Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013-2018

被引：48

作者：

Lestrade, Pieter P. A. ^{[1
]}

Buil, Jochem B. ^{[2
]}

van der Beek, Martha T. ^{[3
]}

Kuijper, Ed J. ^{[3
]}

van Dijk, Karin ^{[4
]}

Kampinga, Greetje A. ^{[5
]}

Rijnders, Bart J. A. ^{[6
]}

Vonk, Alieke G. ^{[6
]}

de Greeff, Sabine C. ^{[7
]}

Schoffelen, Annelot F. ^{[7
]}

van Dissel, Jaap ^{[7
]}

Meis, Jacques F. ^{[2
]}

Melchers, Willem J. G. ^{[2
]}

Verweij, Paul E. ^{[2
]}

机构：

[1] VieCuri Hosp, Venlo, Netherlands

[2] Radboud Univ Nijmegen, Canisius Wilhelmina Hosp, Ctr Expertise Mycol, Med Ctr, Nijmegen, Netherlands

[3] Leiden Univ, Med Ctr, Leiden, Netherlands

[4] Vrije Univ Amsterdam, Amsterdam Univ, Med Ctr, Amsterdam, Netherlands

[5] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

[6] Erasmus MC, Rotterdam, Netherlands

[7] Dutch Natl Inst Publ Hlth & Environm, Ctr Infect Dis Control, Bilthoven, Netherlands

来源：

EMERGING INFECTIOUS DISEASES | 2020年 / 26卷 / 07期

关键词：

EUCAST TECHNICAL NOTE; ITRACONAZOLE; VORICONAZOLE; VALIDATION;

D O I：

10.3201/eid2607.200088

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

We investigated the prevalence of azole resistance of Aspergillus fumigatus isolates in the Netherlands by screening clinical A. fumigatus isolates for azole resistance during 2013-2018. We analyzed azole-resistant isolates phenotypically by in vitro susceptibility testing and for the presence of resistance mutations in the Cyp51A gene. Over the 6-year period, 508 (11%) of 4,496 culture-positive patients harbored an azole-resistant isolate. Resistance frequency increased from 7.6% (95% CI 5.9%-9.8%) in 2013 (58/760 patients) to 14.7% (95% CI 12.3%-17.4%) in 2018 (112/764 patients) (p = 0.0001). TR34/L98H (69%) and TR46/Y121F/T289A (17%) accounted for 86% of Cyp51A mutations. However, the mean voriconazole MIC of TR34/L98H isolates decreased from 8 mg/L (2013) to 2 mg/L (2018), and the voriconazole-resistance frequency was 34% lower in 2018 than in 2013 (p = 0.0001). Our survey showed changing azole phenotypes in TR34/L98H isolates, which hampers the use of current PCR-based resistance tests.

引用

页码：1447 / 1455

页数：9

共 15 条

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