A 20-Year Antifungal Susceptibility Surveillance (From 1999 to 2019) for Aspergillus spp. and Proposed Epidemiological Cutoff Values for Aspergillus fumigatus and Aspergillus flavus: A Study in a Tertiary Hospital in China.
A 20-Year Antifungal Susceptibility Surveillance (From 1999 to 2019) for Aspergillus spp. and Proposed Epidemiological Cutoff Values for Aspergillus fumigatus and Aspergillus flavus: A Study in a Tertiary Hospital in China.
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DOI：
10.3389/fmicb.2021.680884
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发表时间：
2021
影响因子：
5.2
通讯作者：
Liu W
中科院分区：
文献类型：
--
作者：
Yang X;Chen W;Liang T;Tan J;Liu W;Sun Y;Wang Q;Xu H;Li L;Zhou Y;Wang Q;Wan Z;Song Y;Li R;Liu W
抗性曲霉菌的出现。在全球范围内正在增加。临床分离曲霉属的长期药敏监测。菌株对于了解敏感性的动态变化和监测耐药性的出现是有必要的。此外，曲霉属的临床断点（CBP）和流行病学临界值（ECV）都没有。在中国已经成立。在这项研究中，我们对 706 种曲霉菌属菌株进行了 20 年的抗真菌药敏监测。 1999年至2019年在北京大学第一医院临床检验室工作；通过临床和实验室标准研究所 (CLSI) 肉汤微量稀释法测定对三唑类、卡泊芬净和两性霉素 B 的体外抗真菌敏感性。据观察，烟曲霉是最常见的物种，其次是黄曲霉和土曲霉。 40 个分离株（5.7%），包括烟曲霉、黄曲霉、土曲霉、黑曲霉和构巢曲霉，被归类为非野生型（non-WT）。重要的是，在黄曲霉、土曲霉和黑曲霉分离株中观察到了多重耐药性。对 19 个非 WT 烟曲霉分离株的 Cyp51A 突变进行了表征，TR34/L98H/S297T/F495I 是 20 年监测期间最常见的突变。 20年来我国烟曲霉的抗药性总体呈上升趋势。此外，根据 ECV 建立原则，使用收集的最低抑菌浓度 (MIC)/最低有效浓度 (MEC) 数据建立了烟曲霉和黄曲霉的拟议 ECV。因此，除了针对黄曲霉的伊曲康唑外，所有提议的 ECV 均与 CLSI ECV 相同，导致非 WT 率从 6.0% 降至 0.6%。
The emergence of resistant Aspergillus spp. is increasing worldwide. Long-term susceptibility surveillance for clinically isolated Aspergillus spp. strains is warranted for understanding the dynamic change in susceptibility and monitoring the emergence of resistance. Additionally, neither clinical breakpoints (CBPs) nor epidemiological cutoff values (ECVs) for Aspergillus spp. in China have been established. In this study, we performed a 20-year antifungal susceptibility surveillance for 706 isolates of Aspergillus spp. in a clinical laboratory at Peking University First Hospital from 1999 to 2019; and in vitro antifungal susceptibility to triazoles, caspofungin, and amphotericin B was determined by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. It was observed that Aspergillus fumigatus was the most common species, followed by Aspergillus flavus and Aspergillus terreus. Forty isolates (5.7%), including A. fumigatus, A. flavus, A. terreus, Aspergillus niger, and Aspergillus nidulans, were classified as non-wild type (non-WT). Importantly, multidrug resistance was observed among A. flavus, A. terreus, and A. niger isolates. Cyp51A mutations were characterized for 19 non-WT A. fumigatus isolates, and TR34/L98H/S297T/F495I was the most prevalent mutation during the 20-year surveillance period. The overall resistance trend of A. fumigatus increased over 20 years in China. Furthermore, based on ECV establishment principles, proposed ECVs for A. fumigatus and A. flavus were established using gathered minimum inhibitory concentration (MIC)/minimum effective concentration (MEC) data. Consequently, all the proposed ECVs were identical to the CLSI ECVs, with the exception of itraconazole against A. flavus, resulting in a decrease in the non-WT rate from 6.0 to 0.6%.
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影响因子：
9.4
作者：
Balajee, S. Arunmozhi;Kano, Rui;Chiller, Tom
通讯作者：
Chiller, Tom
影响因子：
4.9
作者：
Heo MS;Shin JH;Choi MJ;Park YJ;Lee HS;Koo SH;Lee WG;Kim SH;Shin MG;Suh SP;Ryang DW
通讯作者：
Ryang DW
影响因子：
11.8
作者：
Hagiwara D;Arai T;Takahashi H;Kusuya Y;Watanabe A;Kamei K
通讯作者：
Kamei K
影响因子：
6.5
作者：
Lass-Flörl, C;Griff, K;Nachbaur, D
通讯作者：
Nachbaur, D
影响因子：
1.9
作者：
Leonardelli, Florencia;Theill, Laura;Garcia-Effron, Guillermo
通讯作者：
Garcia-Effron, Guillermo