Azole antifungal resistance in Aspergillus fumigatus: 2008 and 2009

被引：247

作者：

Bueid, Ahmed ^{[2
]}

Howard, Susan J. ^{[1
,2
]}

Moore, Caroline B. ^{[1
,2
]}

Richardson, Malcolm D. ^{[1
,2
]}

Harrison, Elizabeth ^{[2
]}

Bowyer, Paul ^{[2
]}

Denning, David W. ^{[1
,2
]}

机构：

[1] Univ S Manchester Hosp, Mycol Reference Ctr Manchester, Manchester M23 9LT, Lancs, England

[2] Univ Manchester, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2010年 / 65卷 / 10期

基金：

英国惠康基金; 英国医学研究理事会;

关键词：

antifungal drug resistance; sterol 14-alpha demethylase CYP51A; cyp51A mutation; CROSS-RESISTANCE; ITRACONAZOLE; MECHANISM;

D O I：

10.1093/jac/dkq279

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Resistance to azole antifungal drugs in Aspergillus fumigatus is now a major clinical problem in some locations. Here we update our previous experience with data from 2008-09. We tested all A. fumigatus isolates submitted to the Mycology Reference Centre Manchester in 2008 and 2009 for susceptibility to itraconazole, voriconazole and posaconazole. We undertook CYP51A sequencing for most of the azole-resistant isolates. Of 230 isolates, 64 (28%) were azole resistant. In 2008 and 2009, 14% and 20% of patients had resistant isolates, respectively. During this period 62 of 64 (97%) were itraconazole resistant, 2 of 64 (3%) were only voriconazole resistant and 78% of cases were multi-azole resistant. Forty-three percent of isolates did not carry a cyp51A mutation (previously the most common azole resistance mechanism), indicating that other mechanisms must be responsible and are increasing in frequency. Azole resistance is evolving and growing in frequency. Established and novel mechanisms may be responsible.

引用

页码：2116 / 2118

页数：3

共 10 条

[1] Acquired resistance to voriconazole and itraconazole in a patient with pulmonary aspergilloma [J].

Bellete, Bahrie ;

Raberin, Helene ;

Morel, Jerome ;

Flori, Pierre ;

Hafid, Jamal ;

Manhsung, Roger Tran .

MEDICAL MYCOLOGY, 2010, 48 (01) :197-200

[2] Multi-azole resistance in Aspergillus fumigatus [J].

Howard, Susan J. ;

Webster, Ian ;

Moore, Caroline B. ;

Gardiner, Rebecca E. ;

Park, Steven ;

Perlin, David S. ;

Denning, David W. .

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2006, 28 (05) :450-453

[3] Frequency and Evolution of Azole Resistance in Aspergillus fumigatus Associated with Treatment Failure [J].

Howard, Susan J. ;

Cerar, Dasa ;

Anderson, Michael J. ;

Albarrag, Ahmed ;

Fisher, Matthew C. ;

Pasqualotto, Alessandro C. ;

Laverdiere, Michel ;

Arendrup, Maiken C. ;

Perlin, David S. ;

Denning, David W. .

EMERGING INFECTIOUS DISEASES, 2009, 15 (07) :1068-1076

[4] Epidemiological cutoffs and cross-resistance to azole drugs in Aspergillus fumigatus [J].

Luis Rodriguez-Tudela, Juan ;

Alcazar-Fuoli, Laura ;

Mellado, Emilia ;

Alastruey-Izquierdo, Ana ;

Monzon, Araceli ;

Cuenca-Estrella, Manuel .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2008, 52 (07) :2468-2472

[5] A new Aspergillus fumigatus resistance mechanism conferring in vitro cross-resistance to azole antifungals involves a combination of cyp51A alterations [J].

Mellado, E. ;

Garcia-Effron, G. ;

Alcazar-Fuoli, L. ;

Melchers, W. J. G. ;

Verweij, P. E. ;

Cuenca-Estrella, A. ;

Rodriguez-Tudela, J. L. .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2007, 51 (06) :1897-1904

[6] Antifungal drug resistance in Aspergillus [J].

Moore, CB ;

Sayers, N ;

Mosquera, J ;

Slaven, J ;

Denning, DW .

JOURNAL OF INFECTION, 2000, 41 (03) :203-220

[7] Wild-Type MIC Distribution and Epidemiological Cutoff Values for Aspergillus fumigatus and Three Triazoles as Determined by the Clinical and Laboratory Standards Institute Broth Microdilution Methods [J].

Pfaller, M. A. ;

Diekema, D. J. ;

Ghannoum, M. A. ;

Rex, J. H. ;

Alexander, B. D. ;

Andes, D. ;

Brown, S. D. ;

Chaturvedi, V. ;

Espinel-Ingroff, A. ;

Fowler, C. L. ;

Johnson, E. M. ;

Knapp, C. C. ;

Motyl, M. R. ;

Ostrosky-Zeichner, L. ;

Sheehan, D. J. ;

Walsh, T. J. .

JOURNAL OF CLINICAL MICROBIOLOGY, 2009, 47 (10) :3142-3146

[8] Increased expression of a novel Aspergillus fumigatus ABC transporter gene, atrF, in the presence of itraconazole in an itraconazole resistant clinical isolate [J].

Slaven, JW ;

Anderson, MJ ;

Sanglard, D ;

Dixon, GK ;

Bille, J ;

Roberts, IS ;

Denning, DW .

FUNGAL GENETICS AND BIOLOGY, 2002, 36 (03) :199-206

[9] Emergence of Azole Resistance in Aspergillus fumigatus and Spread of a Single Resistance Mechanism [J].

Snelders, Eveline ;

van der Lee, Henrich A. L. ;

Kuijpers, Judith ;

Rijs, Anthonius J. M. M. ;

Varga, Janos ;

Samson, Robert A. ;

Mellado, Emilia ;

Donders, A. Rogier T. ;

Melchers, Willem J. G. ;

Verweij, Paul E. .

PLOS MEDICINE, 2008, 5 (11) :1629-1637

[10] Azole-resistance in Aspergillus: Proposed nomenclature and breakpoints [J].

Verweij, Paul E. ;

Howard, Susan J. ;

Melchers, Willem J. G. ;

Denning, David W. .

DRUG RESISTANCE UPDATES, 2009, 12 (06) :141-147

← 1 →