Pulmonary Aspergillosis in Humboldt Penguins—Susceptibility Patterns and Molecular Epidemiology of Clinical and Environmental Aspergillus fumigatus Isolates from a Belgian Zoo, 2017–2022

Abstract

Aspergillus fumigatus is the main causative agent of avian aspergillosis and results in significant health problems in birds, especially those living in captivity. The fungal contamination by A. fumigatus in the environment of Humboldt penguins (Spheniscus humboldti), located in a Belgian zoo, was assessed through the analysis of air, water, sand and nest samples during four non-consecutive days in 2021–2022. From these samples, potential azole-resistant A. fumigatus (ARAF) isolates were detected using a selective culture medium. A total of 28 veterinary isolates obtained after necropsy of Humboldt penguins and other avian species from the zoo were also included. All veterinary and suspected ARAF isolates from the environment were characterized for their azole-resistance profile by broth microdilution. Isolates displaying phenotypic resistance against at least one medical azole were systematically screened for mutations in the cyp51A gene. A total of 14 (13.6%) ARAF isolates were identified from the environment (n = 8) and from Humboldt penguins (n = 6). The TR34/L98H mutation was observed in all resistant environmental strains, and in two resistant veterinary strains. To the best of our knowledge, this is the first description of this mutation in A. fumigatus isolates from Humboldt penguins. During the period 2017–2022, pulmonary aspergillosis was confirmed in 51 necropsied penguins, which reflects a death rate due to aspergillosis of 68.0%, mostly affecting adults. Microsatellite polymorphism analysis revealed a high level of diversity among environmental and veterinary A. fumigatus isolates. However, a cluster was observed between one veterinary isolate and six environmental strains, all resistant to medical azoles. In conclusion, the environment of the Humboldt penguins is a potential contamination source of ARAF, making their management even more complex.

Epidemiology and Azole Resistance of Clinical Isolates of Aspergillus fumigatus from a Large Tertiary Hospital in Ningxia, China

“…39,40 Moreover, the extensive use of triazole antifungals has resulted in the emergence of azoleresistant A. fumigatus, which poses significant clinical and economic challenges. [41][42][43][44] Our study conducted in Ningxia province, China, observed an increase in the number of identified A. fumigatus strains from 2021 to 2023. Additionally, we discovered two azole-resistant strains during our research.…”

Azole Resistance in Veterinary Clinical Aspergillus fumigatus Isolates in the Netherlands

“…It is difficult to interpret the outcomes of these studies, because sample background information is missing. A recent study reported azole resistance in 17.1% of clinical (6/35) and 11.8% (8/68) of environmental A. fumigatus isolates from Humboldt Penguins and other birds and their surroundings from 2017 to 2022 in a Belgian Zoo [ 32 ]. In this study sequencing of the cyp51A gene revealed the TR 34 /L98H mutation in all environmental isolates and TR 34 /L98H (2/6), F46Y/M172V/E427K (1/6) and the absence of known resistance mutations (3/6) in clinical isolates.…”

Emerging Antifungal Resistance in Fungal Pathogens

“…Despite not being drug-resistant, the outbreak still resulted in 21 infections and 9 deaths, in a population of only 211. A known opportunistic pathogen of penguins [ 25 ], azole drug-resistant A. fumigatus has been isolated from a zoo environment and from Humboldt penguins themselves [ 26 ]. However, little research is dedicated to the impact of aspergillosis on wildlife species in terms of clinical outcome and treatment failure, certainly highlighting a gap in our current knowledge.…”