Cryptococcosis is a serious and sometimes fatal fungal disease caused by Cryptococcus species. Worldwide, it is estimated to kill over 180 000 annually, with 75% of deaths occurring in sub-Saharan Africa. Though cryptococcal infections are rare in otherwise healthy individuals, there have been reported cases in immunocompetent persons. Most cases occur in individuals who have weakened immune systems, particularly those with advanced HIV/AIDS, thus making West Africa a potential hotspot of the disease. Despite this, there is no recent review article with a focus on published findings on cryptococcosis in Western Africa. Common clinical symptoms include chest pain, dry cough, headache, nausea, confusion, fever, fatigue and stiffness of the neck/neurological impairment. The CNS and the lung remain its preferred target even though rare cases of attack on other parts of the body were reported in this review. Cryptococcal antigen screening and India ink preparation were the most commonly used diagnostic methods. Repeated isolation from environmental samples was observed. Overall, data on the clinical prevalence of Cryptococcus are scarce and variable in the region. The environmental prevalence ranges from 2.3% to 22%. This review covers all published research findings on cryptococcosis in West Africa till date. The epidemiological data will likely be of interest to clinicians within and outside the continent. The nations covered in this review include the following: Benin Republic, Burkina Faso, Cote d'ivoire, Ghana, Guinea, Guinea- Bissau, Mali, Nigeria, Senegal and Sierra Leone. More studies are warranted to fill the observed gaps on the epidemiology of Cryptococcus in the region.

Epidemiology of Cryptococcus and cryptococcosis in Western Africa

In vitro antifungal susceptibility profiles of Cryptococcus species isolated from HIV-associated cryptococcal meningitis patients in Zimbabwe

Yeast number and species diversity in urban soils characterized by various intensities of anthropogenic impact in the southern cities of Russia (Krasnodar, Maykop, Simferopol, and Sochi) was investigated. The soils of botanical gardens and the reference soils in the vicinities of cities were used for comparison to reveal the degree of anthropogenic impact. The maximum yeast number was found in a layer of 0–20 cm in the urban soils of Sochi and Simferopol, where it was 5.7 ± 0.2 and 5.4 ± 0.01 log (CFU/g), respectively. The minimum number of yeasts, 2.0 ± 0.1 log (CFU/g), was characteristic of a 60–80-cm layer in the soils in the vicinities of all cities. The number of yeasts was shown to depend primarily on the depth and type of soil and to a lesser extent on location. A total of 20 yeast species were isolated from the studied soils: 10 ascomycetes and 10 basidiomycetes. All basidiomycete yeasts isolated from urban soils and control soils were typical representatives of pedobiont and epiphytic yeast complexes. In the soils of the major tourist cities of Sochi and Simferopol, a high relative abundance of ascomycete species Candida sake and Meyerozyma guilliermondii was found, which fundamentally distinguished the studied soils from the ones of Krasnodar and Maykop. The cities of Sochi and Simferopol are characterized by a higher anthropogenic load compared to Krasnodar and Maykop, which is associated not only with their high population, but also with a significant tourist load. Detection in urban soils of C. sake and M. guilliermondii which, according to some data, are clinically significant, was therefore consequential.

Yeast Complexes in Urban Soils of Some Southern Cities of Russia (Krasnodar, Maykop, Simferopol, and Sochi)

