Document Detail


Azole antifungal resistance in Aspergillus fumigatus: 2008 and 2009.
MedLine Citation:
PMID:  20729241     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Resistance to azole antifungal drugs in Aspergillus fumigatus is now a major clinical problem in some locations. Here we update our previous experience with data from 2008-09.
METHODS: We tested all A. fumigatus isolates submitted to the Mycology Reference Centre Manchester in 2008 and 2009 for susceptibility to itraconazole, voriconazole and posaconazole. We undertook CYP51A sequencing for most of the azole-resistant isolates.
RESULTS: Of 230 isolates, 64 (28%) were azole resistant. In 2008 and 2009, 14% and 20% of patients had resistant isolates, respectively. During this period 62 of 64 (97%) were itraconazole resistant, 2 of 64 (3%) were only voriconazole resistant and 78% of cases were multi-azole resistant. Forty-three percent of isolates did not carry a cyp51A mutation (previously the most common azole resistance mechanism), indicating that other mechanisms must be responsible and are increasing in frequency.
CONCLUSIONS: Azole resistance is evolving and growing in frequency. Established and novel mechanisms may be responsible.
Authors:
Ahmed Bueid; Susan J Howard; Caroline B Moore; Malcolm D Richardson; Elizabeth Harrison; Paul Bowyer; David W Denning
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-20
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  65     ISSN:  1460-2091     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2011-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  England    
Other Details:
Languages:  eng     Pagination:  2116-8     Citation Subset:  IM    
Affiliation:
The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / pharmacology*
Aspergillosis / microbiology*
Aspergillus fumigatus / drug effects*,  isolation & purification
Azoles / pharmacology*
Cytochrome P-450 Enzyme System / genetics
DNA, Fungal / chemistry,  genetics
Drug Resistance, Fungal*
Fungal Proteins / genetics
Humans
Itraconazole / pharmacology
Microbial Sensitivity Tests
Pyrimidines / pharmacology
Sequence Analysis, DNA
Triazoles / pharmacology
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Azoles; 0/DNA, Fungal; 0/Fungal Proteins; 0/Pyrimidines; 0/Triazoles; 0/posaconazole; 0/voriconazole; 84625-61-6/Itraconazole; 9035-51-2/Cytochrome P-450 Enzyme System; EC 1.14.14.-/cytochrome P-450 CYP51A, Aspergillus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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