Surveillance for Azole-Resistant Aspergillus fumigatus in a Centralized Diagnostic Mycology Service, London, United Kingdom, 1998-2017.
Surveillance for Azole-Resistant Aspergillus fumigatus in a Centralized Diagnostic Mycology Service, London, United Kingdom, 1998-2017.
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DOI：
10.3389/fmicb.2018.02234
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发表时间：
2018
影响因子：
5.2
通讯作者：
Armstrong-James D
中科院分区：
文献类型：
--
作者：
Abdolrasouli A;Petrou MA;Park H;Rhodes JL;Rawson TM;Moore LSP;Donaldson H;Holmes AH;Fisher MC;Armstrong-James D
背景/目标：烟曲霉是侵袭性曲霉病的主要原因。三唑类抗真菌药物耐药性的出现阻碍了治疗。在此，我们介绍了 1998 年至 2017 年期间英国伦敦一个主要集中医学真菌学实验室临床分离株中三唑耐药性的流行情况。方法：从未经选择的临床标本中鉴定出大量（n = 1469）临床烟曲霉分离株，并对其对三种三唑、两性霉素 B 和三种棘白菌素药物进行药敏试验。所有分离株均经过表型鉴定，并使用标准肉汤微量稀释方法进行抗真菌敏感性测试。结果：回顾性监测（1998-2011）显示，5/1151（0.43%）分离株对至少一种临床使用的三唑类抗真菌药物具有耐药性。前瞻性监测（2015-2017）显示 7/356 (2.2%) 分离株对至少一种三唑类抗真菌药物具有耐药性，这表明我们实验室中三唑耐药性烟曲霉的发病率有所增加。在 2015 年至 2017 年收集的可用于分子检测的五个分离株中，三个分离株的 cyp51A 基因中含有 TR34/L98H 改变，这些改变与非患者环境中获得耐药性相关。结论：这些数据表明，历史上较低的唑类耐药率可能正在增加，需要对易感患者进行进一步监测。
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.
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影响因子：
14.2
作者：
Arendrup, M. C.;Cuenca-Estrella, M.;Hope, W. W.
通讯作者：
Hope, W. W.
影响因子：
6.7
作者：
Chowdhary A;Kathuria S;Xu J;Meis JF
通讯作者：
Meis JF
影响因子：
11.8
作者：
Denning, David W.;Park, Steven;Perlin, David S.
通讯作者：
Perlin, David S.
影响因子：
9.4
作者：
Ahmad, Suhail;Khan, Ziauddin;Meis, Jacques F.
通讯作者：
Meis, Jacques F.
影响因子：
14.2
作者：
Jensen, R. H.;Hagen, F.;Arendrup, M. C.
通讯作者：
Arendrup, M. C.