Surveillance for azole-resistant Aspergillus fumigatus in a centralized diagnostic mycology service, London, United Kingdom, 1998-2017

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Title: Surveillance for azole-resistant Aspergillus fumigatus in a centralized diagnostic mycology service, London, United Kingdom, 1998-2017
Authors: Abdolrasouli, A
Petrou, MA
Park, H
Rhodes, J
Rawson, T
Moore, L
Donaldson, H
Holmes, A
Fisher, M
Armstrong-James, D
Item Type: Journal Article
Abstract: Background/Objectives: Aspergillus fumigatus is the leading cause of invasive aspergillosis. Treatment is hindered by the emergence of resistance to triazole antimycotic agents. Here, we present the prevalence of triazole resistance among clinical isolates at a major centralized medical mycology laboratory in London, United Kingdom, in the period 1998–2017. Methods: A large number (n = 1469) of clinical A. fumigatus isolates from unselected clinical specimens were identified and their susceptibility against three triazoles, amphotericin B and three echinocandin agents was carried out. All isolates were identified phenotypically and antifungal susceptibility testing was carried out by using a standard broth microdilution method. Results: Retrospective surveillance (1998–2011) shows 5/1151 (0.43%) isolates were resistant to at least one of the clinically used triazole antifungal agents. Prospective surveillance (2015–2017) shows 7/356 (2.2%) isolates were resistant to at least one triazole antifungals demonstrating an increase in incidence of triazole-resistant A. fumigatus in our laboratory. Among five isolates collected from 2015 to 2017 and available for molecular testing, three harbored TR34/L98H alteration in the cyp51A gene that are associated with the acquisition of resistance in the non-patient environment. Conclusion: These data show that historically low prevalence of azole resistance may be increasing, warranting further surveillance of susceptible patients.
Issue Date: 20-Sep-2018
Date of Acceptance: 31-Aug-2018
ISSN: 1664-302X
Publisher: Frontiers Media
Journal / Book Title: Frontiers in Microbiology
Volume: 9
Copyright Statement: t © 2018 Abdolrasouli, Petrou, Park, Rhodes, Rawson, Moore, Donaldson, Holmes, Fisher and Armstrong-James. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Sponsor/Funder: National Institute for Health Research
National Institute for Health Research
Natural Environment Research Council (NERC)
Natural Environment Research Council [2006-2012]
Funder's Grant Number: HPRU-2012-10047
Keywords: Science & Technology
Life Sciences & Biomedicine
Aspergillus fumigatus
azole resistance
antifungal agents
Aspergillus fumigatus
antifungal agents
azole resistance
Publication Status: Published
Article Number: ARTN 2234
Appears in Collections:National Heart and Lung Institute
Department of Medicine
Faculty of Medicine
Epidemiology, Public Health and Primary Care

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