Detection of azole-susceptible and azole-resistant Aspergillus coinfection by cyp51A PCR amplicon melting curve analysis.
J Antimicrob Chemother
; 72(11): 3047-3050, 2017 Nov 01.
Article
en En
| MEDLINE
| ID: mdl-28961889
ABSTRACT
BACKGROUND:
The AsperGenius® assay is a multiplex real-time PCR test that allows the simultaneous detection of Aspergillus species and identification of the most common mutations in the Aspergillus fumigatus cyp51A gene conferring resistance (TR34/L98H and TR46/T289A/Y121F) by using melting curve analysis. Mixed infections with azole-resistant and susceptible A. fumigatus have rarely been described.METHODS:
The AsperGenius® multiplex real-time PCR assay (PathoNostics, Maastricht, the Netherlands) was used on bronchoalveolar lavage (BAL) samples of 91 consecutive patients with a suspected invasive Aspergillus infection at the Erasmus MC University Medical Center, Rotterdam.RESULTS:
In three cases the AsperGenius® assay indicated the simultaneous presence of WT and mutant genes (two patients with TR34/L98H mutation and one patient with TR46/T289A/Y121F mutation) and therefore mixed infections with azole-susceptible and -resistant isolates. In one of the three cases, the mixed infection was confirmed by phenotypic antifungal testing of multiple A. fumigatus colonies.CONCLUSIONS:
The use of a dedicated A. fumigatus cyp51A resistance PCR allowed the detection of mixed infections with azole-resistant and -susceptible Aspergillus strains. These mixed infections may remain undiagnosed with conventional phenotypic susceptibility testing.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Aspergilosis
/
Aspergillus fumigatus
/
Azoles
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Proteínas Fúngicas
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Sistema Enzimático del Citocromo P-450
/
Antifúngicos
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Child
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Humans
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Middle aged
Idioma:
En
Revista:
J Antimicrob Chemother
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos