One year prospective survey of azole resistance in Aspergillus fumigatus at a French cystic fibrosis reference centre: prevalence and mechanisms of resistance

• Published in: Journal of antimicrobial chemotherapy 2019-07, Vol.74 (7), p.1884-1889
• Main Authors: Lavergne, R -A, Morio, F, Danner-Boucher, I, Horeau-Langlard, D, David, V, Hagen, F, Meis, J F, Le Pape, P
• Format: Article
• Language: English
• Subjects: Ecology, environment; Health; Human health and pathology; Life Sciences
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkz144

Abstract Background Studies on Aspergillus fumigatus azole resistance in cystic fibrosis patients are scarce despite the fact that it is the most frequently isolated fungus from respiratory samples from these individuals. Objectives To evaluate resistance prevalence, investigate mechanisms of resistance and explore the relationship between resistant isolates by genotyping. Methods We conducted a prospective 1 year study (from 1 January to 31 December 2015), based on the investigation of up to five colonies per sample from cystic fibrosis patients. Results Twenty-three (6.5%) isolates among the 355 tested were resistant to at least one triazole drug, using the EUCAST reference method, leading to a prevalence of 6.8% (6/88 patients). Analysis of resistance mechanisms highlighted TR34/L98H (n = 10), TR46/Y121F/T289A (n = 1), WT cyp51A (n = 11) and F46Y/M172V/N248T/D255E/E427K (n = 1). No genotype was shared between patients. Conclusions This study showed a relatively stable resistance prevalence in comparison with the previous study conducted in 2010–11 (8%), although resistance mechanisms varied between the two studies.