First determination of azole resistance in Aspergillus fumigatus strains carrying the TR34/L98H mutations in Turkey. Issue 8 (August 2015)

• Record Type: Journal Article
• Authors: Özmerdiven, Gülşah Ece; Ak, Seçil; Ener, Beyza; Ağca, Harun; Cilo, Burcu Dalyan; Tunca, Berrin; Akalın, Halis
• Is Part Of: Journal of infection and chemotherapy. Volume 21:Issue 8(2015:Aug.)
• Page Start: 581
• Page End: 586
• Publication Date: 2015-08
• Subjects: Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2015.04.012
• Languages: English
• ISSNs: 1341-321X

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <p id="abspara0010"> <italic>Aspergillus fumigatus</italic> is the most important etiological agent of invasive aspergillosis. Recently, an increasing number of azole-resistant <italic>A. fumigatus</italic> isolates have been described in various countries. The prevalence of azole resistance was investigated in this study using our culture collection of <italic>A. fumigatus</italic> isolates collected between 1999 and 2012 from clinical specimens. Seven hundred and forty-six <italic>A. fumigatus</italic> isolates, collected from 419 patients, were investigated. First, all isolates were screened for resistance to itraconazole by subculturing on Sabouraud dextrose agar that contained 4 mg/L itraconazole. For isolates that grew on the itraconazole containing agar, the in vitro activities of amphotericin B, itraconazole, voriconazole and posaconazole were determined using the Clinical and Laboratory Standards Institute (CLSI) M38-A reference method. After PCR amplification, the full sequence of the <italic>cyp51A</italic> gene and its promoter region was determined for all in vitro azole-resistant isolates. Itraconazole resistance was found in 10.2% of the <italic>A. fumigatus</italic> isolates. From 2000 onwards, patients were observed annually with an itraconazole-resistant isolate. According to in vitro susceptibility tests, amphotericin B exhibited good activity against all isolates whereas the azoles were resistant. Sequence analysis of the promoter region and <italic>CYP51A</italic> gene indicated the presence of TR34/L98H in 86.8% (n = 66) of isolates. This initial analysis of the resistance mechanism of <italic>A. fumigatus</italic> from Turkey revealed a common TR34/L98H mutation in the <italic>cyp51A</italic> gene.</p> </sec> </abstract>