Zoran, Tamara, Sartori, Bettina, Sappl, Laura, Aigner, Maria, Sanchez-Reus, Ferran ORCID: 0000-0002-6800-5487, Rezusta, Antonio, Chowdhary, Anuradha, Taj-Aldeen, Saad J., Arendrup, Maiken C., Oliveri, Salvatore, Kontoyiannis, Dimitrios P., Alastruey-Izquierdo, Ana, Lagrou, Katrien, Lo Cascio, Giuliana, Meis, Jacques F., Buzina, Walter, Farina, Claudio, Drogari-Apiranthitou, Miranda, Grancini, Anna, Tortorano, Anna M., Willinger, Birgit, Hamprecht, Axel ORCID: 0000-0003-1449-5780, Johnson, Elizabeth, Klingspor, Lena, Arsic-Arsenijevic, Valentina, Cornely, Oliver A., Meletiadis, Joseph ORCID: 0000-0002-8869-1509, Prammer, Wolfgang, Tullio, Vivian, Vehreschild, Jorg-Janne, Trovato, Laura ORCID: 0000-0002-0372-8545, Lewis, Russell E., Segal, Esther, Rath, Peter-Michael, Hamal, Petr ORCID: 0000-0002-5361-8125, Rodriguez-Iglesias, Manuel, Roilides, Emmanuel, Arikan-Akdagli, Sevtap, Chakrabarti, Arunaloke, Colombo, Arnaldo L., Fernandez, Mariana S., Teresa Martin-Gomez, M., Badali, Hamid ORCID: 0000-0002-6010-8414, Petrikkos, Georgios, Klimko, Nikolai, Heimann, Sebastian M., Uzun, Omrum, Roudbary, Maryam, de la Fuente, Sonia, Houbraken, Jos, Risslegger, Brigitte, Lass-Floerl, Cornelia and Lackner, Michaela (2018). Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon? Front. Microbiol., 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-302X

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Abstract

Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods : A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results : The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions : Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Zoran, TamaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sartori, BettinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sappl, LauraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aigner, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sanchez-Reus, FerranUNSPECIFIEDorcid.org/0000-0002-6800-5487UNSPECIFIED
Rezusta, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chowdhary, AnuradhaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taj-Aldeen, Saad J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arendrup, Maiken C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oliveri, SalvatoreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kontoyiannis, Dimitrios P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alastruey-Izquierdo, AnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lagrou, KatrienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lo Cascio, GiulianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meis, Jacques F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buzina, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Farina, ClaudioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Drogari-Apiranthitou, MirandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grancini, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tortorano, Anna M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willinger, BirgitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamprecht, AxelUNSPECIFIEDorcid.org/0000-0003-1449-5780UNSPECIFIED
Johnson, ElizabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klingspor, LenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arsic-Arsenijevic, ValentinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meletiadis, JosephUNSPECIFIEDorcid.org/0000-0002-8869-1509UNSPECIFIED
Prammer, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tullio, VivianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Jorg-JanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trovato, LauraUNSPECIFIEDorcid.org/0000-0002-0372-8545UNSPECIFIED
Lewis, Russell E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Segal, EstherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rath, Peter-MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamal, PetrUNSPECIFIEDorcid.org/0000-0002-5361-8125UNSPECIFIED
Rodriguez-Iglesias, ManuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roilides, EmmanuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arikan-Akdagli, SevtapUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chakrabarti, ArunalokeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Colombo, Arnaldo L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fernandez, Mariana S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teresa Martin-Gomez, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Badali, HamidUNSPECIFIEDorcid.org/0000-0002-6010-8414UNSPECIFIED
Petrikkos, GeorgiosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klimko, NikolaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heimann, Sebastian M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Uzun, OmrumUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roudbary, MaryamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de la Fuente, SoniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Houbraken, JosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Risslegger, BrigitteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lass-Floerl, CorneliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lackner, MichaelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-192326
DOI: 10.3389/fmicb.2018.00516
Journal or Publication Title: Front. Microbiol.
Volume: 9
Date: 2018
Publisher: FRONTIERS MEDIA SA
Place of Publication: LAUSANNE
ISSN: 1664-302X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DESORPTION IONIZATION-TIME; FLIGHT MASS-SPECTROMETRY; AMPHOTERICIN-B; ANTIFUNGAL SUSCEPTIBILITY; SECTION TERREI; IDENTIFICATION; EPIDEMIOLOGY; INFECTIONS; PREVALENCE; FUMIGATUSMultiple languages
MicrobiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19232

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