Azole resistance and cyp51A mutation screening in Aspergillus fumigatus in Mexico
© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissionsoup.com..
BACKGROUND: Fungicide exposure in the environment has driven the emergence of azole-resistant Aspergillus fumigatus worldwide. A screening test allows identification of resistant isolates.
OBJECTIVES: We screened clinical samples for azole-resistant Aspergillus through azole-containing agar plates and identified mutations in the cyp51A gene of A. fumigatus.
METHODS: Aspergillus isolates from clinical samples collected in a tertiary care centre from 2014 to 2017 were screened for azole resistance. Samples were subcultured in azole-containing agar plates. Isolates with a positive screening test were subject to DNA extraction, DNA amplification and sequencing of the cyp51A gene (coding and promoter regions). Clinical data were obtained from medical records.
RESULTS: We screened 43 Aspergillus isolates from 39 patients for azole resistance. Three isolates from three patients grew on azole-containing agar plates: two A. fumigatus and one Aspergillus flavus. PCR analysis and cyp51A sequencing identified the TR34/L98H mutation in both A. fumigatus isolates. The prevalence of cyp51A mutations among A. fumigatus was 8.3% (2/24). Both patients with TR34/L98H mutants were azole naive and presented with invasive aspergillosis; one had multiple myeloma and the other was a liver retransplant recipient. They suffered progressive disease and failed voriconazole therapy.
CONCLUSIONS: To the best of our knowledge, this is the first report of azole-resistant A. fumigatus with the TR34/L98H mutation in two azole-naive patients with refractory invasive aspergillosis in Mexico.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
The Journal of antimicrobial chemotherapy - 74(2019), 7 vom: 01. Juli, Seite 2047-2050 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gonzalez-Lara, Maria F [VerfasserIn] |
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| Links: |
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| Themen: |
9035-51-2 |
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| Anmerkungen: |
Date Completed 11.08.2020 Date Revised 11.08.2020 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jac/dkz121 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298363534 |
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| 100 | 1 | |a Gonzalez-Lara, Maria F |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Azole resistance and cyp51A mutation screening in Aspergillus fumigatus in Mexico |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Revised 11.08.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Fungicide exposure in the environment has driven the emergence of azole-resistant Aspergillus fumigatus worldwide. A screening test allows identification of resistant isolates | ||
| 520 | |a OBJECTIVES: We screened clinical samples for azole-resistant Aspergillus through azole-containing agar plates and identified mutations in the cyp51A gene of A. fumigatus | ||
| 520 | |a METHODS: Aspergillus isolates from clinical samples collected in a tertiary care centre from 2014 to 2017 were screened for azole resistance. Samples were subcultured in azole-containing agar plates. Isolates with a positive screening test were subject to DNA extraction, DNA amplification and sequencing of the cyp51A gene (coding and promoter regions). Clinical data were obtained from medical records | ||
| 520 | |a RESULTS: We screened 43 Aspergillus isolates from 39 patients for azole resistance. Three isolates from three patients grew on azole-containing agar plates: two A. fumigatus and one Aspergillus flavus. PCR analysis and cyp51A sequencing identified the TR34/L98H mutation in both A. fumigatus isolates. The prevalence of cyp51A mutations among A. fumigatus was 8.3% (2/24). Both patients with TR34/L98H mutants were azole naive and presented with invasive aspergillosis; one had multiple myeloma and the other was a liver retransplant recipient. They suffered progressive disease and failed voriconazole therapy | ||
| 520 | |a CONCLUSIONS: To the best of our knowledge, this is the first report of azole-resistant A. fumigatus with the TR34/L98H mutation in two azole-naive patients with refractory invasive aspergillosis in Mexico | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Antifungal Agents |2 NLM | |
| 650 | 7 | |a Azoles |2 NLM | |
| 650 | 7 | |a Fungal Proteins |2 NLM | |
| 650 | 7 | |a Cytochrome P-450 Enzyme System |2 NLM | |
| 650 | 7 | |a 9035-51-2 |2 NLM | |
| 650 | 7 | |a cytochrome P-450 CYP51A, Aspergillus |2 NLM | |
| 650 | 7 | |a EC 1.14.14.- |2 NLM | |
| 700 | 1 | |a Roman-Montes, Carla M |e verfasserin |4 aut | |
| 700 | 1 | |a Diaz-Lomeli, Paulette |e verfasserin |4 aut | |
| 700 | 1 | |a Rangel-Cordero, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Valenzuela, Maria O |e verfasserin |4 aut | |
| 700 | 1 | |a Ponce-de-Leon, Alfredo |e verfasserin |4 aut | |
| 700 | 1 | |a Sifuentes-Osornio, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Ostrosky-Zeichner, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez-Gamboa, Areli |e verfasserin |4 aut | |
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