Abstract
The emergence of azole resistant Aspergillus spp., especially Aspergillus fumigatus, has been described in several countries around the world with varying prevalence depending on the country. To our knowledge, azole resistance in Aspergillus spp. has not been reported in the West Indies yet. In this study, we investigated the antifungal susceptibility of clinical and environmental isolates of Aspergillus spp. from Martinique, and the potential resistance mechanisms associated with mutations in cyp51A gene. Overall, 208 Aspergillus isolates were recovered from clinical samples (n = 45) and environmental soil samples (n = 163). They were screened for resistance to azole drugs using selective culture media. The Minimum Inhibitory Concentrations (MIC) towards voriconazole, itraconazole, posaconazole and isavuconazole, as shown by the resistant isolates, were determined using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) microdilution broth method. Eight isolates (A. fumigatus, n = 6 and A. terreus, n = 2) had high MIC for at least one azole drug. The sequencing of cyp51A gene revealed the mutations G54R and TR34/L98H in two A. fumigatus clinical isolates. Our study showed for the first time the presence of azole resistance in A. fumigatus and A. terreus isolates in the French West Indies.
Highlights
Acquired azole resistance in Aspergillus spp. was first reported in the late 1990s [1,2]and has since become a widespread problem [3] usually associated with a higher rate of treatment failure necessitating therapeutic adjustment in aspergillosis [4,5]
Considering the risk of emergence of azole fungicides-resistant species in Martinique, the aim of the present study was to analyze the prevalence of azole resistance in clinical and environmental Aspergillus isolates in the French West Indies, and to determine whether cyp51A gene alterations were responsible for the emergence of such resistance
45 clinical Aspergillus spp. isolates were collected from bronchoalveolar lavages (n = 14), bronchial fluids (n = 7), sinus samples (n = 7), sputa (n = 5), pleural fluids (n = 4), ear (n = 5), cornea (n = 2), and nose samples (n = 1) of 39 patients hospitalized at Pierre Zobda-Quitman hospital (Martinique University Hospital, Fort-de-France, West Indies, France)
Summary
Acquired azole resistance in Aspergillus spp. was first reported in the late 1990s [1,2]. Has since become a widespread problem [3] usually associated with a higher rate of treatment failure necessitating therapeutic adjustment in aspergillosis [4,5]. This resistance concerns mainly Aspergillus fumigatus [6], though it has involved other species, such as Aspergillus flavus [7] and Aspergillus terreus [8,9,10]. The intensive use of azole fungicides in the agriculture industry expose Aspergillus spp. in the environment to azole fungicides and induce cross-resistance to medical azoles [13,16,17]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
