ABSTRACT

Our understanding of the pathogenic yeasts Cryptococcus neoformans and Cryptococcus gattii has been greatly enhanced by use of genome sequencing technologies. Found ubiquitously as saprotrophs in the environment, inhalation of infectious spores from these pathogens can lead to the disease cryptococcosis. Individuals with compromised immune systems are at particular risk, most notably those living with HIV/AIDS. Genome sequencing in combination with laboratory and clinical studies has revealed diverse lineages with important differences in their observed frequency, virulence and clinical outcomes. However, to date, genomic analyses have focused primarily on clinical isolates that represent only a subset of the diversity in the environment. Enhanced genomic surveillance of these yeasts in their native environments is needed in order to understand their ecology, biology and evolution and how these influence the epidemiology and pathophysiology of clinical disease. This is particularly relevant on the African continent from where global cryptococcal diversity may have originated, yet where environmental sampling and sequencing has been sparse despite harbouring the largest population at risk from cryptococcosis. Here, we review what scientifically and clinically relevant insights have been provided by analysis of environmental Cryptococcus isolates to date and argue that with further sampling, particularly in Africa, many more important discoveries await.

中文翻译：

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需要进行环境监测以了解非洲隐球菌感染的生态学、流行病学和影响

摘要

我们对致病性酵母菌新型隐球菌和加特隐球菌的了解通过使用基因组测序技术已经大大增强。作为环境中普遍存在的腐生菌，吸入这些病原体的传染性孢子可导致隐球菌病。免疫系统受损的个体面临特别的风险，尤其是艾滋病毒/艾滋病感染者。基因组测序与实验室和临床研究相结合，揭示了不同的谱系，在观察到的频率、毒力和临床结果方面存在重要差异。然而，迄今为止，基因组分析主要集中在仅代表环境多样性子集的临床分离株上。为了了解它们的生态，需要在它们的原生环境中加强对这些酵母的基因组监测，生物学和进化以及它们如何影响临床疾病的流行病学和病理生理学。这与全球隐球菌多样性可能起源的非洲大陆尤其相关，尽管那里有最大的隐球菌病风险人群，但环境采样和测序却很少。在这里，我们回顾了通过环境分析提供了哪些科学和临床相关的见解迄今为止分离出隐球菌，并认为随着进一步的采样，特别是在非洲，许多更重要的发现等待着。