Prevalence, mechanisms and genetic relatedness of the human pathogenic fungus Aspergillus fumigatus exhibiting resistance to medical azoles in the environment of Taiwan

doi:10.1111/1462-2920.13988

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Title:	Prevalence, mechanisms and genetic relatedness of the human pathogenic fungus Aspergillus fumigatus exhibiting resistance to medical azoles in the environment of Taiwan
Authors:	Wang, Hsuan-Chen Huang, Jui-Chang Lin, Yong-Hong Chen, Yu-Hsin Hsieh, Ming-I Choi, Pui-Ching Lo, Hsiu-Jung Liu, Wei-Lun Hsu, Ching-Shan Shih, Hsin-I Wu, Chi-Jung Chen, Yee-Chun
Contributors:	Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol, Div Infect Dis Council Agr, Execut Yuan, Tainan Dist Agr Res & Extens Stn, Div Crop Environm Council Agr, Execut Yuan, Kaohsiung Dist Agr Res & Extens Stn, Div Crop Environm Council Agr, Execut Yuan, Taichung Dist Agr Res & Extens Stn, Div Crop Improvement China Med Univ, Sch Dent Fu Jen Catholic Univ Hosp, Dept Emergency & Crit Care Med Fu Jen Catholic Univ, Coll Med, Sch Med Chia Nan Univ Pharm & Sci, Dept Environm Resource Management Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Emergency Med Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med
Keywords:	Tr34/L98H Mutations Invasive Aspergillosis Cyp51A Gene Itraconazole Transporter Epidemiology
Date:	2018-01
Issue Date:	2019-11-15 15:48:35 (UTC+8)
Publisher:	WILEY
Abstract:	Emerging azole resistance in Aspergillus fumigatus poses a serious threat to human health. This nationwide surveillance study investigated the prevalence and molecular characteristics of azole-resistant A. fumigatus environmental isolates in Taiwan, an island country with increasing use of azole fungicides. Of the 2760 air and soil samples screened from 2014 to 2016, 451 A. fumigatus isolates were recovered from 266 samples and 34 isolates from 29 samples displayed resistance to medical azoles (itraconazole, voriconazole or posaconazole). The resistance prevalence was 10.9% and 7.5% in A. fumigatus-positive samples and isolates respectively. Most (29, 85.3%) azole-resistant isolates harboured TR34/L98H mutations, which were widely distributed, clustered genetically with clinical isolates, and had growth rates that were similar to those of the wild-type isolates. Microsatellite genotyping revealed both the global spread of the TR34/L98H isolates and the occurrence of TR34/L98H/S297T/F495I isolates belonging to local microsatellite genotypes. AfuMDR3 and atrF, two efflux transporter genes, were constitutively upregulated in two individual resistant isolates without cyp51A mutations, highlighting their potential roles in azole resistance. These results emphasize the need for periodic environmental surveillance at the molecular level in regions in which azole fungicides are applied, and agricultural fungicide management strategies that generate less selective pressure should be investigated.
Relation:	Journal of Cellular and Molecular Medicine, v.20, n.1, pp.270-280
Appears in Collections:	[Dept. of Environmental Resources Management] Periodical Articles

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