Table_1_Expansion of the Emerging Fungal Pathogen Cryptococcus bacillisporus Into America: Linking Phylogenetic Origin, Geographical Spread and Population Under Exposure Risk.DOCX

In 2018 the fungal pathogen Cryptococcus bacillisporus (AFLP5/VGIII) was isolated for the first time in Chile, representing the only report in a temperate region in South America. We reconstructed the colonization process of C. bacillisporus in Chile, estimating the phylogenetic origin, the potential spread zone, and the population at risk. We performed a phylogenetic analysis of the strain and modeled the environmental niche of the pathogen projecting its potential spread zone into the new colonized region. Finally, we generated risk maps and quantified the people under potential risk. Phylogenetic analysis showed high similarity between the Chilean isolate and two clonal clusters from California, United States and Colombia in South America. The pathogen can expand into all the temperate Mediterranean zone in central Chile and western Argentina, exposing more than 12 million people to this pathogen in Chile. This study has epidemiological and public health implications for the response to a potential C. bacillisporus outbreak, optimizing budgets, routing for screening diagnosis, and treatment implementation.

2018年，研究人员在智利首次分离得到芽孢隐球菌（Cryptococcus bacillisporus，AFLP5/VGIII型），这是南美洲温带地区针对该真菌病原体的首次正式报道。本研究重建了该菌在智利的定殖进程，对其系统发育起源、潜在扩散范围以及受感染风险的高危人群进行了估算。研究团队对该分离株开展了系统发育分析，并对该病原体的环境生态位进行建模，将其潜在扩散范围投射至新的定殖区域。最终，本研究生成了疫情风险地图，并量化了潜在感染风险的人口规模。系统发育分析结果表明，智利分离株与来自美国加利福尼亚州以及南美洲哥伦比亚的两个克隆簇具有高度同源性。该病原体可扩散至智利中部与阿根廷西部的全部温带地中海气候区，仅在智利境内就将使超过1200万人暴露于该病原体的感染风险之下。本研究对于应对潜在的芽孢隐球菌暴发疫情、优化预算分配、规划筛查诊断路径以及推进治疗实施，均具有重要的流行病学与公共卫生指导意义。