Abstract
In a multicenter study, we determined a prevalence rate of 4% for azole-resistant Aspergillus fumigatus in Taiwan. Resistance emerged mainly from the environment (TR34/L98H, TR34/L98H/S297T/F495I, and TR46/Y121F/T289A mutations) but occasionally during azole treatment. A high mortality rate observed for azole-resistant aspergillosis necessitates diagnostic stewardship in healthcare and antifungal stewardship in the environment.
Highlights
Azole resistance in A. fumigatus might develop during patient therapy with medical azoles or through exposure to azole fungicides in the environment; environmental exposure predominantly involves TR34/L98H and TR46/Y121F/T289A mutations in cyp51A [1]
To delineate the influence of clinical and environmental use of azoles on resistance, we conducted a multicenter study that investigated 375 A. fumigatus sensu stricto isolates collected during August 2011–March 2018 from 297 patients at 11 hospitals in Taiwan (Appendix Table 1, Figure 1, https://wwwnc.cdc.gov/EID/ article/26/4/19-0840-App1.pdf)
Genetic relatedness among Aspergillus fumigatus isolates based on microsatellite genotyping, Taiwan
Summary
Multicenter Study of Azole-Resistant Aspergillus fumigatus Clinical Isolates, Taiwan1 Author affiliations: National Health Research Institutes, Zhunan, Taiwan We determined a prevalence rate of 4% for azole-resistant Aspergillus fumigatus in Taiwan.
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