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Radboud Repository
Article . 2014
Data sources: Radboud Repository
Journal of Antimicrobial Chemotherapy
Article . 2014 . Peer-reviewed
Data sources: Crossref
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Multi-azole-resistant Aspergillus fumigatus in the environment in Tanzania

Authors: Chowdhary, A.; Sharma, C.; Boom, M. van den; Yntema, J.B.; Hagen, F.; Verweij, P.E.; Meis, J.F.G.M.;

Multi-azole-resistant Aspergillus fumigatus in the environment in Tanzania

Abstract

Azole resistance in Aspergillus fumigatus isolates has been increasingly reported with variable prevalence worldwide and is challenging the effective management of aspergillosis. Here we report the coexistence of both TR₃₄/L98H and TR₄₆/Y121F/T289A resistance mechanisms in azole-resistant A. fumigatus (ARAF) isolates originating from Tanzania, Africa.A total of 30 soil and woody debris samples from the surroundings of Kilimanjaro Christian Medical Centre, Moshi, Tanzania, were processed for detection of ARAF isolates and were investigated for susceptibility to itraconazole, voriconazole, posaconazole and isavuconazole. All ARAF isolates were subjected to a real-time PCR assay for detection of mutations and were genotyped by microsatellite typing.Of the 30 samples, 29 yielded 108 A. fumigatus isolates. Overall, 15 ARAF isolates were obtained, which included 4 ARAF harbouring the TR₄₆/Y121F/T289A mutation and 11 isolates carrying TR₃₄/L98H. All four TR₄₆/Y121F/T289A A. fumigatus isolates showed high MICs of voriconazole (>16 mg/L) and isavuconazole (8 mg/L). In contrast, the 11 TR₃₄/L98H A. fumigatus isolates were pan-azole resistant. The isolates were cross-resistant to azole fungicides. Notably, 20% of environmental samples harboured ARAF and the TR₄₆/Y121F/T289A resistance mechanism was found in 5.5% of the soil samples, where it coexisted with TR₃₄/L98H. The Tanzanian TR₄₆/Y121F/T289A strains had a genotype identical to Dutch clinical TR₄₆/Y121F/T289A isolates.The present study reports the isolation of resistant A. fumigatus strains harbouring the TR₄₆/Y121F/T289A mutation from Africa. Recovery of TR₄₆/Y121F/T289A from the environment is worrisome and we must strive for effective surveillance of clinical and environmental sources to detect azole resistance in A. fumigatus.

Keywords

Radboudumc 4: lnfectious Diseases and Global Health RIMLS: Radboud Institute for Molecular Life Sciences, Azoles, Antifungal Agents, Drug Resistance, Fungal, Aspergillus fumigatus, Humans, Environment, Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences, Tanzania

  • BIP!
    Impact byBIP!
    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    130
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
130
Top 1%
Top 10%
Top 1%
bronze