Dear Colleagues,

The scope of this Special Issue concerns the C. neoformans/ C. gattii species complex according to a one health approach. Cryptococcal meningitis is a neglected opportunistic disease, caused by yeasts belonging to the Cryptococcus neoformans/C. gattii species complex.

Cryptococcus species have been isolated from several ecological niches, such as soil, pigeon droppings, plants and debris in tree holes. Many new reservoirs are now reported (water, arthropods…). Environmental sampling contributes to a better understanding of the epidemiology of the disease. Many ecological niches have been investigated worldwide in order to elucidate the environmental biotope of these species complex. Finding new biotopes at the origin of the contamination is now essential.

Cryptococcal meningitis is always fatal without treatment and it remains deadly under antifungal treatment in 45% of cases. Fluconazole is the most commonly administered drug for the treatment of cryptococcosis in low-resource countries. Its intensive use in prophylaxis and treatment of many fungal infections leads to an increase in relapse and in the emergence of resistant strains. Studies concerning the resistance of Cryptococcus to fluconazole are of great concern in order to improve patient management. There are not well documented strains of the C. gattii species complex.

The intensive use of pesticides results in environmental contamination and the effects on human or animal environmental pathogens are still largely unknown. The risk of exposure of Cryptococcus exists in the environment and it could have an impact on the sensitivity to clinical antifungals and generate cross-resistance as already demonstrated in Aspergillus fumigatus.

Research on the pathogenesis and virulence mechanisms of Cryptococcus has focused on three main areas: adaptation to the host environment, mechanism of immune evasion and production of virulence factors. The mechanisms by which Cryptococcus modulates the expression of virulence factors are studied but specifically in the C. neoformans species complex, little research has been done on species of the C. gattii complex.

Enhanced genomic surveillance of these yeasts in their native environments is needed in order to understand their molecular epidemiology, ecology, biology and evolution and how these influence the epidemiology and pathophysiology of cryptococcosis.

Prof. Dr. Sébastien Bertout
Dr. Virginie Bellet
Guest Editors

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• C. neoformans and C. gattii species complex
• molecular epidemiology
• resistance to antifungals
• biotope
• virulence factors