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

来源：

JOURNAL OF HOSPITAL INFECTION | 2024年 / 145卷

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.

引用

页码：65 / 76

页数：12

共 40 条

[11] Azole-resistant Aspergillus fumigatus with the environmental TR46/Y121F/T289A mutation in India [J].