A nationwide passive surveillance on fungal infections shows a low burden of azole resistance in molds and yeasts in Tyrol, Austria

Lass‐Flörl, Cornelia; Mayr, A; Aigner, Maria; Lackner, Michaela; Orth‐Höller, Dorothea

doi:10.1007/s15010-018-1170-0

Cited by 13 publications

(9 citation statements)

References 12 publications

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“…Despite reports of azole resistance acquired after treatment, in common and rare yeast species, and description of an increasing percentage of resistant isolates (39), this phenomenon remains rare (1,16,40,41) or has geographical specificity (42,43), and seems to concern especially C. tropicalis, C. glabrata and C. parapsilosis (17). In the present study, we observed a proportion of fluconazole-resistant isolates among C. albicans and C. parapsilosis isolates similar to that reported in international surveys (17,19,20,28,44).…”

Section: Discussionsupporting

confidence: 83%

Azole Susceptibility Profiles of More than 9,000 Clinical Yeast Isolates Belonging to 40 Common and Rare Species

Desnos‐Ollivier

Lortholary

Bretagne

et al. 2021

Antimicrob Agents Chemother

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Invasive yeast infections represent a major global public health issue and only few antifungal agents are available. Azoles are one of the classes of antifungals used for treatment of invasive candidiasis. The determination of antifungal susceptibility profiles using standardized methods is important to identify resistant isolates and to uncover the potential emergence of intrinsically-resistant species. We here report data on 9,319 clinical isolates belonging to 40 pathogenic yeast species recovered in France over 17 years. The antifungal susceptibility profiles were all determined at the National Reference Center for Invasive Mycoses and Antifungals based on the EUCAST broth microdilution method. The centralized collection and analysis allowed us to describe the trends of azoles susceptibility of isolates belonging to common species, confirming the high susceptibility for C. albicans (n=3,295), C. tropicalis (n=641), C. parapsilosis (n=820), and decreased susceptibility for C. glabrata (n=1,274), and P. kudriavzevii (n=343). They also provide interesting data concerning azole susceptibility of Cr. neoformans species complex: showing comparable MICs distribution for the three species but lower MIC50 and MIC90 for serotype D (n=208) compared to serotype A (n=949) and AD hybrids (n=177). Finally, these data provide useful information for rare and/or emerging species such as C. lusitaniae (n=221), S. clavata (n=184), M. guilliermondii complex (n=150), C. haemulonii complex (n=87), R. mucilaginosa (n=55), W. anomalus (n=36).

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Section: Discussionsupporting

confidence: 83%

Azole Susceptibility Profiles of More than 9,000 Clinical Yeast Isolates Belonging to 40 Common and Rare Species

Desnos‐Ollivier

Lortholary

Bretagne

et al. 2021

Antimicrob Agents Chemother

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“…Countries reporting the presence of azole-resistant Aspergillus fumigatus and mechanisms of resistance in surveyed isolates [47,48,49,52,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97]. …”

Section: Figurementioning

confidence: 99%

Emerging Fungal Infections: New Patients, New Patterns, and New Pathogens

Friedman

Schwartz

2019

JoF

276

200

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: The landscape of clinical mycology is constantly changing. New therapies for malignant and autoimmune diseases have led to new risk factors for unusual mycoses. Invasive candidiasis is increasingly caused by non-albicans Candida spp., including C. auris, a multidrug-resistant yeast with the potential for nosocomial transmission that has rapidly spread globally. The use of mould-active antifungal prophylaxis in patients with cancer or transplantation has decreased the incidence of invasive fungal disease, but shifted the balance of mould disease in these patients to those from non-fumigatus Aspergillus species, Mucorales, and Scedosporium/Lomentospora spp. The agricultural application of triazole pesticides has driven an emergence of azole-resistant A. fumigatus in environmental and clinical isolates. The widespread use of topical antifungals with corticosteroids in India has resulted in Trichophyton mentagrophytes causing recalcitrant dermatophytosis. New dimorphic fungal pathogens have emerged, including Emergomyces, which cause disseminated mycoses globally, primarily in HIV infected patients, and Blastomyces helicus and B. percursus, causes of atypical blastomycosis in western parts of North America and in Africa, respectively. In North America, regions of geographic risk for coccidioidomycosis, histoplasmosis, and blastomycosis have expanded, possibly related to climate change. In Brazil, zoonotic sporotrichosis caused by Sporothrix brasiliensis has emerged as an important disease of felines and people.

