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Prevalence and mechanisms of azole resistance in clinical isolates of Aspergillus section Fumigati species in a Canadian tertiary care centre, 2000 to 2013.
- Source :
-
Journal of Antimicrobial Chemotherapy (JAC) . Apr2020, Vol. 75 Issue 4, p849-858. 10p. - Publication Year :
- 2020
-
Abstract
- <bold>Objectives: </bold>Azole resistance among Aspergillus fumigatus isolates is a growing concern worldwide. Induction of mutations during azole therapy, environment-acquired mutations caused by azole fungicides and intrinsic resistance of cryptic Fumigati species all contribute to the burden of resistance. However, there is a lack of data in Canada on this emerging threat.<bold>Methods: </bold>To gain insights into the magnitude and mechanisms of resistance, a 14 year collection of Aspergillus section Fumigati comprising 999 isolates from 807 patients at a Montreal hospital was screened for azole resistance, and resistance mechanisms were investigated with the combined use of genome sequencing, 3D modelling and phenotypic efflux pump assays.<bold>Results: </bold>Overall azole resistance was low (4/807 patients; 0.5%). A single azole-resistant A. fumigatus sensu stricto strain, isolated from a patient with pulmonary aspergillosis, displayed efflux-pump-mediated resistance. Three patients were colonized or infected with azole-resistant cryptic Fumigati species (one Aspergillus thermomutatus, one Aspergillus lentulus and one Aspergillus turcosus). Evidence is presented that azole resistance is efflux-pump-mediated in the A. turcosus isolate, but not in the A. lentulus and A. thermomutatus isolates.<bold>Conclusions: </bold>Azole resistance is rare in our geographic area and currently driven by cryptic Fumigati species. Continued surveillance of emergence of resistance is warranted. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PULMONARY aspergillosis
*ASPERGILLUS
*TERTIARY care
*ASPERGILLUS fumigatus
*FUNGICIDE resistance
*SPECIES
*ANTIFUNGAL agents
*PROTEINS
*RESEARCH
*SPECIALTY hospitals
*HETEROCYCLIC compounds
*RESEARCH methodology
*MEDICAL cooperation
*EVALUATION research
*COMPARATIVE studies
*DISEASE prevalence
*RESEARCH funding
*DRUG resistance in microorganisms
*MICROBIAL sensitivity tests
*PHARMACODYNAMICS
Subjects
Details
- Language :
- English
- ISSN :
- 03057453
- Volume :
- 75
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Antimicrobial Chemotherapy (JAC)
- Publication Type :
- Academic Journal
- Accession number :
- 142279727
- Full Text :
- https://doi.org/10.1093/jac/dkz534