive for Cryptococcus spp. in microculture. All these 175 isolates were sown in the Christensen urea middle to verify the production of urease and submitted to the technique nankin ink to visualize the capsule. Of these, only 24 were selected for the next test that was the auxanograma (assimilation of carbohydrate and nitrogen). Of the 24, 10 were tested in zymograms (fermented sugar), from which 5 were selected for the phenoloxidase test in medium containing dopamine. None of the 5 isolates tested had black or brown color characteristic of Cryptococcus neoformans. According to these tests, we arrived at 5 isolates identified to the genus Cryptococcus, but not the neoformans specie

Investigação de danos visuais em pacientes diagnosticados com meningite criptocócica não associada à imunossupressão

A meningite criptocócica é uma severa doença infecciosa causada pelo Cryptococcus spp. que apresenta alta letalidade e deixa nos sobreviventes uma série de sequelas sensoriais, entre as quais estão as alterações visuais. O objetivo deste estudo foi descrever as perdas visuais sofridas por pacientes, sem história de imunossupressão, diagnosticados com meningite criptocócica, de forma a indicar um possível mecanismo e fatores de risco para essas sequelas visuais. O trabalho foi composto de um estudo de série de casos de pacientes com meningite criptocócica sem história de imunossupressão (n = 7 pacientes, n = 14 olhos) e um estudo transversal analítico de todos os casos de meningite criptocócica sem história de imunossupressão notificados em 14 anos num hospital de referência do Pará (n = 113 casos). No estudo de série de casos, as funções visuais de uma amostra de pacientes foi cuidadosamente analisada por meio de avaliação oftalmológica, testes psicofísicos e eletrofisiológicos. No estudo transversal analítico, foi realizada análise de dados de prontuário com enfoque nas alterações visuais. Observou-se que os pacientes estudados na série de casos apresentaram grave diminuição da acuidade visual e mesmo em pacientes sem queixa visual houve alteração na percepção de cor, na percepção de contraste de luminância em diferentes frequências espaciais e no campo visual. Os testes indicam comprometimento da retina central como principal desencadeadora de uma cascata de alterações que impedem o normal processamento da imagem no córtex visual. Sugere-se que lesões do nervo óptico não foram as únicas responsáveis pelas alterações visuais observadas. Os principais fatores de risco para as alterações visuais observados pelo estudo transversal analítico foram o tempo de doença antes do início do tratamento e a resposta imunológica do paciente.

Antifungal Activity of Decyl Gallate against Several Species of Pathogenic Fungi

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiota fúngica de passeriformes de cativeiros da Região Noroeste do Estado de São Paulo

Birds are hosts for a rich fungal microbiota which can act as potent pathogens for humans and other species of animals, causing thereby serious public health problems. The objective of this study was to evaluate the participation of birds kept in containers in the epidemiology of infectious diseases such as cryptococcosis and aspergillosis, thus verifying the maintenance and spread of pathogens in the environment. 36 samples of excretas of passeriformes were collected and were cultivated in Sabouraud Dextrose Agar 4% at room temperature and 37°C. The isolated fungal colonies were classified according to their morphological and staining characteristics. Subsequently, those in yeast form were peaked in Niger Agar, incubated at 30°C. In one sample showed growth of more than one type of colony and there was verified the presence of 25.0% of Penicillium spp., 19.4% of Trichosporon spp., 13.9% of C. gattii, 11.1% of C. neoformans, 11.1% of Candida spp., 8.3% of Rhizomucor spp., 8.3% of Aspergillus spp., 2.8% of Nigrospora spp. and 2,8% of Geotrichum spp. It can be conluded by the expost that birds shed continuously pathogenic microorganisms in their feces acting in definitive form in the infectious diseases ecoepidemiology.

Delayed diagnosis of cryptococcal meningoencephalitis due to negative cryptococcal antigen test

Cryptococcus spp. commonly causes infection in immunocompromised hosts. Clinical presentation of cryptococcal meningoencephalitis (CM) is variable, but headache, fever and a high intracranial pressure should suggest the diagnosis. The cryptococcal antigen test is a specific and sensitive rapid test that can be performed on blood or cerebrospinal fluid. We report a case of CM in a patient with previously undetected lymphocytopenia. Because cryptococcal antigen test results were negative, diagnosis and treatment were delayed.

