Leonardelli Florencia, Theill Laura, Nardin María Elena, Macedo Daiana, Dudiuk Catiana, Mendez Emilce, Gamarra Soledad, Garcia-Effron Guillermo
Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), CCT- Santa Fe, Argentina.
Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Rev Iberoam Micol. 2017 Jan-Mar;34(1):46-48. doi: 10.1016/j.riam.2016.05.005. Epub 2017 Jan 10.
A 27-year-old male rural worker was admitted with a fungal keratitis due to an injury involving plant detritus.
Specimens were collected for microscopy examination and culture. The isolate was identified by morphological and molecular criteria. Susceptibility testing was performed using CLSI methods. CYP51A gene was PCR amplified and sequenced.
An Aspergillus fumigatus strain resistant to itraconazole (MIC>8μg/ml) was isolated. The isolate was susceptible to amphotericin B, posaconazole, voriconazole and caspofungin. CYP51A sequencing showed two mutations leading on the G54E substitution. The patient received natamycin as treatment.
This is the first report in South America of a clinical A. fumigatus strain carrying the substitution G54E at Cyp51Ap associated with itraconazole resistance. Considering the patient was azole-naive, this resistant isolate may have been acquired from the environment.
一名27岁的男性农民工因涉及植物碎屑的损伤而被收治，诊断为真菌性角膜炎。
采集标本进行显微镜检查和培养。通过形态学和分子标准对分离株进行鉴定。使用CLSI方法进行药敏试验。对CYP51A基因进行PCR扩增和测序。
分离出一株对伊曲康唑耐药（MIC>8μg/ml）的烟曲霉菌株。该分离株对两性霉素B、泊沙康唑、伏立康唑和卡泊芬净敏感。CYP51A测序显示两个导致G54E替代的突变。患者接受那他霉素治疗。
这是南美洲首次报道临床烟曲霉菌株在Cyp51Ap处携带与伊曲康唑耐药相关的G54E替代。考虑到患者未曾使用过唑类药物，这种耐药分离株可能是从环境中获得的。
