Imperial College London
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ProfessorDariusArmstrong-James

Faculty of Medicine, Department of Infectious Disease

Professor of Infectious Diseases and Medical Mycology
 
 
 
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d.armstrong

 
 
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Location

 

Flowers buildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Abdolrasouli:2018:10.1016/j.ijantimicag.2018.08.004,
author = {Abdolrasouli, A and Scourfield, A and Rhodes, J and Shah, A and Elborn, JS and Fisher, MC and Schelenz, S and Armstrong-James, D},
doi = {10.1016/j.ijantimicag.2018.08.004},
journal = {International Journal of Antimicrobial Agents},
pages = {637--642},
title = {High prevalence of triazole resistance in clinical Aspergillus fumigatus isolates in a specialist cardiothoracic centre},
url = {http://dx.doi.org/10.1016/j.ijantimicag.2018.08.004},
volume = {52},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: To evaluate the prevalence of triazole-resistant Aspergillus fumigatus and common molecular cyp51A polymorphisms amongst clinical isolates in a specialised cardiothoracic centre in London, UK. METHODS: All A. fumigatus isolates were prospectively analysed from April 2014 to March 2016. Isolates were screened with a four-well VIPcheck™ plate to assess triazole susceptibility. Resistance was confirmed with a standard microbroth dilution method according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Triazole-resistant A. fumigatus isolates were subjected to a mixed-format real time polymerase chain reaction (RT-PCR) assay (AsperGenius®) to detect common cyp51A alterations. RESULTS: We identified 167 clinical A. fumigatus isolates from 135 patients. Resistance to at least one azole antifungal drug was confirmed in 22/167 (13.2%) of isolates from 18/135 (13.3%) patients, including 12/74 (16.2%) patients with cystic fibrosis (CF). The highest detection rate of azole-resistant A. fumigatus was among the 11- to 20-y age group. All triazole-resistant isolates (n=22) were resistant to itraconazole, 18 showed cross-resistance to posaconazole and 10 displayed reduced susceptibility to voriconazole. No pan-azole-resistant A. fumigatus was identified. TR34/L98H was identified in 6/22 (27.3%) of azole-resistant isolates and detectable in 5/12 (42%) patients with CF. CONCLUSIONS: In our specialist cardiothoracic centre, the prevalence of triazole-resistant A. fumigatus is alarmingly high (13.2%). The majority of azole-resistant isolates were from patients with CF. We found a higher prevalence of the environmentally driven mutation TR34/L98H in our A. fumigatus isolates than in published UK data from other specialist respiratory centres, which may reflect differing patient populations managed at these institutions.
AU  - Abdolrasouli,A
AU  - Scourfield,A
AU  - Rhodes,J
AU  - Shah,A
AU  - Elborn,JS
AU  - Fisher,MC
AU  - Schelenz,S
AU  - Armstrong-James,D
DO  - 10.1016/j.ijantimicag.2018.08.004
EP  - 642
PY  - 2018///
SN  - 0924-8579
SP  - 637
TI  - High prevalence of triazole resistance in clinical Aspergillus fumigatus isolates in a specialist cardiothoracic centre
T2  - International Journal of Antimicrobial Agents
UR  - http://dx.doi.org/10.1016/j.ijantimicag.2018.08.004
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30103005
UR  - http://hdl.handle.net/10044/1/63895
VL  - 52
ER  -
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