Surveillance for azoles resistance in Aspergillus spp. highlights a high number of amphotericin B-resistant isolates

Mycoses
Franqueline Reichert-LimaAngélica Zaninelli Schreiber

Abstract

Aspergillus spp. are the most common invasive mould infection and are responsible for high mortality. Aspergillus fumigatus is currently of interest because resistance to azole antifungals has emerged. The Campinas University Hospital (HC-UNICAMP) receives high-risk patients susceptible to opportunistic infections but there have been no reports of resistant A. fumigatus. This study aimed to assess the susceptibility profile of Aspergillus isolates, specifically looking for azole resistance. ITS and β-tubulin DNA sequencing was performed on 228 sequential clinical isolates. Broth microdilution susceptibility testing was performed for all isolates. A. fumigatus represented 74% of the isolates followed by Aspergillus flavus (12%). Nine A. fumigatus isolates from 9 different patients showed high MIC values to at least 1 azole, but cyp51A polymorphisms were detected in only 6 isolates and none correlated with known resistance mutations. The most troubling observation was that the minimum inhibitory concentration for amphotericin B was elevated (≥2 mg L-1 ) in 87% of patients with A. flavus isolates and 43% with Aspergillus fumigatus isolates. Given that amphotericin B is used to treat azole-resistant infections, these data highlight...Continue Reading

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Jun 4, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michail S LionakisDimitrios P Kontoyiannis
Jul 25, 2019·Journal of Fungi·Daniel Z P Friedman, Ilan S Schwartz
Nov 15, 2019·Clinical Microbiology Reviews·Jean-Paul Latgé, Georgios Chamilos
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Nov 20, 2020·Antibiotics·Chukwuemeka Samson AhamefuleWenxia Fang
Apr 4, 2021·Microorganisms·Anna-Maria DietlCornelia Lass-Flörl
May 25, 2021·Current Fungal Infection Reports·Daiana MacedoGuillermo Garcia-Effron

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