First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East
Pulmonary aspergillosis is a common fungal infection with several clinical manifestations including invasive, allergic and chronic chest diseases. Invasive pulmonary aspergillosis (IPA) is a leading cause of death in immunocompromised patients, particularly those receiving chemotherapy and among bon...
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MDPI AG
2023-07-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/9/8/784 |
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| author | Mohammad Asadzadeh Khaled Alobaid Suhail Ahmad Sara Mazloum |
| author_facet | Mohammad Asadzadeh Khaled Alobaid Suhail Ahmad Sara Mazloum |
| author_sort | Mohammad Asadzadeh |
| collection | DOAJ |
| description | Pulmonary aspergillosis is a common fungal infection with several clinical manifestations including invasive, allergic and chronic chest diseases. Invasive pulmonary aspergillosis (IPA) is a leading cause of death in immunocompromised patients, particularly those receiving chemotherapy and among bone marrow transplant recipients. <i>Aspergillus fumigatus</i> is the most prevalent causative agent and voriconazole is the first-line therapy for IPA. In this study, we report the first isolation of voriconazole-resistant <i>A. fumigatus</i> carrying TR<sub>46</sub>/Y121F/T289A mutations from an immunocompromised pregnant lady in Kuwait. The patient was successfully treated for a probable respiratory infection with caspofungin and voriconazole. The literature review from PubMed has identified itraconazole-resistant clinical and environmental <i>A. fumigatus</i> isolates with TR<sub>34</sub>/L98H mutations in the <i>cyp51A</i> from several Middle Eastern countries including Kuwait. However, clinical <i>A. fumigatus</i> isolates with <i>cyp51A</i> TR<sub>46</sub>/Y121F/T289A mutations have not been reported previously from any country in the region while environmental isolates have been reported only from Iran. The source of voriconazole-resistant <i>A. fumigatus CYP51A</i> TR<sub>46</sub>/Y121F/T289A mutant in our patient remained unknown. Surveillance for azole resistance among clinical and environmental isolates of <i>A. fumigatus</i> is warranted in Kuwait. |
| first_indexed | 2024-03-10T23:50:03Z |
| format | Article |
| id | doaj.art-fe15d12dcf194992b071d8c5eac85fc6 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T23:50:03Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-fe15d12dcf194992b071d8c5eac85fc62023-11-19T01:46:58ZengMDPI AGJournal of Fungi2309-608X2023-07-019878410.3390/jof9080784First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle EastMohammad Asadzadeh0Khaled Alobaid1Suhail Ahmad2Sara Mazloum3Department of Microbiology, College of Medicine, Kuwait University, Safat 13110, KuwaitMycology Reference Laboratory, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya 46300, KuwaitDepartment of Microbiology, College of Medicine, Kuwait University, Safat 13110, KuwaitMicrobiology Laboratory, Jaber Al-Ahmad Hospital, Ministry of Health, South Surra 91711, KuwaitPulmonary aspergillosis is a common fungal infection with several clinical manifestations including invasive, allergic and chronic chest diseases. Invasive pulmonary aspergillosis (IPA) is a leading cause of death in immunocompromised patients, particularly those receiving chemotherapy and among bone marrow transplant recipients. <i>Aspergillus fumigatus</i> is the most prevalent causative agent and voriconazole is the first-line therapy for IPA. In this study, we report the first isolation of voriconazole-resistant <i>A. fumigatus</i> carrying TR<sub>46</sub>/Y121F/T289A mutations from an immunocompromised pregnant lady in Kuwait. The patient was successfully treated for a probable respiratory infection with caspofungin and voriconazole. The literature review from PubMed has identified itraconazole-resistant clinical and environmental <i>A. fumigatus</i> isolates with TR<sub>34</sub>/L98H mutations in the <i>cyp51A</i> from several Middle Eastern countries including Kuwait. However, clinical <i>A. fumigatus</i> isolates with <i>cyp51A</i> TR<sub>46</sub>/Y121F/T289A mutations have not been reported previously from any country in the region while environmental isolates have been reported only from Iran. The source of voriconazole-resistant <i>A. fumigatus CYP51A</i> TR<sub>46</sub>/Y121F/T289A mutant in our patient remained unknown. Surveillance for azole resistance among clinical and environmental isolates of <i>A. fumigatus</i> is warranted in Kuwait.https://www.mdpi.com/2309-608X/9/8/784<i>Aspergillus fumigatus</i>voriconazole resistanceCyp51ATR<sub>46</sub>/Y121F/T289A mutationMiddle East |
| spellingShingle | Mohammad Asadzadeh Khaled Alobaid Suhail Ahmad Sara Mazloum First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East Journal of Fungi <i>Aspergillus fumigatus</i> voriconazole resistance Cyp51A TR<sub>46</sub>/Y121F/T289A mutation Middle East |
| title | First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East |
| title_full | First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East |
| title_fullStr | First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East |
| title_full_unstemmed | First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East |
| title_short | First Report of Azole-Resistant <i>Aspergillus fumigatus</i> with TR<sub>46</sub>/Y121F/T289A Mutations in Kuwait and an Update on Their Occurrence in the Middle East |
| title_sort | first report of azole resistant i aspergillus fumigatus i with tr sub 46 sub y121f t289a mutations in kuwait and an update on their occurrence in the middle east |
| topic | <i>Aspergillus fumigatus</i> voriconazole resistance Cyp51A TR<sub>46</sub>/Y121F/T289A mutation Middle East |
| url | https://www.mdpi.com/2309-608X/9/8/784 |
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