Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance

Yuan Xu,1,2 Min Chen,2 Junhao Zhu,3 Bert Gerrits van den Ende,4 Amanda Juan Chen,5 Abdullah MS Al-Hatmi,6,7 Li Li,3 Qiangqiang Zhang,3 Jianping Xu,8 Wanqing Liao,2 Yuchong Chen9 1Department of Dermatology, The Third People’s Hospital of Hangzhou, Hangzhou, People’s Republic of Ch...

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Main Authors: Xu Y, Chen M, Zhu J, Gerrits van den Ende B, Chen AJ, Al-Hatmi AMS, Li L, Zhang Q, Xu J, Liao W, Chen Y
Format: Article
Language:English
Published: Dove Medical Press 2020-12-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/aspergillus-species-in-lower-respiratory-tract-of-hospitalized-patient-peer-reviewed-article-IDR
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author Xu Y
Chen M
Zhu J
Gerrits van den Ende B
Chen AJ
Al-Hatmi AMS
Li L
Zhang Q
Xu J
Liao W
Chen Y
author_facet Xu Y
Chen M
Zhu J
Gerrits van den Ende B
Chen AJ
Al-Hatmi AMS
Li L
Zhang Q
Xu J
Liao W
Chen Y
author_sort Xu Y
collection DOAJ
description Yuan Xu,1,2 Min Chen,2 Junhao Zhu,3 Bert Gerrits van den Ende,4 Amanda Juan Chen,5 Abdullah MS Al-Hatmi,6,7 Li Li,3 Qiangqiang Zhang,3 Jianping Xu,8 Wanqing Liao,2 Yuchong Chen9 1Department of Dermatology, The Third People’s Hospital of Hangzhou, Hangzhou, People’s Republic of China; 2Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, ChangZheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 3Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 4Department of Food and Indoor Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; 5Department of Medical Mycology, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 6Centre of Expertise in Mycology, Radboud University Medical Centre, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands; 7Ministry of Health, Directorate General of Health Services, Ibri, Oman; 8Department of Biology, McMaster University, Hamilton, Canada; 9Department of Dermatosurgery, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of ChinaCorrespondence: Yuchong Chen Tel/Fax +86-21-61833148Email cyuchong@aliyun.comJunhao Zhu Tel/Fax +86-21-81885502Email zhujh1985@126.comPurpose: To investigate species diversity and prevalence of antifungal resistance among clinical isolates of Aspergillus spp. in Shanghai, China.Patients and Methods: In this study, the Aspergillus spp. isolates were analyzed by multilocus sequence typing (MLST) targeting the internal transcribed spacer (ITS) regions, and partial β-tubulin (BenA) and calmodulin (CaM) genes. The susceptibilities of these isolates to nine antifungal agents were determined according to the protocol in document M38-A3 established by the Clinical and Laboratory Standards Institute (CLSI).Results: The most common Aspergillus spp. was A. fumigatus (58.2%), followed by the A. flavus complex (23.5%), and A. niger complex (15.3%). Isolates belonging to A. tamarii and A. effusus of the A. flavus complex and A. tubingensis and A. awamori of the A. niger complex were identified. Moreover, several mutations were found in the azole target cyp51A gene (TR46/Y121F/T289A and F46Y, G89G, M172V, N248T and D255E) in azole-resistant isolates of A. fumigatus.Conclusion: The results of our study revealed a diversity of species in the lower respiratory tract of inpatients in Shanghai and approximately 9% of our isolates were resistant to at least one of the triazole antifungals. Formulation of local treatment strategies to combat emerging azole resistance and species diversity in clinically relevant Aspergillus spp. is needed.Keywords: Aspergillus, antifungal susceptibility, identification, molecular typing, China
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spelling doaj.art-d3bba7d707d34f40a78d3cf44b751fdb2022-12-21T22:01:42ZengDove Medical PressInfection and Drug Resistance1178-69732020-12-01Volume 134663467260705Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole ResistanceXu YChen MZhu JGerrits van den Ende BChen AJAl-Hatmi AMSLi LZhang QXu JLiao WChen YYuan Xu,1,2 Min Chen,2 Junhao Zhu,3 Bert Gerrits van den Ende,4 Amanda Juan Chen,5 Abdullah MS Al-Hatmi,6,7 Li Li,3 Qiangqiang Zhang,3 Jianping Xu,8 Wanqing Liao,2 Yuchong Chen9 1Department of Dermatology, The Third People’s Hospital of Hangzhou, Hangzhou, People’s Republic of China; 2Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, ChangZheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 3Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 4Department of Food and Indoor Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; 5Department of Medical Mycology, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 6Centre of Expertise in Mycology, Radboud University Medical Centre, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands; 7Ministry of Health, Directorate General of Health Services, Ibri, Oman; 8Department of Biology, McMaster University, Hamilton, Canada; 9Department of Dermatosurgery, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of ChinaCorrespondence: Yuchong Chen Tel/Fax +86-21-61833148Email cyuchong@aliyun.comJunhao Zhu Tel/Fax +86-21-81885502Email zhujh1985@126.comPurpose: To investigate species diversity and prevalence of antifungal resistance among clinical isolates of Aspergillus spp. in Shanghai, China.Patients and Methods: In this study, the Aspergillus spp. isolates were analyzed by multilocus sequence typing (MLST) targeting the internal transcribed spacer (ITS) regions, and partial β-tubulin (BenA) and calmodulin (CaM) genes. The susceptibilities of these isolates to nine antifungal agents were determined according to the protocol in document M38-A3 established by the Clinical and Laboratory Standards Institute (CLSI).Results: The most common Aspergillus spp. was A. fumigatus (58.2%), followed by the A. flavus complex (23.5%), and A. niger complex (15.3%). Isolates belonging to A. tamarii and A. effusus of the A. flavus complex and A. tubingensis and A. awamori of the A. niger complex were identified. Moreover, several mutations were found in the azole target cyp51A gene (TR46/Y121F/T289A and F46Y, G89G, M172V, N248T and D255E) in azole-resistant isolates of A. fumigatus.Conclusion: The results of our study revealed a diversity of species in the lower respiratory tract of inpatients in Shanghai and approximately 9% of our isolates were resistant to at least one of the triazole antifungals. Formulation of local treatment strategies to combat emerging azole resistance and species diversity in clinically relevant Aspergillus spp. is needed.Keywords: Aspergillus, antifungal susceptibility, identification, molecular typing, Chinahttps://www.dovepress.com/aspergillus-species-in-lower-respiratory-tract-of-hospitalized-patient-peer-reviewed-article-IDRaspergillusantifungal susceptibilityidentificationmolecular typingchina
spellingShingle Xu Y
Chen M
Zhu J
Gerrits van den Ende B
Chen AJ
Al-Hatmi AMS
Li L
Zhang Q
Xu J
Liao W
Chen Y
Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
Infection and Drug Resistance
aspergillus
antifungal susceptibility
identification
molecular typing
china
title Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
title_full Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
title_fullStr Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
title_full_unstemmed Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
title_short Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance
title_sort aspergillus species in lower respiratory tract of hospitalized patients from shanghai china species diversity and emerging azole resistance
topic aspergillus
antifungal susceptibility
identification
molecular typing
china
url https://www.dovepress.com/aspergillus-species-in-lower-respiratory-tract-of-hospitalized-patient-peer-reviewed-article-IDR
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