JOURNALOFCLINICALMICROBIOLOGY,Oct.2011,p.3663–3666Vol.49,No.100095-1137/11/$12.00doi:10.1128/JCM.01091-11Copyright©2011,AmericanSocietyforMicrobiology.AllRightsReserved.High-ResolutionMeltingAnalysisforIdentificationoftheCryptococcusneoformans-CryptococcusgattiiComplex�SaraGago,O´scarZaragoza,*IsabelCuesta,JuanL.Rodríguez-Tudela,ManuelCuenca-Estrella,andMaríaJ.Buitrago*ServiciodeMicología,CentroNacionaldeMicrobiología,InstitutodeSaludCarlosIII,Madrid,SpainReceived30May2011/Returnedformodification8July2011/Accepted28July2011Wehavedevelopedatwo-stepmethodbasedonhigh-resolutionmelting(HRM)thatreliablyidentifiesspeciesfromtheCryptococcusspeciescomplex(Cryptococcusneoformansvar.grubii,Cryptococcusneoformansvar.neoformans,andCryptococcusgattii).OurresultsindicatethatHRMcanprovideafastprotocoltoidentifyanddistinguishamongthemainCryptococcusspecies.Cryptococcosisisasystemicmycosiscausedmainlybyencap-sulatedyeastsfromtheCryptococcusneoformans-Cryptococcusgattiicomplex(18).C.neoformansparticularlyinfectsimmuno-compromisedpatients.Withindevelopedcountries,theincidenceofcryptococcosisincreasedamongpatientsinfectedwithHIVattheendofthe20thcentury(11).Theintroductionofhighlyactiveantiretroviraltherapyhasreducedtheincidence,butnottheas-sociatedmortality,ofcryptococcalmeningitis(17,19).Inrecentyears,otherfactorssuchasorgantransplantationhavebeenas-sociatedwithanincreasedriskofacquiringcryptococcosis(1).Inaddition,itsincidenceisstillsignificantindevelopingareas,suchassub-SaharanAfrica,wherecryptococcosisisestimatedtocauseapproximately650,000deathsperyear(19).Cryptococcusgattiihasgainedattentionamongthescientificcommunitybecauseitaffectsindividualswithoutimmunedeficiencies(3).Moreover,C.gattiiwasidentifiedasthecausativeagentoftheoutbreakthatoccurredinVancouverIsland,BritishColumbia,Canada(10),andwhichseemstobespreadinginthenorthwestoftheUnitedStates(5).Classically,C.neoformanscomplexhasbeendividedintosero-typesA,B,C,D,andADbasedonthedifferentialreactivityofthecapsulewithrab...
