Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?

Raquel Sabino was not included as an author in the published article. It was corrected a posteriori.Erratum in - Corrigendum: Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon? [Front Microbiol. 2018] Front Microbiol. 2019 Jan 14;9:3245. doi: 10.3389/fmicb.2018.03245. eCollection 2018.Disponível em: https://www.frontiersin.org/articles/10.3389/fmicb.2018.03245/fullFree PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882871/ | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340063/Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.This work was supported by ECMM, ISHAM, and EFISG and in part by an unrestricted research grant through the Investigator Initiated Studies Programof Astellas, MSD, and Pfizer. This study was fundet by the Christian Doppler Laboratory for invasive fungal infections.info:eu-repo/semantics/publishedVersio

Clinical evaluation of a Mucorales-specific real-time PCR assay in tissue and serum samples

Molecular diagnostic assays can accelerate the diagnosis of fungal infections and subsequently improve patient outcomes. In particular, the detection of infections due to Mucorales is still challenging for laboratories and physicians. The aim of this study was to evaluate a probe-based Mucorales-specific real-time PCR assay (Muc18S) using tissue and serum samples from patients suffering from invasive mucormycosis (IMM). This assay can detect a broad range of clinically relevant Mucorales species and can be used to complement existing diagnostic tests or to screen high-risk patients. An advantage of the Muc18S assay is that it exclusively detects Mucorales species allowing the diagnosis of Mucorales DNA without sequencing within a few hours. In paraffin-embedded tissue samples this PCR-based method allowed rapid identification of Mucorales in comparison with standard methods and showed 91 % sensitivity in the IMM tissue samples. We also evaluated serum samples, an easily accessible material, from patients at risk from IMM. Mucorales DNA was detected in all patients with probable/proven IMM (100 %) and in 29 % of the possible cases. Detection of IMM in serum could enable an earlier diagnosis (up to 21 days) than current methods including tissue samples, which were gained mainly post-mortem. A screening strategy for high-risk patients, which would enable targeted treatment to improve patient outcomes, is therefore possible

A prospective international Aspergillus terreus survey: An EFISG, ISHAM and ECMM joint study

