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Communication

Drug-Resistant Aspergillus flavus Is Highly Prevalent in the Environment of Vietnam: A New Challenge for the Management of Aspergillosis?

by
Tra My N. Duong
1,2,
Phuong Tuyen Nguyen
2,
Thanh Van Le
2,
Huong Lan P. Nguyen
3,
Bich Ngoc T. Nguyen
4,5,
Bich Phuong T. Nguyen
6,
Thu Anh Nguyen
1,6,
Sharon C.-A. Chen
1,7,
Vanessa R. Barrs
1,8,
Catriona L. Halliday
1,7,
Tania C. Sorrell
1,9,
Jeremy N. Day
2,10 and
Justin Beardsley
1,2,9,*
1
Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney 2145, Australia
2
Oxford University Clinical Research Unit, Ho Chi Minh City 70000, Vietnam
3
Hospital for Tropical Diseases, Ho Chi Minh 70000, Vietnam
4
National Lung Hospital, Hanoi 10000, Vietnam
5
Tuberculosis and Lung Diseases Department, Hanoi Medical University, Hanoi 10000, Vietnam
6
Woolcock Institute of Medical Research, Hanoi 10000, Vietnam
7
Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Sydney 2145, Australia
8
Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, China
9
Westmead Institute for Medical Research, Westmead, Sydney 2145, Australia
10
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
*
Author to whom correspondence should be addressed.
J. Fungi 2020, 6(4), 296; https://doi.org/10.3390/jof6040296
Received: 30 September 2020 / Revised: 4 November 2020 / Accepted: 12 November 2020 / Published: 18 November 2020
(This article belongs to the Special Issue Aspergillus Infection)
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Abstract

The burden of aspergillosis, especially Chronic Pulmonary Aspergillosis, is increasingly recognized, and the increasing presence of azole-resistant environmental Aspergillus fumigatus has been highlighted as a health risk. However, a sizable minority of aspergillosis is caused by Aspergillus flavus, which is assumed to be sensitive to azoles but is infrequently included in surveillance. We conducted environmental sampling at 150 locations in a rural province of southern Vietnam. A. flavus isolates were identified morphologically, their identity was confirmed by sequencing of the beta-tubulin gene, and then they were tested for susceptibility to azoles and amphotericin B according to EUCAST methodologies. We found that over 85% of A. flavus isolates were resistant to at least one azole, and half of them were resistant to itraconazole. This unexpectedly high prevalence of resistance demands further investigation to determine whether it is linked to agricultural azole use, as has been described for A. fumigatus. Clinical correlation is required, so that guidelines can be adjusted to take this information into account. View Full-Text
Keywords: Aspergillus flavus; azole resistance; environmental Aspergillus flavus; azole resistance; environmental
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style

Duong, T.M.N.; Nguyen, P.T.; Le, T.V.; Nguyen, H.L.P.; Nguyen, B.N.T.; Nguyen, B.P.T.; Nguyen, T.A.; Chen, S.C.-A.; Barrs, V.R.; Halliday, C.L.; Sorrell, T.C.; Day, J.N.; Beardsley, J. Drug-Resistant Aspergillus flavus Is Highly Prevalent in the Environment of Vietnam: A New Challenge for the Management of Aspergillosis? J. Fungi 2020, 6, 296. https://doi.org/10.3390/jof6040296

AMA Style

Duong TMN, Nguyen PT, Le TV, Nguyen HLP, Nguyen BNT, Nguyen BPT, Nguyen TA, Chen SC-A, Barrs VR, Halliday CL, Sorrell TC, Day JN, Beardsley J. Drug-Resistant Aspergillus flavus Is Highly Prevalent in the Environment of Vietnam: A New Challenge for the Management of Aspergillosis? Journal of Fungi. 2020; 6(4):296. https://doi.org/10.3390/jof6040296

Chicago/Turabian Style

Duong, Tra M.N., Phuong T. Nguyen, Thanh V. Le, Huong L.P. Nguyen, Bich N.T. Nguyen, Bich P.T. Nguyen, Thu A. Nguyen, Sharon C.-A. Chen, Vanessa R. Barrs, Catriona L. Halliday, Tania C. Sorrell, Jeremy N. Day, and Justin Beardsley. 2020. "Drug-Resistant Aspergillus flavus Is Highly Prevalent in the Environment of Vietnam: A New Challenge for the Management of Aspergillosis?" Journal of Fungi 6, no. 4: 296. https://doi.org/10.3390/jof6040296

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