Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy
Objectives: This study was conducted to assess the prevalence of azole resistance in Aspergillus isolates from patients with haematological malignancies or who were undergoing haematopoietic stem cell transplantation and to identify the molecular mechanism of resistance. Methods: In this 28-month pr...
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Elsevier
2020-09-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716520300175 |
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| author | A. Prigitano M.C. Esposto A. Grancini M. Passera M. Paolucci M. Stanzani A. Sartor A. Candoni L. Pitzurra P. Innocenti A. Micozzi G. Lo Cascio M. Delia A. Mosca M. Mikulska C. Ossi C. Fontana M. Pizzolante M. Gelmi C. Cavanna F. Lallitto G. Amato A. Vella L. Pagano R. Bandettini G. De Lorenzis M. Cogliati L. Romanò A. Tortorano |
| author_facet | A. Prigitano M.C. Esposto A. Grancini M. Passera M. Paolucci M. Stanzani A. Sartor A. Candoni L. Pitzurra P. Innocenti A. Micozzi G. Lo Cascio M. Delia A. Mosca M. Mikulska C. Ossi C. Fontana M. Pizzolante M. Gelmi C. Cavanna F. Lallitto G. Amato A. Vella L. Pagano R. Bandettini G. De Lorenzis M. Cogliati L. Romanò A. Tortorano |
| author_sort | A. Prigitano |
| collection | DOAJ |
| description | Objectives: This study was conducted to assess the prevalence of azole resistance in Aspergillus isolates from patients with haematological malignancies or who were undergoing haematopoietic stem cell transplantation and to identify the molecular mechanism of resistance. Methods: In this 28-month prospective study involving 18 Italian centres, Aspergillus isolates from surveillance cultures were collected and screened for azole resistance, and mutations in the cyp51A gene were identified. Resistant isolates were genotyped by microsatellite analysis, and the allelic profiles were compared with those of resistant environmental and clinical isolates from the same geographical area that had been previously genotyped. Results: There were 292 Aspergillus isolates collected from 228 patients. The isolates belonged mainly to the section Fumigati (45.9%), Nigri (20.9%), Flavi (16.8%) and Terrei (4.8%). Three isolates showed itraconazole resistance: Aspergillus fumigatus sensu stricto, Aspergillus lentulus (section Fumigati) and Aspergillus awamori (section Nigri). The itraconazole resistance rates were 1% and 1.48% considering all Aspergillus spp. isolates and the Aspergillus section Fumigati, respectively. The prevalence of azole resistance among all the patients was 1.3%. Among patients harbouring A. fumigatus sensu stricto isolates, the resistance rate was 0.79%. The A. fumigatus isolate, with the TR34/L98H mutation, was genotypically distant from the environmental and clinical strains previously genotyped. Conclusions: In this study, the Aspergillus azole resistance rate was 1% (3/292). In addition to A. fumigatus sensu stricto, A. lentulus and A. awamori azole-resistant isolates were identified. Therefore, it is important have a correct identification at the species level to address a rapid therapy better, quickly understand the shift towards cryptic species and have an updated knowledge of the local epidemiology. |
| first_indexed | 2024-12-21T21:05:29Z |
| format | Article |
| id | doaj.art-a7cc699e5d264663862cfdbbedbb25c3 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-21T21:05:29Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
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| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-a7cc699e5d264663862cfdbbedbb25c32022-12-21T18:50:19ZengElsevierJournal of Global Antimicrobial Resistance2213-71652020-09-0122231237Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in ItalyA. Prigitano0M.C. Esposto1A. Grancini2M. Passera3M. Paolucci4M. Stanzani5A. Sartor6A. Candoni7L. Pitzurra8P. Innocenti9A. Micozzi10G. Lo Cascio11M. Delia12A. Mosca13M. Mikulska14C. Ossi15C. Fontana16M. Pizzolante17M. Gelmi18C. Cavanna19F. Lallitto20G. Amato21A. Vella22L. Pagano23R. Bandettini24G. De Lorenzis25M. Cogliati26L. Romanò27A. Tortorano28Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Corresponding author. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36-20133 Milano, Italy. Tel.: +39 02 50315144.Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ItalyI.