Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?

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dc.citation.volumev. 9
dc.contributor.authorZoran, Tamara
dc.contributor.authorSartori, Bettina
dc.contributor.authorSappl, Laura
dc.contributor.authorAigner, Maria
dc.contributor.authorSanchez-Reus, Ferran
dc.contributor.authorRezusta, Antonio
dc.contributor.authorChowdhary, Anuradha
dc.contributor.authorTaj-Aldeen, Saad J.
dc.contributor.authorArendrup, Maiken C.
dc.contributor.authorOliveri, Salvatore
dc.contributor.authorKontoyiannis, Dimitrios P.
dc.contributor.authorAlastruey-Izquierdo, Ana
dc.contributor.authorLagrou, Katrien
dc.contributor.authorLo Cascio, Giuliana
dc.contributor.authorMeis, Jacques F.
dc.contributor.authorBuzina, Walter
dc.contributor.authorFarina, Claudio
dc.contributor.authorDrogari-Apiranthitou, Miranda
dc.contributor.authorGrancini, Anna
dc.contributor.authorTortorano, Anna M.
dc.contributor.authorWillinger, Birgit
dc.contributor.authorHamprecht, Axel
dc.contributor.authorJohnson, Elizabeth
dc.contributor.authorKlingspor, Lena
dc.contributor.authorArsic-Arsenijevic, Valentina
dc.contributor.authorCornely, Oliver A.
dc.contributor.authorMeletiadis, Joseph
dc.contributor.authorPrammer, Wolfgang
dc.contributor.authorTullio, Vivian
dc.contributor.authorVehreschild, Jorg-Janne
dc.contributor.authorTrovato, Laura
dc.contributor.authorLewis, Russell E.
dc.contributor.authorSegal, Esther
dc.contributor.authorRath, Peter-Michael
dc.contributor.authorHamal, Petr
dc.contributor.authorRodriguez-Iglesias, Manuel
dc.contributor.authorRoilides, Emmanuel
dc.contributor.authorArikan-Akdagli, Sevtap
dc.contributor.authorChakrabarti, Arunaloke
dc.contributor.authorColombo, Arnaldo Lopes [UNIFESP]
dc.contributor.authorFernandez, Mariana S.
dc.contributor.authorTeresa Martin-Gomez, M.
dc.contributor.authorBadali, Hamid
dc.contributor.authorPetrikkos, Georgios
dc.contributor.authorKlimko, Nikolai
dc.contributor.authorHeimann, Sebastian M.
dc.contributor.authorUzun, Omrum
dc.contributor.authorRoudbary, Maryam
dc.contributor.authorde la Fuente, Sonia
dc.contributor.authorHoubraken, Jos
dc.contributor.authorRisslegger, Brigitte
dc.contributor.authorLass-Floerl, Cornelia
dc.contributor.authorLackner, Michaela
dc.coverageLausanne
dc.date.accessioned2020-07-20T16:31:13Z
dc.date.available2020-07-20T16:31:13Z
dc.date.issued2018
dc.description.abstractObjectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods : A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results : The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions : Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.en
dc.description.affiliationMed Univ Innsbruck, Div Hyg & Med Microbiol, Innsbruck, Austria
dc.description.affiliationHosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
dc.description.affiliationUniv Zaragoza, Hosp Univ Miguel Servet, IIS Aragon, Microbiol, Zaragoza, Spain
dc.description.affiliationUniv Delhi, Vallabhbhai Patel Chest Inst, Dept Med Mycol, New Delhi, India
dc.description.affiliationHamad Med Corp, Dept Lab Med & Pathol, Microbiol Div, Doha, Qatar
dc.description.affiliationUniv Copenhagen, Rigshosp, Dept Clin Microbiol, Unit Mycol,Statens Serum Inst, Copenhagen, Denmark
dc.description.affiliationUniv Catania, Dept Biomed & Biotechnol Sci, Catania, Italy
dc.description.affiliationUniv Texas MD Anderson Canc Ctr, Houston, TX USA
dc.description.affiliationInst Salud Carlos III, Natl Ctr Microbiol, Madrid, Spain
dc.description.affiliationKatholieke Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium
dc.description.affiliationUniv Integrata, Azienda Osped, Dipartimento Patol Diagnost, Unita Operat Complessa Microbiol & Virol, Verona, Italy
dc.description.affiliationCanisius Wilhelmina Hosp, Dept Med Microbiol & Infect Dis, Nijmegen, Netherlands
dc.description.affiliationMed Univ Graz, Inst Hyg Microbiol & Environm Med, Graz, Austria
dc.description.affiliationASST Papa Giovanni XXIII, Microbiol Inst, Bergamo, Italy
dc.description.affiliationUniv Athens, ATTIKON Univ Hosp, Dept Internal Med 4, Infect Dis Res Lab, Athens, Greece
dc.description.affiliationCa Granda Osped Maggiore Policlin, IRCCS Fdn, Lab Cent Analisi Chim Clin & Microbiol, Milan, Italy
dc.description.affiliationUniv Milan, Dept Biomed Sci Hlth, Milan, Italy
