Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018
We investigated the prevalence of azole resistance of Aspergillus fumigatus isolates in the Netherlands by screening clinical A. fumigatus isolates for azole resistance during 2013–2018. We analyzed azole-resistant isolates phenotypically by in vitro susceptibility testing and for the presence of re...
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| Format: | Article |
| Language: | English |
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Centers for Disease Control and Prevention
2020-07-01
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| Series: | Emerging Infectious Diseases |
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| Online Access: | https://wwwnc.cdc.gov/eid/article/26/7/20-0088_article |
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| author | Pieter P.A. Lestrade Jochem B. Buil Martha T. van der Beek Ed J. Kuijper Karin van Dijk Greetje A. Kampinga Bart J.A. Rijnders Alieke G. Vonk Sabine C. de Greeff Annelot F. Schoffelen Jaap van Dissel Jacques F. Meis Willem J.G. Melchers Paul E. Verweij |
| author_facet | Pieter P.A. Lestrade Jochem B. Buil Martha T. van der Beek Ed J. Kuijper Karin van Dijk Greetje A. Kampinga Bart J.A. Rijnders Alieke G. Vonk Sabine C. de Greeff Annelot F. Schoffelen Jaap van Dissel Jacques F. Meis Willem J.G. Melchers Paul E. Verweij |
| author_sort | Pieter P.A. Lestrade |
| collection | DOAJ |
| description | We investigated the prevalence of azole resistance of Aspergillus fumigatus isolates in the Netherlands by screening clinical A. fumigatus isolates for azole resistance during 2013–2018. We analyzed azole-resistant isolates phenotypically by in vitro susceptibility testing and for the presence of resistance mutations in the Cyp51A gene. Over the 6-year period, 508 (11%) of 4,496 culture-positive patients harbored an azole-resistant isolate. Resistance frequency increased from 7.6% (95% CI 5.9%–9.8%) in 2013 (58/760 patients) to 14.7% (95% CI 12.3%–17.4%) in 2018 (112/764 patients) (p = 0.0001). TR34/L98H (69%) and TR46/Y121F/T289A (17%) accounted for 86% of Cyp51A mutations. However, the mean voriconazole MIC of TR34/L98H isolates decreased from 8 mg/L (2013) to 2 mg/L (2018), and the voriconazole-resistance frequency was 34% lower in 2018 than in 2013 (p = 0.0001). Our survey showed changing azole phenotypes in TR34/L98H isolates, which hampers the use of current PCR-based resistance tests. |
| first_indexed | 2024-12-13T07:14:54Z |
| format | Article |
| id | doaj.art-f231f061820444da86356cdf6f0326b1 |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-13T07:14:54Z |
| publishDate | 2020-07-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-f231f061820444da86356cdf6f0326b12022-12-21T23:55:35ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592020-07-012671447145510.3201/eid2607.200088Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018Pieter P.A. LestradeJochem B. BuilMartha T. van der BeekEd J. KuijperKarin van DijkGreetje A. KampingaBart J.A. RijndersAlieke G. VonkSabine C. de GreeffAnnelot F. SchoffelenJaap van DisselJacques F. MeisWillem J.G. MelchersPaul E. VerweijWe investigated the prevalence of azole resistance of Aspergillus fumigatus isolates in the Netherlands by screening clinical A. fumigatus isolates for azole resistance during 2013–2018. We analyzed azole-resistant isolates phenotypically by in vitro susceptibility testing and for the presence of resistance mutations in the Cyp51A gene. Over the 6-year period, 508 (11%) of 4,496 culture-positive patients harbored an azole-resistant isolate. Resistance frequency increased from 7.6% (95% CI 5.9%–9.8%) in 2013 (58/760 patients) to 14.7% (95% CI 12.3%–17.4%) in 2018 (112/764 patients) (p = 0.0001). TR34/L98H (69%) and TR46/Y121F/T289A (17%) accounted for 86% of Cyp51A mutations. However, the mean voriconazole MIC of TR34/L98H isolates decreased from 8 mg/L (2013) to 2 mg/L (2018), and the voriconazole-resistance frequency was 34% lower in 2018 than in 2013 (p = 0.0001). Our survey showed changing azole phenotypes in TR34/L98H isolates, which hampers the use of current PCR-based resistance tests.https://wwwnc.cdc.gov/eid/article/26/7/20-0088_articleAspergillus fumigatusantimicrobial resistanceazole-resistantsurveillancefungal infectionsNetherlands |
| spellingShingle | Pieter P.A. Lestrade Jochem B. Buil Martha T. van der Beek Ed J. Kuijper Karin van Dijk Greetje A. Kampinga Bart J.A. Rijnders Alieke G. Vonk Sabine C. de Greeff Annelot F. Schoffelen Jaap van Dissel Jacques F. Meis Willem J.G. Melchers Paul E. Verweij Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 Emerging Infectious Diseases Aspergillus fumigatus antimicrobial resistance azole-resistant surveillance fungal infections Netherlands |
| title | Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 |
| title_full | Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 |
| title_fullStr | Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 |
| title_full_unstemmed | Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 |
| title_short | Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018 |
| title_sort | paradoxal trends in azole resistant aspergillus fumigatus in a national multicenter surveillance program the netherlands 2013 2018 |
| topic | Aspergillus fumigatus antimicrobial resistance azole-resistant surveillance fungal infections Netherlands |
| url | https://wwwnc.cdc.gov/eid/article/26/7/20-0088_article |
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