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Azole resistance among clinical isolates of Aspergillus fumigatus in Lima-Peru

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dc.contributor.author Bustamante, Beatriz
dc.contributor.author Illescas, Luis Ricardo
dc.contributor.author Posadas, Andres
dc.contributor.author Campos, Pablo E.
dc.date.accessioned 2019-08-08T15:23:46Z
dc.date.available 2019-08-08T15:23:46Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7153
dc.description.abstract Azole resistance among Aspergillus fumigatus isolates, which is mainly related to mutations in the cyp51A gene, is a concern because it is rising, worldwide disseminated, and associated with treatment failure and death. Data on azole resistance of aspergillus from Latin American countries is very scarce and do not exist for Peru. Two hundred and seven Aspergillus clinical isolates collected prospectively underwent mycology and molecular testing for specie identification, and 143 isolates were confirmed as A. fumigatus sensu stricto (AFSS). All AFSS were tested for in vitro azole susceptibility, and resistant isolates underwent PCR amplification and sequencing of the whole cyp51A gene and its promoter. The in vitro susceptibility showed a minimal inhibitory concentration (MIC) range, MIC50 and MIC90 of 0.125 to >16, 0.25, and 0.5 μg/ml for itraconazole; 0.25 to 2, 0.5, and 0.5 μg/ml for voriconazole; and 0.003 to 1, 0.06, and 0.125 μg/ml for posaconazole. Three isolates (2%) showed resistance to itraconazole and exhibited different mutations of the cyp51A gene. One isolate harbored the mutation M220K, while a second one exhibited the G54 mutation plus a modification in the cyp51A gene promoter. The third isolate, from an azole naive patient, presented an integration of a 34-bp tandem repeat (TR34) in the promoter region of the gene and a substitution of leucine 98 by histidine (L98H). The three source patients had a diagnosis or suspicion of chronic pulmonary aspergillosis. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof urn:issn:1460-2709
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Microbial Sensitivity Tests en_US
dc.subject Young Adult en_US
dc.subject Child, Preschool en_US
dc.subject Infant en_US
dc.subject aspergillosis en_US
dc.subject Aspergillus fumigatus en_US
dc.subject azole resistance en_US
dc.subject cyp51A gene en_US
dc.subject susceptibility testing en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Child en_US
dc.subject Prospective Studies en_US
dc.subject Qualitative Research en_US
dc.subject Aged, 80 and over en_US
dc.subject Drug Resistance, Multiple, Fungal en_US
dc.subject Antifungal Agents/pharmacology en_US
dc.subject Aspergillus fumigatus/drug effects/genetics en_US
dc.subject Azoles/pharmacology en_US
dc.subject Cytochrome P-450 Enzyme System/genetics en_US
dc.subject Fungal Proteins/genetics en_US
dc.subject Mutation en_US
dc.subject Pulmonary Aspergillosis/microbiology en_US
dc.title Azole resistance among clinical isolates of Aspergillus fumigatus in Lima-Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/mmy/myz032
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#4.03.00

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