dc.description.affiliationMed Univ Vienna, Dept Lab Med, Div Clin Microbiol, Vienna, Austria
dc.description.affiliationUniv Cologne, Inst Med Microbiol Immunol & Hyg, Cologne, Germany
dc.description.affiliationPubl Hlth England, Mycol Reference Lab, Bristol, Avon, England
dc.description.affiliationKarolinska Univ Hosp, Karolinska Inst, Dept Lab Med, Stockholm, Sweden
dc.description.affiliationUniv Belgrade, Inst Microbiol & Immunol, Fac Med, Natl Reference Med Mycol Lab, Belgrade, Serbia
dc.description.affiliationUniv Cologne, German Ctr Infect Res, Ctr Integrated Oncol CIO Koln Bonn,Clin Trials Ct, Dept Internal Med,Cologne Excellence Cluster Cell, Cologne, Germany
dc.description.affiliationATTIKON Univ, Hosp Athens, Natl Kapodistrian Univ Athens, Clin Microbiol Lab, Athens, Greece
dc.description.affiliationKlinikum Wels Grieskirchen, Dept Hyg & Med Microbiol, Wels, Austria
dc.description.affiliationDiv Microbiol, Dept Publ Hlth & Pediat, Turin, Italy
dc.description.affiliationUniv Hosp Cologne, Dept Internal Med, Cologne, Germany
dc.description.affiliationPartner Site Bonn Cologne, German Ctr Infect Res, Cologne, Germany
dc.description.affiliationBiometec Univ Catania, AOU Policlin Vittorio Emanuele Catania, Catania, Italy
dc.description.affiliationUniv Bologna, S Orsola Malpighi, Dept Med & Surg Sci, Infect Dis Unit, Bologna, Italy
dc.description.affiliationTel Aviv Univ, Sackler Sch Med, Dept Clin Microbiol & Immunol, Tel Aviv, Israel
dc.description.affiliationUniv Duisburg Essen, Univ Hosp Essen, Inst Med Microbiol, Essen, Germany
dc.description.affiliationPalacky Univ Olomouc, Fac Med & Dent, Dept Microbiol, Olomouc, Czech Republic
dc.description.affiliationUniv Hosp Olomouc, Olomouc, Czech Republic
dc.description.affiliationUniv Cadiz, Puerta Mar Univ Hosp, Clin Microbiol, Cadiz, Spain
dc.description.affiliationHippokrateion Hosp, Aristotle Univ Sch Hlth Sci, Fac Med, Infect Dis Unit,Dept Pediat 3, Thessaloniki, Greece
dc.description.affiliationHacettepe Univ Med Sch, Dept Med Microbiol, Ankara, Turkey
dc.description.affiliationPostgrad Inst Med Educ & Res, Dept Medial Microbiol, Div Mycol, Chandigarh, India
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUniv Nacl Nordeste, CONICET, Inst Medicina Reg, Dept Micol, Resistencia, Argentina
dc.description.affiliationVall Hebron Univ Hosp, Dept Microbiol, Div Clin Mycol, Barcelona, Spain
dc.description.affiliationMazandaran Univ Med Sci, Dept Med Mycol & Parasitol, Invas Fungi Res Ctr, Sari, Iran
dc.description.affiliationEuropean Univ Cyprus, Sch Med, Nicosia, Cyprus
dc.description.affiliationNorth Western State Med Univ, Dept Clin Mycol Allergy & Immunol, St Petersburg, Russia
dc.description.affiliationUniv Hosp Cologne, Dept Internal Med, Cologne, Germany
dc.description.affiliationHacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey
dc.description.affiliationIran Univ Med Sci, Sch Med, Dept Med Mycol & Parasitol, Tehran, Iran
dc.description.affiliationHosp Ernest Lluch Martin, Dept Dermatol, Zaragoza, Spain
dc.description.affiliationWesterdijk Fungal Biodivers Inst, Dept Appl & Ind Mycol, Utrecht, Netherlands
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipECMM
dc.description.sponsorshipISHAM
dc.description.sponsorshipEFISG
dc.description.sponsorshipAstellas
dc.description.sponsorshipMSD
dc.description.sponsorshipPfizer
dc.description.sponsorshipChristian Doppler Laboratory for invasive fungal infections
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.3389/fmicb.2018.00516
dc.identifier.citationFrontiers In Microbiology. Lausanne, v. 9, 2018.
dc.identifier.doi10.3389/fmicb.2018.00516
dc.identifier.fileWOS000428531200001.pdf
dc.identifier.issn1664-302X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55799
dc.identifier.wosWOS:000428531200001
dc.language.isoeng
dc.publisherFrontiers Media Sa
dc.relation.ispartofFrontiers In Microbiology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectcryptic speciesen
dc.subjectAspergillus section Terreien
dc.subjectsusceptibility profilesen
dc.subjectazolesen
dc.subjectCyp51A alterationsen
dc.titleAzole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?en
dc.typeinfo:eu-repo/semantics/article
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