9 14.9 −9.0 non-VGIIb 18.0 31.5 13.4 VGIIc VGIIc B9235 VGIIc 25.9 13.7 −12.1 non-VGIIa 24.1 14.9 −9.2 LY411575 purchase non-VGIIb 18.4 32.4 14.0 VGIIc VGIIc B9244

VGIIc 27.2 19.1 −8.1 non-VGIIa 26.2 16.9 −9.2 non-VGIIb 20.2 32.5 12.3 VGIIc VGIIc B9245 VGIIc 28.4 22.9 −5.5 non-VGIIa 25.2 17.4 −7.8 non-VGIIb 20.7 34.5 13.8 VGIIc VGIIc B9295 VGIIc 21.0 17.1 −3.8 non-VGIIa 26.0 19.6 −6.4 non-VGIIb 22.1 28.1 5.9 VGIIc VGIIc B9302 VGIIc 26.7 15.6 −11.1 non-VGIIa 23.7 15.4 −8.3 non-VGIIb 19.4 34.3 15.0 VGIIc VGIIc B9374 VGIIc 27.4 21.6 −5.8 non-VGIIa 24.0 15.3 −8.7 non-VGIIb 19.4 33.4 14.0 VGIIc VGIIc Table 6 Interassay and Intraassay for MLST and Subtyping MAMA Assay interrun CV (%) intrarun CV (%) VGI 4.33 1.56 VGII 2.35 0.22 VGIII 0.43 0.60 VGIV 1.37 1.08 VGIIa 0.22 0.50 VGIIb 1.27 0.92 VGIIc 1.61 0.32 Table 7 Lower limit dynamic range for MLST and subtyping MAMA primer sets Primer set tested Limit (pg) Median Ct VGI 0.5 31.7 non-VGI 0.5 31.1 VGII 0.5 29.5 non-VGII 0.5 28.7 VGIII 0.5 28.5 non-VGIII 0.5 29.9 VGIV 0.5 33.7 non-VGIV 0.5 33.2 VGIIa 0.5 30.2 non-VGIIa 0.5 31.2 VGIIb 0.5 30.1 non-VGIIb 0.5 28.5 VGIIc 0.5 37.4 non-VGIIc 0.05 39.4 Discussion C. gattii is an Epacadostat datasheet emerging pathogen in the US Pacific Northwest and British Columbia.

Molecular and epidemiological investigations revealed the Vancouver Island, BC outbreak was attributed to a novel and seemingly hypervirulent VGIIa Defactinib manufacturer genotype [7, 20, 22]; moreover, the recent PNW outbreak was attributed to an additional novel genotype, VGIIc [23]. These apparent new genotypes (VGIIa and VGIIc), are responsible for greater than 90% of C. gattii infections in the BC/PNW region [7]. Given the increased virulence, varying antifungal susceptibilities and clinical outcomes caused by these genotypes, as compared to other C. gattii genotypes, it will be useful to conduct regular genotyping of C. gattii isolates for both clinical and epidemiological response purposes [5, 7, 9, 16]. We have developed a MAMA real-time PCR panel for cost-efficient and rapid

genotyping of C. gattii molecular types (I-IV) and VGII subtypes (a-c) as a means to better understand Selleckchem Pembrolizumab genotype distribution of C. gattii in North America. To validate the assays, we screened DNA from a diverse North American and international isolate collection of C. gattii isolates from human, environmental, and animal sources. All DNA had been previously typed by MLST. The assay panel performed with 100% sensitivity and specificity and was 100% concordant with MLST results. The VGII subtype specific assays may be more pertinent to the North American public health and medical communities; the molecular type (I-IV) specific assays will be useful for both North American and global genotyping.