POPULATION GENETICS AND MOLECULAR EPIDEMIOLOGY OF Cryptococcus neoformans OF CLINICAL ISOLATE FROM BRAZIL USING MULTILOCUS SEQUENCE TYPING (MLST)

Cryptococcosis is a fungal infection caused by mean of complex Cryptococcus neoformans and Cryptococcus gattii, which presents mainly in the form meningoencephalitis. More than 223.000 cases of cryptococcosis occur annually in the world in patients HIV / AIDS, about 5.000 in Latin America, and call attention Brazil and Colombia being the countries with the highest incidence. The increase in potentially fatal cases of cryptococcosis in immunocompromised and immunocompetent hosts, and emergence of outbreaks, reinforces the need for vigilance of its causative agents around the world. Although the OMS unknown the cryptococcosis as a Neglected Tropical Disease (NDT), this disease was listed in the G-Finder report as it disproportionately affects developing countries, receiving 0.2% of available funding as NDT. The agents of cryptococcosis disclose five serotypes and eight major molecular types: serotypes A, AD and D, molecular types VNI - VNIV, for C. neoformans, and serotypes B and C, molecular types VGI - VGIV, for C. gattii. Recently, several of molecular subtypes (ST) have been discovered from the sequencing of various loci. These ST’s shows clinical and eco-epidemiological different according some author and the prevalence, virulence, antimicrobial resistance, mortality rates and prognosis of the infection, justify their correct identification. The present study aims to characterize C. neoformans population from Brazil through the identification of these ST’s. To date, 41 clinicial isolates of C. neoformans that originally from the Brazilian states; Rio de Janeiro (n = 29), Amazonas (n = 10), Tocantins (n= 1) and Brasília (n=1) using Multilocus Sequence Typing (MLST), ISHAM, which is based on the sequencing of six nucleic genes (CAP59, GPD1, LAC1, PLB1, SOD1 and URA5) and the IGS1 region, for molecular epidemiology studies. Partial results suggest that clinical isolates are highly clonal. At moment, 25/41 clinical isolates were done and 16 were partially analyses. Our preliminary analyses revealed two molecular types VNI (22/25) and VNII (n = 3/25) and four different ST’s: The ST93 (n = 20), most common and prevalent in the Southeast region; ST40 (n = 3), ST32 (n = 1) and ST23 (n = 1) are potentially more virulent. The identification of these molecular subtypes increases the need for further studies, with a greater sampling, in addition to a constant epidemiological surveillance for the identification of these ST’s in Brazil.