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“…Aspergillus fumigatus , Aspergillus flavus and Aspergillus terreus exist ubiquitously in the environment. However, they are also important human pathogens causing allergic bronchopulmonary aspergillosis in patients with asthma or cystic fibrosis, chronic pulmonary aspergillosis in those with impaired lung tissue architecture and severe invasive infections in immunocompromised patients [ 1 , 2 , 3 ]. A. fumigatus is the most common cause of human Aspergillus infections globally, whereas the incidence of the other two species varies geographically.…”

Section: Introductionmentioning

confidence: 99%

“…A. fumigatus is the most common cause of human Aspergillus infections globally, whereas the incidence of the other two species varies geographically. A. flavus is the second most common species in Asia but A. terreus the second most common species in Austria [ 1 , 3 ]. A. fumigatus is known to be abundant in decaying vegetation in fields, forests, and compost heaps while both A. terreus and A. flavus are known to be abundant in soils [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Dissection of the Activity of Agricultural Fungicides against Clinical Aspergillus Isolates with and without Environmentally and Medically Induced Azole Resistance

Jørgensen

Helleberg

Hare

et al. 2021

JoF

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Azole resistance is an emerging problem in patients with aspergillosis. The role of fungicides for resistance development and occurrence is not fully elucidated. EUCAST reference MICs of 17 fungicides (11 azoles and 6 others), five azole fungicide metabolites and four medical triazoles were examined against two reference and 28 clinical isolates of A. fumigatus, A. flavus and A. terreus with (n = 12) and without (n = 16) resistance mutations. Eight/11 azole fungicides were active against wild-type A. fumigatus, A. flavus and A. terreus, including four (metconazole, prothioconazole-desthio, prochloraz and imazalil) with low MIC50 (≤2 mg/L) against all three species and epoxiconazole, propiconazole, tebuconazole and difenoconazole also against wild-type A. terreus. Mefentrifluconazole, azole metabolites and non-azole fungicides MICs were >16 mg/L against A. fumigatus although partial growth inhibition was found with mefentrifluconazole. Moreover, mefentrifluconazole and axozystrobin were active against wild-type A. terreus. Increased MICs (≥3 dilutions) were found for TR34/L98H, TR34(3)/L98H, TR46/Y121F/T289A and G432S compared to wild-type A. fumigatus for epoxiconazole, propiconazole, tebuconazole, difenoconazole, prochloraz, imazalil and metconazole (except G432S), and for prothioconazole-desthio against TR46/Y121F/T289A, specifically. Increased MICs were found in A. fumigatus harbouring G54R, M220K and M220R alterations for five, one and one azole fungicides, respectively, compared to MICs against wild-type A. fumigatus. Similarly, increased MICs wer found for A. terreus with G51A, M217I and Y491H alterations for five, six and two azole fungicides, respectively. Azole fungicides showed activity against wild-type A. fumigatus, A. terreus and A. flavus, but not against all mutant isolates, suggesting the environmental route of azole resistance may have a role for all three species.

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A nationwide passive surveillance on fungal infections shows a low burden of azole resistance in molds and yeasts in Tyrol, Austria

Cited by 13 publications

References 12 publications

Azole Susceptibility Profiles of More than 9,000 Clinical Yeast Isolates Belonging to 40 Common and Rare Species

Azole Susceptibility Profiles of More than 9,000 Clinical Yeast Isolates Belonging to 40 Common and Rare Species

Emerging Fungal Infections: New Patients, New Patterns, and New Pathogens

Dissection of the Activity of Agricultural Fungicides against Clinical Aspergillus Isolates with and without Environmentally and Medically Induced Azole Resistance

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