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Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?
Zoran, Tamara; Sartori, Bettina; Sappl, Laura; Aigner, Maria; Sánchez-Reus, Ferran; Rezusta, Antonio; Chowdhary, Anuradha; Taj-Aldeen, Saad J; Arendrup, Maiken C; Oliveri, Salvatore; Kontoyiannis, Dimitrios P; Alastruey-Izquierdo, Ana; Lagrou, Katrien; Cascio, Giuliana Lo; Meis, Jacques F; Buzina, Walter; Farina, Claudio; Drogari-Apiranthitou, Miranda; Grancini, Anna; Tortorano, Anna M; Willinger, Birgit; Hamprecht, Axel; Johnson, Elizabeth; Klingspor, Lena; Arsic-Arsenijevic, Valentina; Cornely, Oliver A; Meletiadis, Joseph; Prammer, Wolfgang; Tullio, Vivian; Vehreschild, Jörg-Janne; Trovato, Laura; Lewis, Russell E; Segal, Esther; Rath, Peter-Michael; Hamal, Petr; Rodriguez-Iglesias, Manuel; Roilides, Emmanuel; Arikan-Akdagli, Sevtap; Chakrabarti, Arunaloke; Colombo, Arnaldo L; Fernández, Mariana S; Martin-Gomez, M Teresa; Badali, Hamid; Petrikkos, Georgios; Klimko, Nikolai; Heimann, Sebastian M; Uzun, Omrum; Roudbary, Maryam; de la Fuente, Sonia; Houbraken, Jos.
Afiliação
  • Zoran T; Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Sartori B; Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Sappl L; Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Aigner M; Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Sánchez-Reus F; Servei de Microbiologia, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
  • Rezusta A; Microbiologia, Hospital Universitario Miguel Servet, IIS Aragon, Universidad de Zaragoza, Zaragoza, Spain.
  • Chowdhary A; Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India.
  • Taj-Aldeen SJ; Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
  • Arendrup MC; Unit of Mycology, Department of Clinical Microbiology, Statens Serum Institute, Copenhagen University, Rigshospitalet, Copenhagen, Denmark.
  • Oliveri S; Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
  • Kontoyiannis DP; University of Texas MD Anderson Cancer Center, Houston, TX, United States.
  • Alastruey-Izquierdo A; National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
  • Lagrou K; Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
  • Cascio GL; Unità Operativa Complessa di Microbiologia e Virologia, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
  • Meis JF; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands.
  • Buzina W; Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
  • Farina C; Microbiology Institute, ASST Papa Giovanni XXIII, Bergamo, Italy.
  • Drogari-Apiranthitou M; Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Grancini A; Laboratorio Centrale di Analisi Chimico Cliniche e Microbiologia, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Tortorano AM; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
  • Willinger B; Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
  • Hamprecht A; Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.
  • Johnson E; Mycology Reference Laboratory, Public Health England, Bristol, United Kingdom.
  • Klingspor L; Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
  • Arsic-Arsenijevic V; National Reference Medical Mycology Laboratory, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia.
  • Cornely OA; Department I of Internal Medicine, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Clinical Trials Centre Cologne, Center for Integrated Oncology (CIO Köln-Bonn), German Centre for Infection Research, University of Cologne, Cologne, Germany.
  • Meletiadis J; Clinical Microbiology Laboratory, National Kapodistrian University of Athens, ATTIKON University Hospital Athens, Athens, Greece.
  • Prammer W; Department of Hygiene and Medical Microbiology, Klinikum Wels-Grieskirchen, Wels, Austria.
  • Tullio V; Department of Public Health and Pediatrics, Microbiology Division, Turin, Italy.
  • Vehreschild JJ; Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.
  • Trovato L; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.
  • Lewis RE; A.O.U. Policlinico Vittorio Emanuele Catania, Biometec-University of Catania, Catania, Italy.
  • Segal E; Infectious Diseases Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
  • Rath PM; Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Hamal P; Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  • Rodriguez-Iglesias M; Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czechia.
  • Roilides E; Clinical Microbiology, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain.
  • Arikan-Akdagli S; Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece.
  • Chakrabarti A; Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey.
  • Colombo AL; Division of Mycology, Department of Medial Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Fernández MS; Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
  • Martin-Gomez MT; Departmento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia, Argentina.
  • Badali H; Division of Clinical Mycology, Department of Microbiology, Vall d'Hebron University Hospital, Barcelona, Spain.
  • Petrikkos G; Department of Medical Mycology and Parasitology, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
  • Klimko N; School of Medicine, European University Cyprus, Nicosia, Cyprus.
  • Heimann SM; Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, Saint Petersburg, Russia.
  • Uzun O; Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.
  • Roudbary M; Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey.
  • de la Fuente S; Department of Medical Mycology and Parasitology, School of Medicine, Iran University of Medical Science, Tehran, Iran.
  • Houbraken J; Department of Dermatology, Hospital Ernest Lluch Martin, Zaragoza, Spain.
Front Microbiol ; 9: 516, 2018.
Article em En | MEDLINE | ID: mdl-29643840
ABSTRACT

Objectives:

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Front Microbiol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Áustria
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Front Microbiol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Áustria