Molecular evidence that the range of the vancouver island outbreak of cryptococcus gattii infection has expanded into the pacific northwest in the united states

Abstract

Cryptococcus neoformans frequently causes fungal meningitis in immunocompromised patients, whereas the related species C. gattii is restricted to tropicalandsubtropical regions,whereit usually infectsimmunocompetentindividuals. Anoutbreak of C. gattii infection thatbeganin1999onVancouverIsland has resulted inendemicC. gattii infectionand causednumeroushumanandveterinary infections; theoutbreak'srangehasspreadtomainlandBritishColumbia.The outbreak-related isolates have been molecular type VGIIa, the major genotype, or VGIIb, the minor genotype. Since 2006,humanand veterinary cases of C. gattii infection have emerged in Washington and Oregon. Multilocus sequence typing demonstrates the spread of C. gattii VGIIa and VGIIb from Vancouver Island to the Pacific Northwest. Clinical strains recovered in Oregon represent a unique VGIIc genotype. © 2009 by the Infectious Diseases Society of America.