ArticleBrazilian 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.
Article in Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology], 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCryptococcosis remains a severe systemic mycosis, especially among people living with HIV/AIDS, and culture-based molecular data from Amazonas remain limited.
objectivesThe 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.
methodsWe 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.
resultsVNI 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.
conclusionVNI was the dominant molecular type in this severe reference-center cryptococcosis series from Amazonas. Phenotypic findings should be interpreted as exploratory and hypothesis-generating.
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