Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain
Por:
Escribano, P, Rodriguez-Sanchez, B, Diaz-Garcia, J, Martin-Gomez, MT, Ibanez-Martinez, E, Rodriguez-Mayo, M, Pelaez, T, de la Pedrosa, EGG, Tejero-Garcia, R, Marimon, JM, Reigadas, E, Rezusta, A, Labayru-Echeverria, C, Perez-Ayala, A, Ayats, J, Cobo, F, Pazos, C, Lopez-Soria, L, Alastruey-Izquierdo, A, Munoz, P, Guinea, J, Sánchez-Reus F., Hernaez Crespo, Silvia
Publicada:
1 ago 2021
Ahead of Print:
1 ago 2021
Resumen:
Objectives: We aimed to assess the percentage of azole resistance in Aspergillus fumigatus in Spain.
Methods: Thirty participating Spanish hospitals stored all morphologically identified A. fumigatus sensu lato clinical isolates-regardless their clinical significance-from 15 February to 14 May 2019. Isolates showing azole resistance according to the EUCAST 9.3.2 methodology were molecularly identified and the cyp51A gene was studied in A. fumigatus sensu stricto isolates.
Results: Eight hundred and forty-seven isolates from 725 patients were collected in 29 hospitals (A. fumigatus sensu stricto (n = 828) and cryptic species (n = 19)). Isolates were mostly from the lower respiratory tract (94.0%; 797/847). Only cryptic species were amphotericin B resistant. Sixty-three (7.4%) out of the 847 isolates were resistant to >= 1 azole(s). Azole resistance was higher in cryptic species than in A. fumigatus sensu stricto (95%, 18/19 vs. 5.5%, 45/828); isavuconazole was associated to the lowest number of non-wild type isolates. The dominant mechanism of resistance was the presence of TR34 -L98H substitutions (n = 24 out of 63). Out of the 725 patients, 48 (6.6%) carried either cryptic species (n = 14) or A. fumigatus sensu stricto (n = 34; 4.7%) resistant isolates. Aspergillus fumigatus sensu stricto harbouring either the TR34 -L98H (n = 19) or TR46 /Y121F/T289A (n = 1) mutations were detected in patients in hospitals located at 7/24 studied cities.
Discussion: Of the patients, 6.6% carry azole-resistant A. fumigatus sensu lato isolates in Spain. TR34-L98H is the dominant cyp51A gene substitutions, although its presence is not widespread. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Escribano, P:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Rodriguez-Sanchez, B:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Diaz-Garcia, J:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Martin-Gomez, MT:
Hosp Univ Vall dHebron, Serv Microbiol, Barcelona, Spain
Ibanez-Martinez, E:
Inst Invest Sanitaria La Fe, Valencia, Spain
Rodriguez-Mayo, M:
Complejo Hosp Univ A Coruna, Serv Microbiol Clin, La Coruna, Spain
Pelaez, T:
Hosp Univ Cent Asturias, Serv Microbiol, Oviedo, Spain
Fdn Invest & Innovat Biosanitaria Principado Astu, Oviedo, Spain
de la Pedrosa, EGG:
Hosp Ramon & Cajal, Serv Microbiol, Madrid, Spain
Inst Ramon y Cajal Invest Sanitaria, Madrid, Spain
Inst Salud Carlos III, Red Espanola Invest Patol Infecciosa REIPI, Madrid, Spain
Tejero-Garcia, R:
Inst Salud Carlos III, Red Espanola Invest Patol Infecciosa REIPI, Madrid, Spain
Hosp Univ Reina Sofia, Serv Microbiol Clin, Cordoba, Spain
Inst Maimonides Invest Biomed, Cordoba, Spain
Marimon, JM:
Donostialdea Integrated Hlth Org, Microbiol Dept, Resp Infect & Antimicrobial Resistance Grp, Biodonostia Infect Dis Area, Donostia San Sebastian, Spain
Reigadas, E:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Rezusta, A:
Hosp Univ Miguel Servet, Serv Microbiol, Zaragoza, Spain
Hosp Univ Burgos, Inst Invest Sanitaria Aragon, Burgos, Spain
Labayru-Echeverria, C:
Hosp Univ Burgos, Lab Microbiol, Burgos, Spain
Perez-Ayala, A:
Hosp 12 Octubre, Serv Microbiol, Madrid, Spain
Hosp 12 Octubre, Inst Invest, Madrid, Spain
Ayats, J:
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Univ Barcelona, IDIBELL, Hosp Univ Bellvitge, Microbiol Dept, Barcelona, Spain
Cobo, F:
Inst Invest Biosanitaria IBS, Granada, Spain
Univ Hosp Virgen de las Nieves, Granada, Spain
Pazos, C:
Complejo Hosp Univ Caceres, Serv Microbiol Clin, Caceres, Spain
Lopez-Soria, L:
Hosp Univ Cruces, Serv Microbiol, Baracaldo, Spain
Inst Invest Sanitaria Biocruces Bizkaia, Baracaldo, Spain
Alastruey-Izquierdo, A:
Inst Salud Carlos III, Red Espanola Invest Patol Infecciosa REIPI, Madrid, Spain
Natl Ctr Microbiol ISCIII, Mycol Reference Lab, Madrid, Spain
Munoz, P:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Univ Complutense Madrid, Fac Med, Med Dept, Madrid, Spain
Guinea, J:
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Sánchez-Reus F.:
Hospital Santa Creu i Sant Pau, Barcelona, Spain
Hernaez Crespo, Silvia:
Hospital de Txagorritxu, Vitoria-Gasteiz, Spain
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