Azole resistance in Aspergillus isolates by different types of patients and correlation with environment - An Italian prospective multicentre study (ARiA study).
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents
/ pharmacology
Aspergillosis
/ drug therapy
Aspergillus
/ drug effects
Aspergillus fumigatus
/ drug effects
Azoles
/ pharmacology
Child
Child, Preschool
Cytochrome P-450 Enzyme System
/ genetics
Drug Resistance, Fungal
/ genetics
Environmental Microbiology
Fungal Proteins
/ genetics
Genes, Fungal
Genotype
Humans
Infant
Italy
/ epidemiology
Microsatellite Repeats
/ genetics
Middle Aged
Mutation
Prevalence
Prospective Studies
A. thermomutatus
Aspergillus
Aspergillus fumigatus
Italy
azole resistance
cystic fibrosis
environmental origin
genotypic analysis
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
29
12
2020
received:
28
10
2020
accepted:
30
12
2020
pubmed:
14
1
2021
medline:
22
9
2021
entrez:
13
1
2021
Statut:
ppublish
Résumé
A wide range of frequency of azole-resistance in A fumigatus in different patient populations worldwide was observed threatening to reduce therapeutic options. Estimate the prevalence of azole-resistance, investigate the molecular mechanisms of resistance, compare the genotypes of resistant clinical isolates with those from the surrounding environment. Aspergillus isolates were collected by seven Italian hospital microbiology laboratories. Strains were isolated from different clinical samples from unselected patients. The azole-resistance was evaluated using screening test and microdilution EUCAST method. The molecular mechanism of resistance was performed sequencing the cyp51A gene. Resistant isolates were genotyped by microsatellite analysis and their profiles compared with those of azole-resistant isolates from previous Italian studies. 425 Aspergillus isolates from 367 patients were analysed. The azole-resistance rates were 4.9% and 6.6% considering all Aspergillus spp. isolates and the A fumigatus sensu stricto, respectively. All resistant isolates except one were from a single hospital. Two rare azole-resistant species were identified: A thermomutatus and A lentulus. The predominant resistance mechanism was TR This study confirms the trend of azole-resistance rate in Italy, showing a geographical difference. Data reinforce the importance of surveillance programmes to monitor the local epidemiological situation.
Sections du résumé
BACKGROUND
BACKGROUND
A wide range of frequency of azole-resistance in A fumigatus in different patient populations worldwide was observed threatening to reduce therapeutic options.
OBJECTIVES
OBJECTIVE
Estimate the prevalence of azole-resistance, investigate the molecular mechanisms of resistance, compare the genotypes of resistant clinical isolates with those from the surrounding environment.
METHODS
METHODS
Aspergillus isolates were collected by seven Italian hospital microbiology laboratories. Strains were isolated from different clinical samples from unselected patients. The azole-resistance was evaluated using screening test and microdilution EUCAST method. The molecular mechanism of resistance was performed sequencing the cyp51A gene. Resistant isolates were genotyped by microsatellite analysis and their profiles compared with those of azole-resistant isolates from previous Italian studies.
RESULTS
RESULTS
425 Aspergillus isolates from 367 patients were analysed. The azole-resistance rates were 4.9% and 6.6% considering all Aspergillus spp. isolates and the A fumigatus sensu stricto, respectively. All resistant isolates except one were from a single hospital. Two rare azole-resistant species were identified: A thermomutatus and A lentulus. The predominant resistance mechanism was TR
CONCLUSIONS
CONCLUSIONS
This study confirms the trend of azole-resistance rate in Italy, showing a geographical difference. Data reinforce the importance of surveillance programmes to monitor the local epidemiological situation.
Substances chimiques
Antifungal Agents
0
Azoles
0
Fungal Proteins
0
Cytochrome P-450 Enzyme System
9035-51-2
cytochrome P-450 CYP51A, Aspergillus
EC 1.14.14.-
Banques de données
GENBANK
['AF338659']
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
528-536Subventions
Organisme : Gilead Fellowship Program 2016
Informations de copyright
© 2021 Blackwell Verlag GmbH.
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