Carbon and nitrogen limitation increase chitosan antifungal activity in Neurospora crassa and fungal human pathogens

Chitosan permeabilizes plasma membrane and kills sensitive filamentous fungi and yeast. Membrane fluidity and cell energy determine chitosan sensitivity in fungi. A five-fold reduction of both glucose (main carbon (C) source) and nitrogen (N) increased 2-fold Neurospora crassa sensitivity to chitosan. We linked this increase with production of intracellular reactive oxygen species (ROS) and plasma membrane permeabilization. Releasing N. crassa from nutrient limitation reduced chitosan antifungal activity in spite of high ROS intracellular levels. With lactate instead of glucose, C and N limitation increased N. crassa sensitivity to chitosan further (4-fold) than what glucose did. Nutrient limitation also increased sensitivity of filamentous fungi and yeast human pathogens to chitosan. For Fusarium proliferatum, lowering 100-fold C and N content in the growth medium, increased 16-fold chitosan sensitivity. Similar results were found for Candida spp. (including fluconazole resistant strains) and Cryptococcus spp. Severe C and N limitation increased chitosan antifungal activity for all pathogens tested. Chitosan at 100 μg ml-1 was lethal for most fungal human pathogens tested but non-toxic to HEK293 and COS7 mammalian cell lines. Besides, chitosan increased 90% survival of Galleria mellonella larvae infected with C. albicans. These results are of paramount for developing chitosan as antifungal.

Comparative study of disk diffusion and microdilution methods for evaluation of antifungal activity of natural compounds against medical yeasts Candida spp and Cryptococcus sp

Antifungal activity of natural products has been tested by adapting methods designed for synthetic drugs. In this study, two methods for the determination of antifungal activity of natural products, agar diffusion and broth microdilution, the CLSI reference methods for synthetic drugs, are compared and discussed. The microdilution method was more sensitive. The minimal inhibitory concentrations (MIC) of crude extracts, fractions and pure substances from different species of the plant families Piperaceae, Rubiaceae, Clusiaceae, Fabaceae and Lauraceae, from the Biota project, were determined. Antifungal activities against Candida albicans, C.krusei, C.parapsilosis and Cryptococcus neoformans were produced by several samples.

Market access of Papua New Guinea bananas (Musa spp.) with particular respect to banana fly (Bactrocera musae (Tryon)) (Diptera: Tephritidae)

International market access for fresh commodities is regulated by international accepted phytosanitary guidelines, the objectives of which are to reduce the biosecurity risk of plant pest and disease movement. Papua New Guinea (PNG) has identified banana as a potential export crop and to help meet international market access requirements, this thesis provides information for the development of a pest risk analysis (PRA) for PNG banana fruit. The PRA is a three step process which first identifies the pests associated with a particular commodity or pathway, then assesses the risk associated with those pests, and finally identifies risk management options for those pests if required. As the first step of the PRA process, I collated a definitive list on the organisms associated with the banana plant in PNG using formal literature, structured interviews with local experts, grey literature and unpublished file material held in PNG field research stations. I identified 112 organisms (invertebrates, vertebrate, pathogens and weeds) associated with banana in PNG, but only 14 of these were reported as commonly requiring management. For these 14 I present detailed information summaries on their known biology and pest impact. A major finding of the review was that of the 14 identified key pests, some research information occurs for 13. The single exception for which information was found to be lacking was Bactrocera musae (Tryon), the banana fly. The lack of information for this widely reported ‘major pest on PNG bananas’ would hinder the development of a PNG banana fruit PRA. For this reason the remainder of the thesis focused on this organism, particularly with respect to generation of information required by the PRA process. Utilising an existing, but previously unanalysed fruit fly trapping database for PNG, I carried out a Geographic Information System analysis of the distribution and abundance of banana in four major regions of PNG. This information is required for a PRA to determine if banana fruit grown in different parts of the country are at different risks from the fly. Results showed that the fly was widespread in all cropping regions and that temperature and rainfall were not significantly correlated with banana fly abundance. Abundance of the fly was significantly correlated (albeit weakly) with host availability. The same analysis was done with four other PNG pest fruit flies and their responses to the environmental factors differed to banana fly and each other. This implies that subsequent PRA analyses for other PNG fresh commodities will need to investigate the risk of each of these flies independently. To quantify the damage to banana fruit caused by banana fly in PNG, local surveys and one national survey of banana fruit infestation were carried out. Contrary to expectations, infestation was found to be very low, particularly in the widely grown commercial cultivar, Cavendish. Infestation of Cavendish fingers was only 0.41% in a structured, national survey of over 2 700 banana fingers. Follow up laboratory studies showed that fingers of Cavendish, and another commercial variety Lady-finger, are very poor hosts for B. musae, with very low host selection rates by female flies and very poor immature survival. An analysis of a recent (within last decade) incursion of B. musae into the Gazelle Peninsula of East New Britain Province, PNG, provided the final set of B. musae data. Surveys of the fly on the peninsular showed that establishment and spread of the fly in the novel environment was very rapid and thus the fly should be regarded as being of high biosecurity concern, at least in tropical areas. Supporting the earlier impact studies, however, banana fly has not become a significant banana fruit problem on the Gazelle, despite bananas being the primary starch staple of the region. The results of the research chapters are combined in the final Discussion in the form of a B. musae focused PRA for PNG banana fruit. Putting the thesis in a broader context, the Discussion also deals with the apparent discrepancy between high local abundance of banana fly and very low infestation rates. This discussion focuses on host utilisation patterns of specialist herbivores and suggests that local pest abundance, as determined by trapping or monitoring, need not be good surrogate for crop damage, despite this linkage being implicit in a number of international phytosanitary protocols.

