%0 Journal Article
%T Global Molecular Epidemiology of Cryptococcus neoformans and Cryptococcus gattii: An Atlas of the Molecular Types
%A Massimo Cogliati
%J Scientifica
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/675213
%X Cryptococcosis is a fungal disease affecting more than one million people per year worldwide. The main etiological agents of cryptococcosis are the two sibling species Cryptococcus neoformans and Cryptococcus gattii that present numerous differences in geographical distribution, ecological niches, epidemiology, pathobiology, clinical presentation and molecular characters. Genotyping of the two Cryptococcus species at subspecies level supplies relevant information to understand how this fungus has spread worldwide, the nature of its population structure, and how it evolved to be a deadly pathogen. At present, nine major molecular types have been recognized: VNI, VNII, VNB, VNIII, and VNIV among C. neoformans isolates, and VGI, VGII, VGIII, and VGIV among C. gattii isolates. In this paper all the information available in the literature concerning the isolation of the two Cryptococcus species has been collected and analyzed on the basis of their geographical origin, source of isolation, level of identification, species, and molecular type. A detailed analysis of the geographical distribution of the major molecular types in each continent has been described and represented on thematic maps. This study represents a useful tool to start new epidemiological surveys on the basis of the present knowledge. 1. Introduction According to the last report (December 2010) from the Joint United Nations Program on HIV/AIDS and the World Health Organization (http://www.unaids.org/), 34 million people worldwide suffer from HIV infection/AIDS, 2.7 million people are newly infected every year from this disease, and 1.8 million people die from AIDS-related causes. Neuropathological conditions are present in approximately 70% to 90% of AIDS patients [1]. Cryptococcal meningitis is considered an AIDS-defining condition [2¨C4], and it is the most common fungal infection of the central nervous system and the third most frequent neurological complication in AIDS patients [1]. The main etiological agents of cryptococcosis are the basidiomycetous yeasts Cryptococcus neoformans and Cryptococcus gattii which can also infect, although with a significantly lower incidence, people with decreased immunity such as individuals with sarcoidosis, lymphoproliferative disorders, those undergoing immunosuppressive therapies [4¨C6], and more rarely immunocompetent people [7, 8]. Worldwide, C. neoformans and C. gattii infections cause an estimated one million cases of cryptococcal meningitis per year among people with HIV/AIDS, resulting in nearly 625,000 deaths (Centers for Disease Control and
%U http://www.hindawi.com/journals/scientifica/2013/675213/