| RRC ID |
60935
|
| 著者 |
Takeda K, Suzuki J, Watanabe A, Arai T, Koiwa T, Shinfuku K, Narumoto O, Kawashima M, Fukami T, Tamura A, Nagai H, Matsui H, Kamei K.
|
| タイトル |
High detection rate of azole-resistant Aspergillus fumigatus after treatment with azole antifungal drugs among patients with chronic pulmonary aspergillosis in a single hospital setting with low azole resistance.
|
| ジャーナル |
Med Mycol
|
| Abstract |
The prevalence of azole-resistant Aspergillus fumigatus (ARAF) among chronic pulmonary aspergillosis (CPA) patients treated with azoles in Japan is unknown. The aim of this study was to determine the detection rate of ARAF in isolates from CPA patients who were treated with azoles for varying durations. The potential mechanism of acquiring resistance was examined by sequencing cyp51A and hmg1, two genes associated with ARAF. A. fumigatus isolates (n = 120) were collected from CPA patients (n = 104) between February 2012 and February 2019, at National Hospital Organization Tokyo National Hospital. The isolates were tested for susceptibility to the azole drugs itraconazole (ITCZ) and voriconazole (VRCZ). The detection rate of ARAF among all isolates was 8.3% (n = 10). Of the 10 resistant isolates, eight were ITCZ-resistant and five were VRCZ-resistant. Among 47 isolates obtained from 36 CPA patients who were treated with ITCZ (for an average of 256 days) and/or VRCZ (for an average of 29 days), the resistance rates were 17.0% and 10.6%, respectively. In addition, 46.2% of 13 isolates obtained from CPA patients with ongoing azole treatment at the time of antifungal therapy failure were resistant to azoles. Among the 10 ARAF isolates, a point mutation was detected in cyp51A in seven isolates and in hmg1 in two isolates. ARAF was detected at a high rate in CPA patients, particularly in those with ongoing long-term azole treatment, at the time of azole antifungal therapy failure.
|
| 巻・号 |
59(4)
|
| ページ |
327-334
|
| 公開日 |
2021-4-6
|
| DOI |
10.1093/mmy/myaa052
|
| PII |
5869101
|
| PMID |
32642756
|
| MeSH |
Aged
Antifungal Agents / pharmacology*
Aspergillus fumigatus / drug effects*
Aspergillus fumigatus / genetics
Azoles / classification
Azoles / pharmacology*
Azoles / therapeutic use*
Chronic Disease / therapy
Drug Resistance, Fungal / genetics*
Female
Fungal Proteins / genetics
Genotype
Hospitals / statistics & numerical data*
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Prevalence
Pulmonary Aspergillosis / drug therapy*
Pulmonary Aspergillosis / epidemiology
Pulmonary Aspergillosis / microbiology
Retrospective Studies
Tokyo / epidemiology
|
| IF |
2.822
|
| リソース情報 |
| 病原真核微生物 |
Paecilomyces variotii IFM 58693, Aspergillus flavus IFM 56856, Aspergillusfumigatus IFM 58690, Aspergillus fumigatus IFM 58689 |