Utilization and optimization of a waste stream cellulose culture medium for pigment production by Penicillium spp

Aims This research sought to determine optimal corn waste stream–based fermentation medium C and N sources and incubation time to maximize pigment production by an indigenous Indonesian Penicillium spp., as well as to assess pigment pH stability. Methods and Results A Penicillium spp. was isolated from Indonesian soil, identified as Penicillium resticulosum, and used to test the effects of carbon and nitrogen type and concentrations, medium pH, incubation period and furfural on biomass and pigment yield (PY) in a waste corncob hydrolysate basal medium. Maximum red PY (497·03 ± 55·13 mg l−1) was obtained with a 21 : 1 C : N ratio, pH 5·5–6·0; yeast extract-, NH4NO3-, NaNO3-, MgSO4·7H2O-, xylose- or carboxymethylcellulose (CMC)-supplemented medium and 12 days (25°C, 60–70% relative humidity, dark) incubation. C source, C, N and furfural concentration, medium pH and incubation period all influenced biomass and PY. Pigment was pH 2–9 stable. Conclusions Penicillium resticulosum demonstrated microbial pH-stable-pigment production potential using a xylose or CMC and N source, supplemented waste stream cellulose culture medium. Significance and Impact of the Study Corn derived, waste stream cellulose can be used as a culture medium for fungal pigment production. Such application provides a process for agricultural waste stream resource reuse for production of compounds in increasing demand.

Wolbachia infection alters olfactory-cued locomotion in Drosophila spp

Wolbachia pipientis is an endosymbiotic bacterium present in diverse insect species. Although it is well studied for its dramatic effects on host reproductive biology, little is known about its effects on other aspects of host biology, despite its presence in a wide array of host tissues. This study examined the effects of three Wolbachia strains on two different Drosophila species, using a laboratory performance assay for insect locomotion in response to olfactory cues. The results demonstrate that Wolbachia infection can have significant effects on host responsiveness that vary with respect to the Wolbachia strain-host species combination. The wRi strain, native to Drosophila simulans, increases the basal activity level of the host insect as well as its responsiveness to food cues. In contrast, the wMel strain and the virulent wMelPop strain, native to Drosophila melanogaster, cause slight decreases in responsiveness to food cues but do not alter basal activity levels in the host. Surprisingly, the virulent wMelPop strain has very little impact on host responsiveness in D. simulans. This novel strain-host relationship was artificially created previously by transinfection. These findings have implications for understanding the evolution and spread of Wolbachia infections in wild populations and for Wolbachia-based vector-borne disease control strategies currently being developed.