Performance of Molecular Approaches for Detection and Azole Resistance Surveillance in Cystic Fibrosis.

triazole resistance is an emerging concern for treating chronically infected/colonized patients. This study sought to evaluate the performance of PCR assays to detect fungi together with azole resistance in sputum samples from cystic fibrosis (CF) patients. In total, 119 sputum samples from 87 CF patients were prospectively processed for detection by means of mycological culture and four qPCR assays, 2 in-house methods and two commercial multiplex real-time PCR assays simultaneously detecting and the most relevant gene mutations (MycoGENIE and AsperGenius). Azole susceptibility of isolates was assessed using Etest method and gene mutation were characterized by sequencing. The overall rate of detection with the four qPCR assays ranged from 47.9 to 57.1%, contrasting with 42/119 (35.3%) positive cultures with . The high sensitivity of PCR on sputum could then contribute to more effective grading of disease in CF patients. Five out of 41 isolated strains (12.2%) exhibited azole-resistant MIC patterns, three of which harbored mutations and only 1/3 with the sequence TR/L98H. Combined with culture, PCR assay achieved high sensitivity screening in CF samples. However, targeting was only moderately effective for azole resistance monitoring, while resistance remains of great concern.