Aspergillus Species and Antifungals Susceptibility in Clinical Setting in the North of Portugal: Cryptic Species and Emerging Azoles Resistance in A. fumigatus.
Aspergillus Species and Antifungals Susceptibility in Clinical Setting in the North of Portugal: Cryptic Species and Emerging Azoles Resistance in A. fumigatus.
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DOI：
10.3389/fmicb.2018.01656
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发表时间：
2018
影响因子：
5.2
通讯作者：
Pinheiro D
中科院分区：
文献类型：
--
作者：
Pinto E;Monteiro C;Maia M;Faria MA;Lopes V;Lameiras C;Pinheiro D
曲霉属是人类广泛疾病的病原体。他们对唑类药物的耐药性不断增强，这是人类曲霉病治疗的基石，是世界各地令人担忧的问题。考虑到缺乏来自葡萄牙的关于该主题的数据，特别是来自北方地区的数据，计划进行一项回顾性监测研究，以评估隐蔽曲霉属菌种和唑类耐药性的频率。共227个临床分离株，主要来自呼吸道（92.1%），从三家医院收集的人口约300万人，研究了他们的流行病学和抗真菌药敏模式确定的E.DEF.9.3协议的EUCAST。采用分子生物学方法，7曲霉菌复合体进行了鉴定，烟曲霉狭义是最常见的分离株（86.7%）。隐种的检出率为7.5%; welwitschiae（A.尼日尔complex-3.1%）和A. lentulus（A.烟曲霉复合菌群占2.2%。在隐种中，伏立康唑、泊沙康唑和艾沙康唑的耐药率分别为47.1%、82.4%和100%。五A。严格意义上的烟曲霉表现出对泛唑的抗性。cyp 51 A基因测序结果显示，1株存在TR 46/Y121 F/T289 A突变，2株存在TR 34/L98 H突变。本研究强调需要确定菌株的物种水平，并评估其抗真菌药物的敏感性，在所有人类起源的曲霉属。分离物，特别是来自侵袭性曲霉病的分离物。
Aspergillus spp. are agents of a broad-spectrum of diseases among humans. Their growing resistance to azoles, the cornerstone in the management of human aspergillosis, is a worrisome problem around the world. Considering lack of data from Portugal on this topic, particularly from the northern region, a retrospective surveillance study was planned to assess frequency of cryptic Aspergillus species and azoles resistance. A total of 227 clinical isolates, mainly from the respiratory tract (92.1%), collected from three hospitals serving a population of about three million people, were studied for their epidemiology and antifungal susceptibility patterns determined by the E.DEF.9.3 protocol of EUCAST. Employing molecular methods, seven Aspergillus complexes were identified; Aspergillus fumigatus sensu stricto was the most frequent isolate (86.7%). A 7.5% prevalence of cryptic species was found; A. welwitschiae (A. niger complex-3.1%) and A. lentulus (A. fumigatus complex-2.2%) were the most frequent. Amongst cryptic species, it was found a percentage of resistance to voriconazole, posaconazole and isavuconazole of 47.1, 82.4, and 100%, respectively. Five A. fumigatus sensu stricto showed pan-azole resistance. Sequencing their cyp51A gene revealed the presence of one isolate with TR46/Y121F/T289A mutation and two isolates with TR34/L98H mutation. This study emphasizes the need to identify strains to the species level and to evaluate their antifungal susceptibility in all human originated Aspergillus spp. isolates, particularly those from invasive aspergillosis.