Electronic equipment and appliances in special wards of hospitals as a source of azole-resistant Aspergillus fumigatus: a multi-centre study from Iran

被引:5
作者
Ghazanfari, M. [1 ,2 ]
Abastabar, M. [1 ,2 ]
Haghani, I. [1 ]
Kermani, F. [2 ]
Keikhac, N. [3 ]
Kholoujini, M. [4 ]
Minooeianhaghighi, M. H. [5 ]
Jeddi, S. A. [6 ]
Shokri, A. [7 ]
Ghojoghi, A. [8 ]
Amirizad, K. [9 ]
Azishj, M. [10 ]
Nasirzadeh, Y. [2 ]
Roohi, B. [2 ]
Nosratabadi, M. [2 ,11 ]
Hedayati, S. [12 ]
Ghanbari, S. [2 ,12 ]
Valadan, R. [13 ]
Hedayati, M. T. [1 ,2 ,14 ]
机构
[1] Mazandaran Univ Med Sci, Communicable Dis Inst, Invas Fungi Res Ctr, Sari, Iran
[2] Mazandaran Univ Med Sci, Sch Med, Dept Med Mycol & Parasitol, Sari, Iran
[3] Zahedan Univ Med Sci, Res Inst Cellular & Mol Sci Infect Dis, Infect Dis & Trop Med Res Ctr, Zahedan, Iran
[4] Hamadan Univ Med Sci, Beheshti Hosp, Hamadan, Iran
[5] Gonabad Univ Med Sci, Fac Med, Infect Dis Res Ctr, Dept Med Microbiol, Gonabad, Iran
[6] Abadan Univ Med Sci, Sch Allied Sci, Dept Lab Sci, Abadan, Iran
[7] North Khorasan Univ Med Sci, Vector Borne Dis Res Ctr, Bojnurd, Iran
[8] Ahvaz Jundishapur Univ Med Sci, Sch Med, Dept Med Mycol, Ahvaz, Iran
[9] Tarbiat Modares Univ, Fac Med Sci, Dept Mycol, Tehran, Iran
[10] Dezful Univ Med Sci, Sch Med, Dept Med Parasitol & Mycol, Dezful, Iran
[11] Sirjan Fac Med Sci, Dept Med Lab Sci, Sirjan, Iran
[12] Mazandaran Univ Med Sci, Student Res Comm Ctr, Sari, Iran
[13] Mazandaran Univ Med Sci, Res Ctr MCBRC, Dept Immunol Mol & Cell Biol, Sari, Iran
[14] Mazandaran Univ Med Sci, Invas Fungi Res Ctr, Fac Med, Dept Med Mycol, Sari, Iran
关键词
Aspergillus fumigatus; Azole resistance; CYP51A; TRIAZOLE-RESISTANCE; TR46/Y121F/T289A; ENVIRONMENT; PREVALENCE; MUTATIONS;
D O I
10.1016/j.jhin.2023.12.011
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Azole-resistant Aspergillus fumigatus (ARAf), reported as a global public health concern, has been unexpectedly observed in different countries. Aim: To identify ARAf and detect azole resistance related to the CYP51A mutation in different hospital environmental samples. Methods: In this multi -centre study from Iran, surfaces of electronic equipment and appliances from different hospitals in Iran were sampled using cotton swabs. All samples were cultured using azole-containing agar plates (ACAPs). Recovered Aspergillus isolates were identified at the species level using partial DNA sequencing of the b-tubulin gene. The azole susceptibility testing of A. fumigatus isolates was performed using the Clinical and Laboratory Standards Institute M38 -A3 guideline. The sequencing of the CYP51A gene was also performed to detect mutations related to resistance. Findings: Out of the 693 collected samples, 89 (12.8%) Aspergillus species were recovered from ACAPs. Aspergillus fumigatus (41.6%) was the most prevalent, followed by A. tubingensis (23.6%) and A. niger (15.6%). Among 37 isolates of A. fumigatus, 19 (51.3%) showed high minimum inhibitory concentration (MIC) values to at least one of the three azoles, voriconazole, itraconazole, and posaconazole. CYP51A polymorphisms were detected in all 19 isolates, of which 52.6% showed the TR34/L98H mutation. Other detected mutations were G432C, G448S, G54E/G138C, F46Y, and Y121F/M220I/D255E. T289F and G432C were the first reported mutations in ARAf. Conclusion: There was a considerable level of azole resistance in hospital environmental samples, a serious warning for patients vulnerable to aspergillosis. Our findings have also revealed a different mutation pattern in the CYP51A gene. 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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收藏
页码:65 / 76
页数:12
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