Emergence of Triazole Resistance in Aspergillus spp. in Latin America

Macedo, Daiana; Leonardelli, Florencia; Gamarra, Soledad; García‐Effrón, Guillermo

doi:10.1007/s12281-021-00418-6

Cited by 9 publications

(5 citation statements)

References 100 publications

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“…En Brasil, se detectó 1,8% de AF resistentes a VOR (16) . En Martinica (mar Caribe) se reportó 8,9% de AF clínicos resistentes a azoles con altos MIC (17) .…”

Section: Discussionunclassified

Azole resistance in strains of Aspergillus fumigatus sensu stricto isolated from respiratory clinical samples

Guevara,

Villanueva-Cotrina,

Cayampi Quispe

et al. 2023

An Fac med

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La aspergilosis invasiva presenta alta mortalidad en pacientes con enfermedades crónicas e inmunocomprometidos. Aspergillus fumigatus sensu stricto (AFSS) es el principal agente etiológico y su tipificación requiere de métodos moleculares. La incidencia incrementada de AI resistentes a los antifúngicos demanda un diagnóstico certero y oportuno. Métodos. Se estudiaron 20 cepas de la micoteca del Instituto de Medicina Tropical – Universidad Nacional Mayor de San Marcos, aisladas de muestras respiratorias e identificadas como Aspergillus fumigatus sensu lato mediante el estudio macroscópico y microscópico. Las cepas fueron referidas a la Universidad Nacional del Litoral para su tipificación mediante una PCR screening para AFSS basada en secuencias del gen CYP51A y el estudio de sensibilidad antifúngica para voriconazol (VOR), itraconazol (ITC), posaconazol (POS), isavuconazol (ISA), anidulafungina (ANF), caspofungina (CSF) y anfotericina B (AMB) obteniendo la concentración inhibitoria mínima (CIM) mediante el protocolo de CLSI M38M51S-Ed3. Resultados. Las 20 cepas fueron identificadas como AFSS. Ninguna de las cepas tuvo una CIM por encima del punto de corte clínico (VOR), ni epidemiológico (ITC, ISA, AMB y CSF). POS fue la droga más potente frente a la colección de cepas evaluadas (media geométrica (GM) de CIM de 0,042 µg/ml). Conclusiones. Todos los aislamientos fueron tipificados como AFSS sensibles a los azoles según los puntos de corte clínico, posaconazol tuvo la mayor actividad antifúngica. Nuestros hallazgos aportan a incrementar la escasa información sobre la etiología y sensibilidad a los antifúngicos de uso clínico de las aspergilosis invasiva en nuestro país.

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“…En Brasil, se detectó 1,8% de AF resistentes a VOR (16) . En Martinica (mar Caribe) se reportó 8,9% de AF clínicos resistentes a azoles con altos MIC (17) .…”

Section: Discussionunclassified

Azole resistance in strains of Aspergillus fumigatus sensu stricto isolated from respiratory clinical samples

Guevara,

Villanueva-Cotrina,

Cayampi Quispe

et al. 2023

An Fac med

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“… 19 Of concern and with very limited information, resistance to azoles has been identified in environmental isolates in the region, which may limit the use of these products. 20 , 21 …”

Section: Fungal Burden Latin Americamentioning

confidence: 99%

“…19 Of concern and with very limited information, resistance to azoles has been identified in environmental isolates in the region, which may limit the use of these products. 20,21 Fusarium is mainly observed in patients with leukemias or transplants. Isolations of these microorganisms have been relatively limited, and outbreaks caused by this type of microorganism have been observed in the region, especially in Brazil where it is more frequent than mucormycosis in this group of patients.…”

Section: Fungal Burden Latin Americamentioning

confidence: 99%

Antifungal stewardship: the Latin American experience

Riera,

Cortes Luna,

Rabagliatti

et al. 2023

ASHE

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Antifungal stewardship is a critical component of healthcare management that focuses on optimizing the use of antifungal medications to improve patient outcomes, minimize resistance, and reduce healthcare costs. In resource-limited settings, the prevalence of fungal infections remains a significant health concern, often exacerbated by factors such as compromised immune systems, inadequate diagnostic capabilities, and limited access to antifungal agents. This paper reviews the current state of antifungal stewardship practices in developing countries, addressing the unique socioeconomic and healthcare landscape.

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“…fumigatus species, which are uncommon and resistant to treatment (6)(7)(8). In patients with HM, the gold standard for diagnosing IA is histopathological evaluation through tissue biopsy.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Patients with Hematologic Malignancies and Invasive Aspergillosis: A Cross-sectional Clinical Report from Iran

Salehi,

Shahrbaf,

Shahi

et al. 2024

Jundishapur J Microbiol

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Background: The incidence of invasive aspergillosis (IA) has significantly increased in recent decades. In patients with hematologic malignancies (HM), IA is associated with higher mortality rates. Objectives: This study aimed to assess the clinical features of IA in patients with HM. Methods: In this retrospective study, we utilized the hospital information system (HIS) database to extract clinical and paraclinical characteristics of patients with various HMs who received a diagnosis of probable or proven IA during their hospitalization at Imam Khomeini Hospital Complex in Tehran, Iran, between March 2018 and March 2022 Results: Among 350 patients with HM evaluated, 51 patients (14.6%) were identified as having IA, including 40 cases (78.4%) classified as probable and 11 (21.6%) as proven. Among these, 34 individuals (66.7%) were male. The most common symptoms included fever (n = 23, 62.7%), cough (n = 20, 39.2%), and fever that did not respond to antibiotic therapy (n = 16, 31.4%). The most prevalent malignancies were AML (n = 28, 54.9%), ALL (n = 16, 31.4%), and lymphoma (n = 7, 13.7%). Out of the 51 patients with HM and IA, 48 (94.1%) had abnormal findings on chest CT scans, with the majority (n = 31, 72.1%) showing a nodule with a halo sign. Aspergillus flavus (n = 19/24, 79.2%) was the most commonly isolated species. Initially, patients received liposomal amphotericin B or caspofungin as empiric antifungal therapy, which was then switched to voriconazole once the diagnosis of IA was probable or proven. Eight patients (15.6%) did not survive. Conclusions: Patients with HM presenting with fever and cough should undergo close monitoring for IA. A higher incidence of IA is observed in AML patients, and voriconazole could be considered as antifungal prophylaxis in HM patients. A. flavus is likely the most frequent cause of IA in Iranian patients with HM.

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Emergence of Triazole Resistance in Aspergillus spp. in Latin America

Cited by 9 publications

References 100 publications

Azole resistance in strains of Aspergillus fumigatus sensu stricto isolated from respiratory clinical samples

Azole resistance in strains of Aspergillus fumigatus sensu stricto isolated from respiratory clinical samples

Antifungal stewardship: the Latin American experience

Clinical Characteristics of Patients with Hematologic Malignancies and Invasive Aspergillosis: A Cross-sectional Clinical Report from Iran

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