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Volume 18, Number 10—October 2012

Research

Autochthonous and Dormant Cryptococcus gattii Infections in Europe

Ferry HagenComments to Author , M. Francisca Colom, Daniëlle Swinne, Kathrin Tintelnot, Roberta Iatta, Maria Teresa Montagna, Josep M. Torres-Rodriguez, Massimo Cogliati, Aristea Velegraki, Arjan Burggraaf, Alwin Kamermans, Johanna M. Sweere, Jacques F. Meis, Corné H.W. Klaassen, and Teun Boekhout
Author affiliations: Royal Netherlands Academy of Arts and Sciences Fungal Biodiversity Centre, Utrecht, the Netherlands (F. Hagen, A. Burggraaf, A. Kamermans, J.M. Sweere, T. Boekhout); University Medical Center Utrecht, Utrecht (F. Hagen, T Boekhout); Universidad Miguel Hernàndez, Alicante, Spain (M.F. Colom); Institute of Public Health, Brussels, Belgium (D. Swinne); Robert Koch-Institut, Berlin, Germany (K. Tintelnot); Università degli Studi di Bari, Bari, Italy (R. Iatta, M.T. Montagna); Autonomous University of Barcelona, Barcelona, Spain (J.M. Torres-Rodriguez); Università degli Studi di Milano, Milan, Italy (M. Cogliati); University of Athens, Athens, Greece (A. Velegraki); University College Utrecht, Utrecht (J.M. Sweere); Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands (J.F. Meis); and Canisius Wilhelmina Hospital, Nijmegen (J.F. Meis, C.H.W. Klaassen)

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Table

Distribution of Cryptococcus gattii strains*

Source of isolation Genotype
Total† Total (%)
AFLP4/VGI AFLP5/VGIII AFLP6/VGII AFLP7/VGIV AFLP10/VGIV
All C. gattii isolates 146 22 108 13 2 0 291 (100)

Human

84 16 68 12 2 0 182 (62.5)‡

Environment

37 5 17 0 0 0 59 (20.3)‡

Animal

24 0 23 1 0 0 48 (16.5)‡

Unknown

1 1 0 0 0 0 2 (0.7)‡
Africa

Human

18 0 3 8 0 29 36 (12.7)§

Environment

6 0 0 0 0 6

Animal

0 0 0 1 0 1
Asia (clinical) 19 0 5 2 0 26 26 (8.9)§
Australia

Human

2 1 8 0 0 11 18 (6.2)§

Environment

5 0 1 0 0 6

Animal

0 0 1 0 0 1
Europe¶

Human

29# 1** 23†† 2‡‡ 2§§ 57 100 (34.4)§

Environment

22 0 0 0 0 22

Animal

21 0 0 0 0 21
North America¶

Human

3 8 19 0 0 30 69 (23.7)§

Environment

4 3 10 0 0 17

Animal

2 0 20 0 0 22
South America¶

Human

12 3 10 0 0 25 36 (12.4)§

Environment

0 2 6 0 0 8

Animal

1 0 2 0 0 3

Unknown

Human

1 3 0 0 0 4 6 (2.1)§

Unknown

1 1 0 0 0 2

*The number of C. gattii isolates is provided for each geographic area and further subdivided per genotype and source of isolation. AFLP, amplified fragment length polymorphism; human, human clinical patient.
†Total number of isolates per geographic area.
‡The percentage of isolates is given for the source of isolation subset.
§The percentage of isolates is given as a percentage of all isolates.
¶Ten interspecies hybrid C. gattii × C. neoformans isolates were excluded from the set of isolates from Europe (n = 7), North America (n = 1), and South America (n = 2).
#Twelve patients with an autochthonous acquired infection (16 isolates) and 11 patients with an infection acquired outside Europe (13 isolates).
**Infection acquired outside Europe.
††Four patients with an autochthonous infection (10 isolates) and 10 patients with an infection acquired outside Europe (13 isolates).
‡‡Two phenotypically different isolates from an emigrant from Zambia.
§§Two phenotypically different isolates from an emigrant from Mexico.

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