Azole resistance in Aspergillus species in Southern Taiwan: An epidemiological surveillance study

被引：21

作者：

Chen, Yi-Chun ^{[1
]}

Kuo, Shu-Fang ^{[2
,3
]}

Wang, Hsuan-Chen ^{[4
]}

Wu, Chi-Jung ^{[4
,5
]}

Lin, Yin-Shiou ^{[1
]}

Li, Wei-Sin ^{[1
]}

Lee, Chen-Hsiang ^{[1
,6
]}

机构：

[1] Kaohsiung Chang Gung Mem Hosp, Div Infect Dis, Dept Internal Med, 123 Ta Pei Rd, Kaohsiung 833, Taiwan

[2] Kaohsiung Chang Gung Mem Hosp, Dept Lab Med, Kaohsiung, Taiwan

[3] Chang Gung Univ, Coll Med, Dept Med Biotechnol & Lab Sci, Taoyuan, Taiwan

[4] Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol, Tainan, Taiwan

[5] Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Internal Med, Tainan, Taiwan

[6] Chang Gung Univ, Coll Med, Kaohsiung, Taiwan

来源：

MYCOSES | 2019年 / 62卷 / 12期

关键词：

air sampling; Aspergillus species; azole resistance; TR34; L98H; TR46; Y121F; T289A; INVASIVE ASPERGILLOSIS; FUMIGATUS; TR46/Y121F/T289A; INFECTIONS;

D O I：

10.1111/myc.13008

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Poor clinical outcomes for invasive aspergillosis are associated with antifungal resistance. Performing antifungal susceptibility tests on clinically relevant Aspergillus isolates from patients and environmental regions with known azole resistance is recommended. The aim of the study was to assess the presence of azole resistance in clinical Aspergillus spp. isolates and those from hospital environments and farmlands within a 40 km radius of the hospital. Clinical Aspergillus spp. isolates were cultured, as well as environmental Aspergillus spp. isolates obtained from air samples. Samples were subcultured in azole-containing agar plates. Isolates with a positive screening test were subjected to YeastOne methods to determine their minimum inhibitory concentrations of antifungals. Resistance mechanisms were investigated in the azole-resistant Aspergillus spp. isolates. No azole-resistant clinical or environmental A flavus, A oryaze, A niger or A terreus isolates were found in the present study. All A fumigatus clinical isolates were azole-susceptible. Seven A fumigatus environmental isolates were associated with cyp51A mutations, including two that harboured TR34/L98H mutations with S297T/F495I substitutions, two with TR34/L98H mutations and three with TR46/Y121F/T289A mutations. One of these isolates was collected from farmland, one was from A ward and five were from B ward. The proportion of azole-resistant A fumigatus was 10.2% (6/59) and 3.2% (1/31) in the hospital environments and the farmlands near the hospital, respectively. The results showed that azole-resistant A fumigatus existed within hospital environments. This emphasises the importance of periodic surveillance in hospital environments and monitoring for the emergence of azole-resistant A fumigatus clinical isolates.

引用

页码：1174 / 1181

页数：8

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