Objectives: A prospective international multicentre surveillance study was conducted to investigate the prevalence and amphotericin B susceptibility of Aspergillus terreus species complex infections. Methods: A total of 370 cases from 21 countries were evaluated. Results: The overall prevalence of A. terreus species complex among the investigated patients with mould-positive cultures was 5.2% (370/7116). Amphotericin B MICs ranged from 0.125 to 32 mg/L, (median 8 mg/L). Conclusions: Aspergillus terreus species complex infections cause a wide spectrum of aspergillosis and the majority of cryptic species display high amphotericin B MICs.Fil: Risslegger, Brigitte. Universidad de Innsbruck; AustriaFil: Zoran, Tamara. Universidad de Innsbruck; AustriaFil: Lackner, Michaela. Universidad de Innsbruck; AustriaFil: Aigner, María. Universidad de Innsbruck; AustriaFil: Sanchez Reus, Ferrán. Hospital de la Santa Creu I Sant Pau; EspañaFil: Rezusta, Antonio. Universidad de Zaragoza; EspañaFil: Chowdhary, Anuradha. University of Delhi; IndiaFil: Alcacer Sanchez, Juan Manuel. Hospital de la Santa Creu I Sant Pau;Fil: Taj Aldeen, Saad Jaber. Hamad Medical Corporation; QatarFil: Arendrup, Maiken C.. Universidad de Copenhagen; DinamarcaFil: Oliveri, Salvatore. Università degli Studi di Catania; ItaliaFil: Kontoyiannis, Dimitrios P.. The University of Texas MD Anderson Cancer Center; Estados UnidosFil: Alastruey Izquierdo, Ana. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Lagrou, Katrien. Katholikie Universiteit Leuven; BélgicaFil: Lo Cascio, Giuliana. Azienda Ospedaliera Universitaria Integrata; ItaliaFil: Meis, Jacques F.. Canisius Wilhelmina Hospital; Países BajosFil: Buzina, Walter. Medical University of Graz; AustriaFil: Farina, Claudio. ASST Papa Giovanni XXIII. Microbiology Institute; ItaliaFil: Drogari Apiranthitou, Miranda. Universidad Nacional y Kapodistriaca de Atenas; GreciaFil: Grancini, Anna. Cà Granda Ospedale Maggiore Policlinico; ItaliaFil: Tortorano, Anna Maria. Università degli Studi di Milano; ItaliaFil: Willinger, Birgit. Universidad de Viena; AustriaFil: Hamprecht, Axel. Universitat Zu Köln; AlemaniaFil: Johnson, Elizabeth. Public Health England. Mycology Reference Laboratory; Reino UnidoFil: Klingspor, Lena. Karolinska Huddinge Hospital; SueciaFil: Arsic Arsenijevic, Valentina. University of Belgrade; SerbiaFil: Cornely, Oliver A.. Universitat Zu Köln; AlemaniaFil: Meletiadis, Joseph. Universidad Nacional y Kapodistriaca de Atenas; GreciaFil: Prammer, Wolfgang. Klinikum Wels-Grieskirchen; AustriaFil: Tullio, Vivian. Università di Torino; ItaliaFil: Vehreschild, Jörg Janne. Universitat Bonn; Alemania. Universitat Zu Köln; AlemaniaFil: Trovato, Laura. Università degli Studi di Catania; ItaliaFil: Lewis, Russell E.. Universidad de Bologna; ItaliaFil: Segal, Esther. Tel Aviv University; IsraelFil: Rath, Peter Michael. Universitat Essen; AlemaniaFil: Hamal, Petr. Universtity Hospital Olomouc; República Checa. Palacky University Olomouc; República ChecaFil: Rodríguez Iglesias, Manuel. Universidad de Cádiz; EspañaFil: Roilides, Emmanuel. Aristotle University School of Health Sciences; GreciaFil: Arikan Akdagli, Sevtap. Hacettepe University; TurquíaFil: Chakrabarti, Arunaloke. Postgraduate Institute of Medical Education and Research; IndiaFil: Colombo, Arnaldo L.. Universidade Federal de Sao Paulo; BrasilFil: Fernández, Mariana Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Martin Gomez, M. Teresa. Vall d’Hebron University Hospital; EspañaFil: Badali, Hamid. Mazandaran University of Medical Sciences; IránFil: Petrikkos, Georgios. European University Cyprus; ChipreFil: Klimko, Nikolai. North Western State Medical University; RusiaFil: Heimann, Sebastian M.. Universitat Zu Köln; AlemaniaFil: Houbraken, Jos. Fungal Biodiversity Centre; Países BajosFil: Uzun, Omrum. Hacettepe University Medical School; TurquíaFil: Edlinger, Michael. Universidad de Innsbruck; AustriaFil: de la Fuente, Sonia. Hospital Ernest Lluch Martin; EspañaFil: Lass Flörl, Cornelia. Universidad de Innsbruck; Austri

Proposed nomenclature for Pseudallescheria, Scedosporium and related genera

As a result of fundamental changes in the International Code of Nomenclature on the use of separate names for sexual and asexual stages of fungi, generic names of many groups should be reconsidered. Members of the ECMM/ISHAM working group on Pseudallescheria/Scedosporium infections herein advocate a novel nomenclature for genera and species in Pseudallescheria, Scedosporium and allied taxa. The generic names Parascedosporium, Lomentospora, Petriella, Petriellopsis, and Scedosporium are proposed for a lineage within Microascaceae with mostly Scedosporium anamorphs producing slimy, annellidic conidia. Considering that Scedosporium has priority over Pseudallescheria and that Scedosporium prolificans is phylogenetically distinct from the other Scedosporium species, some name changes are proposed. Pseudallescheria minutispora and Petriellidium desertorum are renamed as Scedosporium minutisporum and S. desertorum, respectively. Scedosporium prolificans is renamed as Lomentospora prolificans.10 page(s

DataSheet1.pdf

<p>Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied.</p><p>Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene.</p><p>Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V.</p><p>Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.</p