Triazole resistance in Aspergillus fumigatus isolates from patients with cystic fibrosis in Italy

• Published in: Journal of cystic fibrosis 2017-01, Vol.16 (1), p.64-69
• Main Authors: Prigitano, Anna, Esposto, Maria Carmela, Biffi, Arianna, De Lorenzis, Gabriella, Favuzzi, Vincenza, Koncan, Raffaella, Lo Cascio, Giuliana, Barao Ocampo, Marisol, Colombo, Carla, Pizzamiglio, Giovanna, Romanò, Luisa, Tortorano, Anna Maria
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antifungal Agents - pharmacology; Aspergillus fumigatus; Aspergillus fumigatus - drug effects; Aspergillus fumigatus - genetics; Aspergillus fumigatus - isolation & purification; Azole resistance; Child; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - epidemiology; Cystic Fibrosis - microbiology; Cytochrome P-450 Enzyme System - genetics; Drug Resistance, Fungal - genetics; Environment; Female; Fungal Proteins - genetics; Humans; Italy; Italy - epidemiology; Male; Microbial Sensitivity Tests - methods; Point Mutation; Prevalence; Pulmonary Aspergillosis - diagnosis; Pulmonary Aspergillosis - drug therapy; Pulmonary Aspergillosis - epidemiology; Pulmonary Aspergillosis - etiology; Pulmonary/Respiratory; Triazoles - pharmacology
• ISSN: 1569-1993; 1873-5010
• DOI: 10.1016/j.jcf.2016.06.006

Abstract Background Aspergillus fumigatus is frequently recovered from respiratory secretions of cystic fibrosis (CF) patients. Azole resistance has been increasingly reported. Objectives To assess the prevalence of azole resistance in A. fumigatus isolates from patients followed by two CF centers of northern Italy. Methods 423 isolates (220 patients) were screened for azole resistance. Resistance was confirmed with the EUCAST method and cyp51A gene sequencing. Microsatellite genotyping was performed and results were compared with those of environmental resistant isolates. Results No resistance was detected in one center, while 8.2% of the patients of the other center harbored resistant isolates. The TR34 /L98H alteration in the cyp51A gene, present in seven cases, resulted associated with poor in-vitro activity of all tested azoles. Conclusions The environmental origin of the resistance seems to be probable since azole resistance was found also in naïve patients and an identical microsatellite genotype in clinical and environmental isolates was observed.