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ABSTRACT: Objectives
Azole resistance among Aspergillus fumigatus isolates is a growing concern worldwide. Induction of mutations during azole therapy, environment-acquired mutations caused by azole fungicides and intrinsic resistance of cryptic Fumigati species all contribute to the burden of resistance. However, there is a lack of data in Canada on this emerging threat.Methods
To gain insights into the magnitude and mechanisms of resistance, a 14?year collection of Aspergillus section Fumigati comprising 999 isolates from 807 patients at a Montreal hospital was screened for azole resistance, and resistance mechanisms were investigated with the combined use of genome sequencing, 3D modelling and phenotypic efflux pump assays.Results
Overall azole resistance was low (4/807 patients; 0.5%). A single azole-resistant A. fumigatus sensu stricto strain, isolated from a patient with pulmonary aspergillosis, displayed efflux-pump-mediated resistance. Three patients were colonized or infected with azole-resistant cryptic Fumigati species (one Aspergillus thermomutatus, one Aspergillus lentulus and one Aspergillus turcosus). Evidence is presented that azole resistance is efflux-pump-mediated in the A. turcosus isolate, but not in the A. lentulus and A. thermomutatus isolates.Conclusions
Azole resistance is rare in our geographic area and currently driven by cryptic Fumigati species. Continued surveillance of emergence of resistance is warranted.
SUBMITTER: Parent-Michaud M
PROVIDER: S-EPMC7069474 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Parent-Michaud Maxime M Dufresne Philippe J PJ Fournier Eric E Folch Benjamin B Martineau Christine C Moreira Sandrine S Doucet Nicolas N De Repentigny Louis L Dufresne Simon F SF
The Journal of antimicrobial chemotherapy 20200401 4
<h4>Objectives</h4>Azole resistance among Aspergillus fumigatus isolates is a growing concern worldwide. Induction of mutations during azole therapy, environment-acquired mutations caused by azole fungicides and intrinsic resistance of cryptic Fumigati species all contribute to the burden of resistance. However, there is a lack of data in Canada on this emerging threat.<h4>Methods</h4>To gain insights into the magnitude and mechanisms of resistance, a 14 year collection of Aspergillus section Fu ...[more]