espanolRESUMEN Cryptococcus neoformans/Cryptococcus gattii son agentes etiologicos de la criptococosis, el primero tiene distribucion mundial y su habitat principal son las excretas de palomas (Columba livia), mientras que el ultimo se ha aislado de arboles y en pocas ocasiones de heces de aves. En este estudio se comparo en condiciones de laboratorio, el crecimiento de C. neoformans y C. gattii en extractos de excretas de paloma. Se utilizaron dos extractos de heces de aves cautivas: uno de una muestra en la que se aislo C. neoformans (extracto positivo) y otro de una muestra negativa para este hongo (extracto negativo), los cuales fueron inoculados con C. neoformans y C. gattii. Los extractos permitieron el desarrollo de las dos especies y, mostraron un patron de crecimiento uniforme en el extracto negativo, mientras que, en el positivo, el crecimiento de C. neoformans fue mayor comparado con el de C. gattii (P = 0.0001). El crecimiento de C. gattii fue menor a un pH superior a 7,5, mientras que el crecimiento de C. neoformans no mostro diferencias significativas en los dos extractos independiente de las variaciones del pH. Se necesitan mas estudios para elucidar la interaccion de estas dos especies en las excretas de palomas. portuguesRESUMO Cryptococcus neoformans / Cryptococcus gattii sao agentes etiologicos da criptococose, o primeiro tem distribuicao mundial e seu habitat principal e a excrecao de pombos (Columba livia), enquanto o ultimo foi isolado de arvores e raramente de fezes de aves. Neste estudo, o crescimento de C. neoformans e C. gattii nos extratos de excrementos de pombo foi comparado em condicoes de laboratorio. Foram utilizados dois extratos de fezes de aves em cativeiro: um de uma amostra em que C. neoformans (extrato positivo) foi isolado e outro de uma amostra negativa para esse fungo (extrato negativo), que foi inoculado com C. neoformans e C gattii Os extratos permitiram o desenvolvimento das duas especies e mostraram um padrao de crescimento uniforme no extrato negativo, enquanto no positivo o crescimento de C. neoformans foi maior em comparacao ao de C. gattii (P = 0,0001). O crescimento de C. gattii foi menor a pH maior que 7,5, enquanto o crescimento de C. neoformans nao mostrou diferencas significativas nos dois extratos, independentemente das variacoes de pH. Mais estudos sao necessarios para elucidar a interacao dessas duas especies nos excrementos de pombos. EnglishABSTRACT Cryptococcus neoformans/Cryptococcus gattii are etiologic agents of cryptococcosis, the former has a worldwide distribution, and its habitat is associated with pigeon excreta (Columba livia), whereas the latter it has been mainly associated with trees and rarely from the feces of birds. In this study was to compare, under laboratory conditions, the growth of C. neoformans and C. gattii in extracts of pigeon excreta. Two extracts of captive bird feces were used: one prepared from a sample in which C. neoformans was isolated (positive extract) and one from which sample was negative for this fungus (negative extract). Under laboratory conditions, the extracts allowed the development of both species. Both showed a uniform pattern of growth in the negative extract, whereas in the positive, C. neoformans growth was significantly higher than that of C. gattii (P = 0.0001). The growth of the C. gattii was lower in positive extracts and it seems to decrease at pH greater than 7.5, whereas the growth of C. neoformans showed no significant differences regardless of pH variations. Further studies are need to elucidate the interaction between these two species in the excreta of pigeon.

http://www.scielo.org.co/pdf/entra/v16n1/2539-0279-entra-16-01-218.pdf

Crecimiento del complejo Cryptococcus neoformans/ Cryptococcus gattiien extractos de excretas de palomas

Context: An upper gastrointestinal endoscopy (UGIE) is now a routine procedure and is a guide to the prevalence and nature of gastrointestinal tract diseases in an area. Aim: To report indications and findings for UGIE in a tertiary hospital in Kaduna, Nigeria, and compare with past reports in the region and from the rest of Nigeria and Africa. Settings and Design: A retrospective review of endoscopy records (2014–2021) of consecutive patients referred to the endoscopy unit of Barau Dikko Teaching Hospital, Kaduna, Nigeria. Statistical Analysis: The data were analyzed using IBM SPSS version 22. Results: Over seven years, 1,525 patients had diagnostic UGIE: mean age = 44.8 years (range 8–100), 61% ≥ 40 years, and 55.7% females. Dyspepsia (70%) and hematemesis/melena (14%) were the most common indications. Superficial gastritis (60%) was the most common endoscopic finding. Peptic ulcer disease (PUD) was diagnosed in 9.6% of patients: Gastric ulcer (6.6%) was more common than duodenal ulcer (3.6%) and more frequent in males than females (9.5% vs. 4.3%, P = 0.000) and in those ≥ 40 years compared with < 40 years (7.8% vs 5%, P = 0.032). Duodenal ulcer was also more common in males (6% vs 1.8%, P = 0.000). Erosive gastritis (20.5%), hiatus hernia (14.4%), esophagitis (13.7%), atrophic gastritis (8.3%), nodular gastritis (6.6%), esophageal varices (6.1%), and gastric carcinoma (1.2%) were other findings. There was no abnormality detected in 6% of patients. Conclusion: We reported a marked change in the pattern of some gastroduodenal diseases in our region. The patients are older and predominantly female. The prevalence of PUD has markedly declined with gastric ulcer now almost twice as common as duodenal ulcer.

