Azole Resistance and cyp51A Mutation of Aspergillus fumigatus in a Tertiary Referral Hospital in Taiwan
Abstract
1. Introduction
2. Materials and Methods
2.1. Preparation and Molecular Identification of Fungal Isolates
2.2. Antifungal Susceptibility Testing
2.3. Detection of cyp51A Mutations in Azole-Resistant Isolates
2.4. Ethics Statement
3. Results
3.1. Fungal Isolates
3.2. Antifungal Susceptibility Testing
3.3. Detection of cyp51A Mutations in Azole-Resistant Isolates
3.4. Clinical Profiles of Patients from Whom the Azole-Resistant A. fumigatus Were Isolated
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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AFG | MFG | CAS | 5FC | POS | VRC | ITC | FLC | AMB | |
---|---|---|---|---|---|---|---|---|---|
MIC range | ≤0.015 | ≤0.008 | ≤0.008–0.06 | 8–>64 | ≤0.008–0.5 | 0.25–8 | ≤0.015–>16 | 32–>256 | 1–4 |
MIC50 | ≤0.015 | ≤0.008 | ≤0.008 | >64 | 0.03 | 0.5 | 0.06 | >256 | 2 |
MIC90 | ≤0.015 | ≤0.008 | 0.015 | >64 | 0.03 | 0.5 | 0.12 | >256 | 2 |
Strain No. | AFST Method | ISA | POS | VRC | ITC | FLC | AMB |
---|---|---|---|---|---|---|---|
CGMHD 1497 | YeastOne | ND | 0.03 | 0.5 | 0.06 | >256 | 4 |
CLSI | 0.25 | 0.125 | 0.25 | 0.25 | >64 | 0.5 | |
CGMHD 1524 | YeastOne | ND | 0.03 | 0.5 | 0.06 | >256 | 4 |
CLSI | 0.5 | 0.125 | 0.25 | 0.5 | >64 | 0.5 | |
CGMHD 2417 | YeastOne | ND | 0.03 | 0.5 | 0.06 | >256 | 4 |
CLSI | 0.25 | 0.125 | 0.25 | 0.125 | >64 | 1 | |
CGMHD 0641 | YeastOne | ND | 0.03 | 1 | 0.12 | >256 | 1 |
CLSI | 0.5 | 0.125 | 0.5 | 0.25 | >64 | 0.25 | |
CGMHD 0744 | YeastOne | ND | 0.06 | 1 | 0.12 | >256 | 2 |
CLSI | 1 | 0.25 | 1 | 0.5 | >64 | 0.5 | |
CGMHD 1652 | YeastOne | ND | 0.5 | 8 | >16 | >256 | 2 |
CLSI | 4 | 0.5 | 4 | >16 | >64 | 0.25 | |
CGMHD 2261 | YeastOne | ND | 0.5 | 1 | >16 | >256 | 2 |
CLSI | >4 | 0.5 | 2 | >16 | >64 | 1 |
Case No. | Age/ Gender | Specimen | Clinical Profile | Strain | cyp51A Mutation | MIC (μg/mL) | |||
---|---|---|---|---|---|---|---|---|---|
POS | VRC | ITC | ISA | ||||||
Case 1 | 50/ female | BAL | Clinical diagnosis: Hemoptysis due to bronchiectasis and bronchiolitis Treatment course: Symptomatic treatment Outcome: The patient had a favorable outcome and visited as a regular outpatient for more than 3 years. | CGMHD 1652 | TR34/L98H | 0.5 | 4 | >16 | 4 |
Case 2 | 82/male | BAL | Clinical diagnosis: Invasive fungal tracheobronchitis. GM index in serum was 0.82. Treatment course: Voriconazole 300mg q12h loading day 1 then voriconazole 200mg q12h Outcome: After 19 days of voriconazole treatment, the patient died of respiratory failure with multi-organ failure. | CGMHD 2261 | TR34/L98H/S297T/F495I | 0.5 | 2 | >16 | >4 |
Case 3 | 80/ female | BAL | Clinical diagnosis: Necrotizing pneumonia caused by carbapenem-resistant Klebsiella pneumoniae, and invasive aspergillosis. GM index in serum was 5.55. Treatment course: Caspofungin 35 mg qd due to liver failure Outcome: The patient died of profound shock, respiratory failure, and multi-organ failure after 10 days of treatment. | CGMHD 0744 | F46Y/M172V/N248T/D255E/E427K | 0.25 | 1 | 0.5 | 1 |
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Hsu, T.-H.; Huang, P.-Y.; Fan, Y.-C.; Sun, P.-L. Azole Resistance and cyp51A Mutation of Aspergillus fumigatus in a Tertiary Referral Hospital in Taiwan. J. Fungi 2022, 8, 908. https://doi.org/10.3390/jof8090908
Hsu T-H, Huang P-Y, Fan Y-C, Sun P-L. Azole Resistance and cyp51A Mutation of Aspergillus fumigatus in a Tertiary Referral Hospital in Taiwan. Journal of Fungi. 2022; 8(9):908. https://doi.org/10.3390/jof8090908
Chicago/Turabian StyleHsu, Tsun-Hao, Po-Yen Huang, Yun-Chen Fan, and Pei-Lun Sun. 2022. "Azole Resistance and cyp51A Mutation of Aspergillus fumigatus in a Tertiary Referral Hospital in Taiwan" Journal of Fungi 8, no. 9: 908. https://doi.org/10.3390/jof8090908
APA StyleHsu, T.-H., Huang, P.-Y., Fan, Y.-C., & Sun, P.-L. (2022). Azole Resistance and cyp51A Mutation of Aspergillus fumigatus in a Tertiary Referral Hospital in Taiwan. Journal of Fungi, 8(9), 908. https://doi.org/10.3390/jof8090908