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, ItalyMicrobiology and Virology Unit, Asst. Papa Giovanni XXIII, Bergamo, ItalyInstitute of Hematology, Lorenzo e Ariosto Seràgnoli, Sant’Orsola-Malpighi Hospital Policlinico, University of Bologna, Bologna, ItalyInstitute of Hematology, Lorenzo e Ariosto Seràgnoli, Sant’Orsola-Malpighi Hospital Policlinico, University of Bologna, Bologna, ItalyDivision of Hematology, ASUIUD, University of Udine, Udine, ItalyDivision of Hematology, ASUIUD, University of Udine, Udine, ItalyDipartimento di Medicina, Università degli Studi di Perugia, Perugia, ItalyLaboratory of Microbiology and Virology, Comprensorio Sanitario di Bolzano—AS Alto Adige, Bolzano, ItalyDepartment of Translational and Precision Medicine, Sapienza Università di Roma, Rome, ItalyMicrobiology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, ItalyDepartment of Emergency and Organ Transplantation—UO Haematology with transplantation, AO Universitaria Policlinico di Bari, Bari, ItalyInterdisciplinary Department of Medicine, AO Universitaria Policlinico di Bari, Bari, ItalyUniversità degli Studi di Genova (DISSAL) and Ospedale Policlinico San Martino, Genoa, ItalyLaboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, ItalyDepartment of Experimental Medicine, University of Tor Vergata Polyclinic of Tor Vergata, Rome, ItalyLaboratory of Microbiology, Vito Fazzi Regional Hospital Lecce, Lecce, ItalyASST Spedali Civili di Brescia, Brescia, ItalyMicrobiology and Virology Unit, IRCCS Policlinico San Matteo, Pavia, ItalyMicrobiology and Virology Unit, IRCCS Policlinico San Matteo, Pavia, ItalyUOC. Patologia Clinica, AO A. Cardarelli, Naples, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, ItalyClinical Pathology and Microbiology Laboratory Unit, Istituto Giannina Gaslini, Genoa, ItalyDepartment of Agricultural and Environmental Sciences—Production, Landscape, Agroenergy, Università degli Studi di Milano, Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ItalyObjectives: This study was conducted to assess the prevalence of azole resistance in Aspergillus isolates from patients with haematological malignancies or who were undergoing haematopoietic stem cell transplantation and to identify the molecular mechanism of resistance. Methods: In this 28-month prospective study involving 18 Italian centres, Aspergillus isolates from surveillance cultures were collected and screened for azole resistance, and mutations in the cyp51A gene were identified. Resistant isolates were genotyped by microsatellite analysis, and the allelic profiles were compared with those of resistant environmental and clinical isolates from the same geographical area that had been previously genotyped. Results: There were 292 Aspergillus isolates collected from 228 patients. The isolates belonged mainly to the section Fumigati (45.9%), Nigri (20.9%), Flavi (16.8%) and Terrei (4.8%). Three isolates showed itraconazole resistance: Aspergillus fumigatus sensu stricto, Aspergillus lentulus (section Fumigati) and Aspergillus awamori (section Nigri). The itraconazole resistance rates were 1% and 1.48% considering all Aspergillus spp. isolates and the Aspergillus section Fumigati, respectively. The prevalence of azole resistance among all the patients was 1.3%. Among patients harbouring A. fumigatus sensu stricto isolates, the resistance rate was 0.79%. The A. fumigatus isolate, with the TR34/L98H mutation, was genotypically distant from the environmental and clinical strains previously genotyped. Conclusions: In this study, the Aspergillus azole resistance rate was 1% (3/292). In addition to A. fumigatus sensu stricto, A. lentulus and A. awamori azole-resistant isolates were identified. Therefore, it is important have a correct identification at the species level to address a rapid therapy better, quickly understand the shift towards cryptic species and have an updated knowledge of the local epidemiology.http://www.sciencedirect.com/science/article/pii/S2213716520300175Aspergillus spp.Azole resistanceHaematologicalHaematopoietic stem cell transplantation |
| spellingShingle | A. Prigitano M.C. Esposto A. Grancini M. Passera M. Paolucci M. Stanzani A. Sartor A. Candoni L. Pitzurra P. Innocenti A. Micozzi G. Lo Cascio M. Delia A. Mosca M. Mikulska C. Ossi C. Fontana M. Pizzolante M. Gelmi C. Cavanna F. Lallitto G. Amato A. Vella L. Pagano R. Bandettini G. De Lorenzis M. Cogliati L. Romanò A. Tortorano Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy Journal of Global Antimicrobial Resistance Aspergillus spp. Azole resistance Haematological Haematopoietic stem cell transplantation |
| title | Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy |
| title_full | Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy |
| title_fullStr | Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy |
| title_full_unstemmed | Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy |
| title_short | Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy |
| title_sort | prospective multicentre study on azole resistance in aspergillus isolates from surveillance cultures in haematological patients in italy |
| topic | Aspergillus spp. Azole resistance Haematological Haematopoietic stem cell transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2213716520300175 |
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