Mohammadi Faezezeh, Hashemi Seyed Jamal, Seyedmousavi Seyed Mojtaba, Akbarzade Dorna
Dep. of Medical Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Dept. of Medical Mycology and Parasitology, School of Public Hygiene, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2018 Jul;47(7):994-1000.
is a major cause of allergic syndromes, aspergilloma and life-threatening invasive infections in immunocompromised hosts. To date, a wide range of mutations in have been described conferring azole-resistance, which commonly involves modifications in the -gene (substitutions at codons G54, G138, P216, F219, M220, G448 and specifically codon L98 in combination with a 34-bp tandem repeat in the promoter region of the gene), the target for azole antifungals. We investigated the prevalence of azole-resistance in clinical isolates obtained from patients in Iran during 2010 to 2014.
Overall, 172 clinical isolates obtained from patients with underlying disease including transplantation, granulocytopenia, chronic liver disease, chronic obstructive pulmonary disease (COPD) and allergic bronchopulmonary aspergillosis (ABPA). Samples were collected between Jan 2009 and Nov 2014 from five provinces of Iran (Tehran, Shiraz, Isfahan, Khorasan razavi and East Azerbaijan). Antifungal susceptibility test was determined according to EUCAST reference method for itraconazole (ITC), voriconazole (VRC) and posaconazole (POS). All isolates were confirmed by amplification of the partial tubulin gene.
Of 172 isolates tested, six isolates (3.5%) had high MIC values of ITC (>16 mg/L) and VRC (≥4 mg/L). All six isolates showed a multi-resistant phenotype with high MICs of ITC and VRC.
We determined in-vitro susceptibility a profile of 172 clinically isolates of against triazole in Iran. Azole-resistance is an emerging problem in and international surveillance is warranted.
是免疫功能低下宿主中过敏性综合征、曲菌球及危及生命的侵袭性感染的主要病因。迄今为止，已描述了中导致唑类耐药的多种突变，这些突变通常涉及 -基因的修饰（密码子G54、G138、P216、F219、M220、G448处的替换，特别是密码子L98与该基因启动子区域34 bp串联重复序列的组合），唑类抗真菌药的作用靶点。我们调查了2010年至2014年期间从伊朗患者中分离出的临床分离株中唑类耐药的流行情况。
总共从患有包括移植、粒细胞减少、慢性肝病、慢性阻塞性肺疾病（COPD）和变应性支气管肺曲霉病（ABPA）等基础疾病的患者中分离出172株临床分离株。样本于2009年1月至2014年11月期间从伊朗的五个省份（德黑兰、设拉子、伊斯法罕、霍拉桑拉扎维和东阿塞拜疆）采集。根据欧盟CAST关于伊曲康唑（ITC）、伏立康唑（VRC）和泊沙康唑（POS）的参考方法测定抗真菌药敏试验。所有分离株均通过部分微管蛋白基因的扩增进行确认。
在测试的172株分离株中，有6株（3.5%）对ITC（>16 mg/L）和VRC（≥4 mg/L）具有高MIC值。所有6株分离株均表现出对ITC和VRC高MIC的多重耐药表型。
我们测定了伊朗172株临床分离株对三唑类药物的体外药敏情况。唑类耐药是一个新出现的问题，有必要进行国际监测。