Diagnostic upper gastrointestinal endoscopy in Kaduna, Northwest Nigeria: Indications and findings

Objective : To establish the environmental reservoirs of Cryptococcus neoformans and  Cryptococcus gattii in Nairobi, Kenya. Design : Prospective study. Setting : Kenya Medical Research Institute, Mycology laboratory, Nairobi, Kenya. Subjects : A total of 400 environmental samples from different sites were analysed including; avian droppings, tree swabs, soil contaminated with avian droppings and swabs from garbage damping sites. Samples were subjected to various phenotypic tests including microscopic morphology, physiological and biochemical tests, pigmentation on bird seed agar and reaction on Canavanine-Glycine-Bromothymol Blue agar. Results : Cryptococcus neoformans was isolated from 23/200 (11.5%) dropping samples and Cryptococcus gattii in 5/200 (2.5%) of the same samples. Cryptococcus gattii was isolated from 7/60 (11.7%) tree swabs and Cryptococcus neoformans in 5/60 (8.5%) of the same samples. From other sites there was no Cryptococcus gattii recovered with (5/50: 10%), (6/60: 10%), (2/30: 6.7%) Cryptococcus neoformans recovered from chicken cage, garbage damping site and soil respectively. Conclusion : Findings clearly showed a high presence of Cryptococcus neoformans  and Cryptococcus gattii from several environmental sites in Nairobi, Kenya .This could probably explain the high incidence of cryptococcal meningitis in HIV/AIDS patients in Kenya.

/pdf/isolation-and-characterisation-of-cryptococcus-neoformans-igqy9from8.pdf

Isolation and characterisation of cryptococcus neoformans and cryptococcus gattii from environmental sources in nairobi, kenya.

Objective : To determine anti-fungal susceptibility of Cryptococcus neoformans and Cryptococcus gattii from environmental and clinical sources in Nairobi, Kenya. Design : Prospective study. Setting : Kenya Medical Research Institute, Mycology laboratory, Nairobi, Kenya. Subjects : A total of 123 isolates were tested for their susceptibility to fluconazole (FLC), amphotericin B(AMP) and fluorocytosine (5FC). Clinical isolates were 70(66 Cryptococcus neoformans and 4 Cryptococcus gattii ) while environmental isolates were 53(41 C. neoformans and 12 C. gattii ). The isolates were characterised using various phenotypic tests including microscopic morphology, physiological and biochemical tests (API 20 Caux), pigmentation on bird seed agar and reaction on canavanineglycine- bromthymolblue agar. European Committee on Anti-microbial Susceptibility Standards (EUCAST) was used as the reference method for susceptibility testing. Results : Most C. neoformans isolates; clinical (61/66; 92.4%) and environmental (38/41; 92.7%) were susceptible to FLC. The number of C. neoformans isolates inhibited at susceptible dose dependent (SDD) range (16-32μg/ml) by FLC were clinical (4/66; 6.1%) and environmental (2/41; 4.9%). One C. neoformans isolate each; clinical (1/66; 1.5%) and environmental (1/41; 2.4%) was resistant to FLC. All C. gatti isolates from clinical and environmental were fully susceptible to FLC. The percentage of C. neoformans isolates that were susceptible (S) (MIC ≤ 1.0 μg/ml) to AMP were; clinical(52/66; 90.2%) and environmental (37/41; 78.8%) while the rest were susceptible dose dependent (SDD) with MIC (2-8μg/ml). Reduced susceptibilities to 5FC was displayed in all clinical and environmental C. neoformans and C. gatii isolates; for instance resistance to 5FC was reported in C. neoformans ; clinical (8/66; 12.1%) and environmental (1/41; 2.4 %). Among the C. gattii isolates there was also decreased susceptibility to 5FC with Minimum Inhibition Concentration (MIC) range of between 0.5-32 μg/ml. There were no significant differences in susceptibility ranges among all the clinical and environmental isolates. Conclusion : This study demonstrated reduced susceptibilities among C. neoformans and C. gattii isolates to commonly used anti-fungal drugs.

https://www.ajol.info/index.php/eamj/article/view/118827/108310

Susceptibility of Cryptococcus neoformans and Cryptococcus gattii from clinical and environment sources in Nairobi, Kenya

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Isolation and characterisation of cryptococcus neoformans and cryptococcus gattii from environmental sources in nairobi, kenya.

Susceptibility of Cryptococcus neoformans and Cryptococcus gattii from clinical and environment sources in Nairobi, Kenya