RT Journal Article
T1 Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?
A1 Zoran, Tamara
A1 Sartori, Bettina
A1 Sappl, Laura
A1 Aigner, Maria
A1 Sánchez-Reus, Ferran
A1 Rezusta, Antonio
A1 Chowdhary, Anuradha
A1 Taj-Aldeen, Saad J
A1 Arendrup, Maiken C
A1 Oliveri, Salvatore
A1 Kontoyiannis, Dimitrios P
A1 Alastruey-Izquierdo, Ana
A1 Lagrou, Katrien
A1 Cascio, Giuliana Lo
A1 Meis, Jacques F
A1 Buzina, Walter
A1 Farina, Claudio
A1 Drogari-Apiranthitou, Miranda
A1 Grancini, Anna
A1 Tortorano, Anna M
A1 Willinger, Birgit
A1 Hamprecht, Axel
A1 Johnson, Elizabeth
A1 Klingspor, Lena
A1 Arsic-Arsenijevic, Valentina
A1 Cornely, Oliver A
A1 Meletiadis, Joseph
A1 Prammer, Wolfgang
A1 Tullio, Vivian
A1 Vehreschild, Jörg-Janne
A1 Trovato, Laura
A1 Lewis, Russell E
A1 Segal, Esther
A1 Rath, Peter-Michael
A1 Hamal, Petr
A1 Rodriguez-Iglesias, Manuel
A1 Roilides, Emmanuel
A1 Arikan-Akdagli, Sevtap
A1 Chakrabarti, Arunaloke
A1 Colombo, Arnaldo L
A1 Fernández, Mariana S
A1 Martin-Gomez, M Teresa
A1 Badali, Hamid
A1 Petrikkos, Georgios
A1 Klimko, Nikolai
A1 Heimann, Sebastian M
A1 Uzun, Omrum
A1 Roudbary, Maryam
A1 de la Fuente, Sonia
A1 Houbraken, Jos
A1 Risslegger, Brigitte
A1 Lass-Flörl, Cornelia
A1 Lackner, Michaela
K1 Aspergillus section Terrei
K1 Cyp51A alterations
K1 azoles
K1 cryptic species
K1 susceptibility profiles
AB Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.
SN 1664-302X
YR 2018
FD 2018-03-28
LK http://hdl.handle.net/10668/12335
UL http://hdl.handle.net/10668/12335
LA en
DS RISalud
RD Apr 12, 2025