First itraconazole resistant Aspergillus fumigatus clinical isolate harbouring a G54E substitution in Cyp51Ap in South America
First itraconazole resistant Aspergillus fumigatus clinical isolate harbouring a G54E substitution in Cyp51Ap in South America
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DOI：
10.1016/j.riam.2016.05.005
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发表时间：
2017-01-31
影响因子：
1.9
通讯作者：
Garcia-Effron, Guillermo
中科院分区：
文献类型：
--
作者：
Leonardelli, Florencia;Theill, Laura;Garcia-Effron, Guillermo
背景：1例27岁男性农民工因植物碎屑损伤导致真菌性角膜炎入院。材料和方法：采集标本进行显微镜检查和培养。对该菌株进行了形态鉴定和分子鉴定。药敏试验采用CLSI方法。结果：分离到一株对伊曲康唑耐药的烟曲霉菌株(MIC>；8mU g/ml)。分离株对两性霉素B、泊沙康唑、伏立康唑和卡泊芬净敏感。CYP51A测序显示有两个突变导致了G54E的替换。患者接受纳他霉素治疗。结论：这是南美首例临床发现的与伊曲康唑耐药相关的烟曲霉菌Cyp51Ap G54E基因突变。考虑到患者是未服用唑类药物，这种耐药分离株可能是从环境中获得的。(C)2016年西班牙裔美国人协会。版权所有：Elsevier Espalia，S.L.U。
Background: A 27-year-old male rural worker was admitted with a fungal keratitis due to an injury involving plant detritus.Materials and methods: Specimens were collected for microscopy examination and culture. The isolate was identified by morphological and molecular criteria. Susceptibility testing was performed using CLSI methods. CYP51A gene was PCR amplified and sequenced.Results: An AspergillUs fumigatus strain resistant to itraconazole (MIC> 8 mu g/ml) was isolated. The isolate was susceptible to amphotericin B, posaconazole, voriconazole and caspofungin. CYP51A sequencing showed two mutations leading on the G54E substitution. The patient received natamycin as treatment.Conclusions: This is the first report in South America of a clinical A. fumigatus strain carrying the substitution G54E at Cyp51Ap associated with itraconazole resistance. Considering the patient was azole-naive, this resistant isolate may have been acquired from the environment. (C) 2016 Asociacion Espanola de Micologia. Published by Elsevier Espalia, S.L.U. All rights reserved.