Cryptococcus gattii as an important fungal pathogen of western North America

Research output: Contribution to journalArticle

Abstract

Cryptococcus gattii, a pathogenic fungus historically appreciated to be endemic to tropical regions, was recognized to emerge in a more temperate zone of North America in the 1990s. Early reports focused on an outbreak that was first apparent on Vancouver Island (BC, Canada), involving both the veterinary and human population. More recently, it has been recognized that this organism is endemic to a wider geography in western North America, with recognized disease caused by unique molecular subtypes in both healthy and immunosuppressed human hosts and a variety of domestic and wild animals. A number of cases of disease caused by C. gattii isolates that are unrelated to the Vancouver Island-Pacific Northwest outbreak strains have also been recognized in different parts of the USA. As microbiology laboratories have historically not identified these organisms to the species level, our current understanding of the scope of this infection is probably an underestimate. Ongoing public health epidemiologic efforts will be facilitated by increased attention towards culture-confirmed diagnosis and species identification in clinical microbiology laboratories. Early experience presents a strong rationale for increasing diagnostic attention, with multiple clinical features that are unique to this infection, including variability in antifungal susceptibilities and a heightened need for aggressive management of inflammatory responses. Larger prospective studies to evaluate and optimize clinical management are needed.

Original languageEnglish (US)
Pages (from-to)637-643
Number of pages7
JournalExpert Review of Anti-Infective Therapy
Volume10
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Cryptococcus gattii
North America
Microbiology
Islands
Disease Outbreaks
Northwestern United States
Geography
Wild Animals
Domestic Animals
Immunocompromised Host
Infection
Canada
Fungi
Public Health
Prospective Studies
Population

Keywords

  • cryptococcosis
  • Cryptococcus gattii
  • North America

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)
  • Microbiology
  • Virology

Cite this

Cryptococcus gattii as an important fungal pathogen of western North America. / Marr, Kieren.

In: Expert Review of Anti-Infective Therapy, Vol. 10, No. 6, 06.2012, p. 637-643.

Research output: Contribution to journalArticle

@article{b6a9c824d45c40fda5c173096111ca1e,
title = "Cryptococcus gattii as an important fungal pathogen of western North America",
abstract = "Cryptococcus gattii, a pathogenic fungus historically appreciated to be endemic to tropical regions, was recognized to emerge in a more temperate zone of North America in the 1990s. Early reports focused on an outbreak that was first apparent on Vancouver Island (BC, Canada), involving both the veterinary and human population. More recently, it has been recognized that this organism is endemic to a wider geography in western North America, with recognized disease caused by unique molecular subtypes in both healthy and immunosuppressed human hosts and a variety of domestic and wild animals. A number of cases of disease caused by C. gattii isolates that are unrelated to the Vancouver Island-Pacific Northwest outbreak strains have also been recognized in different parts of the USA. As microbiology laboratories have historically not identified these organisms to the species level, our current understanding of the scope of this infection is probably an underestimate. Ongoing public health epidemiologic efforts will be facilitated by increased attention towards culture-confirmed diagnosis and species identification in clinical microbiology laboratories. Early experience presents a strong rationale for increasing diagnostic attention, with multiple clinical features that are unique to this infection, including variability in antifungal susceptibilities and a heightened need for aggressive management of inflammatory responses. Larger prospective studies to evaluate and optimize clinical management are needed.",
keywords = "cryptococcosis, Cryptococcus gattii, North America",
author = "Kieren Marr",
year = "2012",
month = "6",
doi = "10.1586/eri.12.48",
language = "English (US)",
volume = "10",
pages = "637--643",
journal = "Expert Review of Anti-Infective Therapy",
issn = "1478-7210",
publisher = "Expert Reviews Ltd.",
number = "6",

}

TY - JOUR

T1 - Cryptococcus gattii as an important fungal pathogen of western North America

AU - Marr, Kieren

PY - 2012/6

Y1 - 2012/6

N2 - Cryptococcus gattii, a pathogenic fungus historically appreciated to be endemic to tropical regions, was recognized to emerge in a more temperate zone of North America in the 1990s. Early reports focused on an outbreak that was first apparent on Vancouver Island (BC, Canada), involving both the veterinary and human population. More recently, it has been recognized that this organism is endemic to a wider geography in western North America, with recognized disease caused by unique molecular subtypes in both healthy and immunosuppressed human hosts and a variety of domestic and wild animals. A number of cases of disease caused by C. gattii isolates that are unrelated to the Vancouver Island-Pacific Northwest outbreak strains have also been recognized in different parts of the USA. As microbiology laboratories have historically not identified these organisms to the species level, our current understanding of the scope of this infection is probably an underestimate. Ongoing public health epidemiologic efforts will be facilitated by increased attention towards culture-confirmed diagnosis and species identification in clinical microbiology laboratories. Early experience presents a strong rationale for increasing diagnostic attention, with multiple clinical features that are unique to this infection, including variability in antifungal susceptibilities and a heightened need for aggressive management of inflammatory responses. Larger prospective studies to evaluate and optimize clinical management are needed.

AB - Cryptococcus gattii, a pathogenic fungus historically appreciated to be endemic to tropical regions, was recognized to emerge in a more temperate zone of North America in the 1990s. Early reports focused on an outbreak that was first apparent on Vancouver Island (BC, Canada), involving both the veterinary and human population. More recently, it has been recognized that this organism is endemic to a wider geography in western North America, with recognized disease caused by unique molecular subtypes in both healthy and immunosuppressed human hosts and a variety of domestic and wild animals. A number of cases of disease caused by C. gattii isolates that are unrelated to the Vancouver Island-Pacific Northwest outbreak strains have also been recognized in different parts of the USA. As microbiology laboratories have historically not identified these organisms to the species level, our current understanding of the scope of this infection is probably an underestimate. Ongoing public health epidemiologic efforts will be facilitated by increased attention towards culture-confirmed diagnosis and species identification in clinical microbiology laboratories. Early experience presents a strong rationale for increasing diagnostic attention, with multiple clinical features that are unique to this infection, including variability in antifungal susceptibilities and a heightened need for aggressive management of inflammatory responses. Larger prospective studies to evaluate and optimize clinical management are needed.

KW - cryptococcosis

KW - Cryptococcus gattii

KW - North America

UR - http://www.scopus.com/inward/record.url?scp=84863210161&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863210161&partnerID=8YFLogxK

U2 - 10.1586/eri.12.48

DO - 10.1586/eri.12.48

M3 - Article

C2 - 22734955

AN - SCOPUS:84863210161

VL - 10

SP - 637

EP - 643

JO - Expert Review of Anti-Infective Therapy

JF - Expert Review of Anti-Infective Therapy

SN - 1478-7210

IS - 6

ER -