Prevalence and in vitro antifungal susceptibility of cryptic species of the genus Aspergillus isolated in clinical samples

Vidal-Acuña, María Reyes; Ruiz, María Antonia Carmona; Torres, Marı́a José; Aznar, Javier

doi:10.1016/j.eimc.2018.07.010

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…Two isolates had the TR 34 -L98H substitutions and were sourced from patients in Seville and Donostia (data not reported) [6]. Furthermore, two single-hospital studies reported very low rates of azole resistance in clinical A. fumigatus sensu stricto isolates collected at Seville (none) or Madrid (1.8%) [17,18].…”

Section: Discussionmentioning

confidence: 99%

Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain

Escribano¹,

Rodríguez‐Sánchez²,

Díaz-García³

et al. 2021

Clinical Microbiology and Infection

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showing azole resistance according to the EUCAST 9.3.2 methodology were molecularly identified and the cyp51A gene was studied in A. fumigatus sensu stricto isolates. Results: Eight hundred and forty-seven isolates from 725 patients were collected in 29 hospitals (A. fumigatus sensu stricto (n ¼ 828) and cryptic species (n ¼ 19)). Isolates were mostly from the lower respiratory tract (94.0%; 797/847). Only cryptic species were amphotericin B resistant. Sixty-three (7.4%) out of the 847 isolates were resistant to 1 azole(s). Azole resistance was higher in cryptic species than in A. fumigatus sensu stricto (95%, 18/19 vs. 5.5%, 45/828); isavuconazole was associated to the lowest number of non-wild type isolates. The dominant mechanism of resistance was the presence of TR 34 -L98H substitutions (n ¼ 24 out of 63). Out of the 725 patients, 48 (6.6%) carried either cryptic species (n ¼ 14) or A. fumigatus sensu stricto (n ¼ 34; 4.7%) resistant isolates. Aspergillus fumigatus sensu stricto harbouring either the TR 34 -L98H (n ¼ 19) or TR 46 /Y121F/T289A (n ¼ 1) mutations were detected in patients in hospitals located at 7/24 studied cities. Discussion: Of the patients, 6.6% carry azole-resistant A. fumigatus sensu lato isolates in Spain. TR 34 -L98H is the dominant cyp51A gene substitutions, although its presence is not widespread.

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Section: Discussionmentioning

confidence: 99%

Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain

Escribano¹,

Rodríguez‐Sánchez²,

Díaz-García³

et al. 2021

Clinical Microbiology and Infection

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“…A. niger and A. tubingensis are two closely related species in the section Nigri [ 40 ]. The antifungal susceptibility profiles of these two species have already been reported in Iran [ 41 ] and in other countries [ 42 ]. A. fumigatus is more clear-cut in mechanisms of azole resistance than black aspergilli.…”

Section: Discussionmentioning

confidence: 96%

A Whole Genome Sequencing-Based Approach to Track down Genomic Variants in Itraconazole-Resistant Species of Aspergillus from Iran

Nargesi

Valadan

Abastabar

et al. 2022

JoF

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The antifungal resistance in non-fumigatus Aspergillus spp., as well as Aspergillus fumigatus, poses a major therapeutic challenge which affects the entire healthcare community. Mutation occurrence of cyp51 gene paralogs is the major cause of azole resistance in Aspergillus spp.,. To obtain a full map of genomic changes, an accurate scan of the entire length of the Aspergillus genome is necessary. In this study, using whole genome sequencing (WGS) technique, we evaluated the mutation in cyp51A, cyp51B, Cdr1B, AtrR, Hmg1, HapE and FfmA genes in different clinical isolates of Aspergillus fumigatus, Aspergillus niger, Aspergillus tubingensis, Aspergillus welwitschiae and Aspergillus terreus which responded to minimum inhibitory concentrations of itraconazole above 16 µg mL−1. We found different nonsynonymous mutations in the cyp51A, cyp51B, Cdr1B, AtrR, Hmg1, HapE and FfmA gene loci. According to our findings, Aspergillus species isolated from different parts of the world may represent different pattern of resistance mechanisms which may be revealed by WGS.

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“…In response to this urgent issue, the ECDC has declared that epidemiological surveillance studies are a useful tool to provide local information regarding A. fumigatus azole susceptibility levels 22 . In Spain, multiple studies have evaluated the distribution of Aspergillus species and the prevalence of azole resistance from clinical samples, but most of these studies were limited due to a lack of environmental samples, 23,24,27 although a few studies have included these type of isolates 29,31 . The inclusion of environmental isolates has been reinforced by the finding of the hospital setting as a hypothetical source of dissemination of azole‐resistant A. fumigatus 43 …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in the last decade, the ECDC (European Center for Disease Prevention and Control) has recommended epidemiological surveillance studies to update locally A. fumigatus azole susceptibility information 22 . Several countries have started these surveillance studies, mainly from clinical samples, 23–28 but also, to a lesser extent, including environmental samples 29–31 …”

Section: Introductionmentioning

confidence: 99%

Distribution of Aspergillus species and prevalence of azole resistance in clinical and environmental samples from a Spanish hospital during a three‐year study period

Lucio,

Alcazar‐Fuoli,

Gil

et al. 2024

Mycoses

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BackgroundSurveillance studies are crucial for updating trends in Aspergillus species and antifungal susceptibility information.ObjectivesDetermine the Aspergillus species distribution and azole resistance prevalence during this 3‐year prospective surveillance study in a Spanish hospital.Materials and MethodsThree hundred thirty‐five Aspergillus spp. clinical and environmental isolates were collected during a 3‐year study. All isolates were screened for azole resistance using an agar‐based screening method and resistance was confirmed by EUCAST antifungal susceptibility testing. The azole resistance mechanism was confirmed by sequencing the cyp51A gene and its promoter. All Aspergillus fumigatus strains were genotyped using TRESPERG analysis.ResultsAspergillus fumigatus was the predominant species recovered with a total of 174 strains (51.94%). The rest of Aspergillus spp. were less frequent: Aspergillus niger (14.93%), Aspergillus terreus (9.55%), Aspergillus flavus (8.36%), Aspergillus nidulans (5.37%) and Aspergillus lentulus (3.28%), among other Aspergillus species (6.57%). TRESPERG analysis showed 99 different genotypes, with 72.73% of the strains being represented as a single genotype. Some genotypes were common among clinical and environmental A. fumigatus azole‐susceptible strains, even when isolated months apart. We describe the occurrence of two azole‐resistant A. fumigatus strains, one clinical and another environmental, that were genotypically different and did not share genotypes with any of the azole‐susceptible strains.ConclusionsAspergillus fumigatus strains showed a very diverse population although several genotypes were shared among clinical and environmental strains. The isolation of azole‐resistant strains from both settings suggest that an efficient analysis of clinical and environmental sources must be done to detect azole resistance in A. fumigatus.

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Prevalence and in vitro antifungal susceptibility of cryptic species of the genus Aspergillus isolated in clinical samples

Cited by 7 publications

References 27 publications

Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain

Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain

A Whole Genome Sequencing-Based Approach to Track down Genomic Variants in Itraconazole-Resistant Species of Aspergillus from Iran

Distribution of Aspergillus species and prevalence of azole resistance in clinical and environmental samples from a Spanish hospital during a three‐year study period

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