Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Mycoses. 2020 May;63(5):430-436. doi: 10.1111/myc.13064. Epub 2020 Mar 13.
Azole resistance in Aspergillus fumigatus is an emerging problem and reported from all continents. As triazole antifungals are the mainstay of therapy in the management of invasive aspergillosis, azole-resistant A fumigatus has become a major medical concern and with complicated clinical management.
Screening of environmental presence of azole-resistant A fumigatus in Iran.
Compost from Northern Iran, collected between 2017 and 2018, was screened for the presence of azole-resistant A fumigatus with azole-containing agar. Phenotypic MICs were obtained from selected, molecularly confirmed isolates. cyp51A gene sequencing and genotyping of azole-resistant isolates were done.
Among 300 compost samples, three A fumigatus isolates had high voriconazole MICs (≥16 mg/L) and harboured the TR /Y121F/T289A mutation in the cyp51A gene. Microsatellite typing of these isolates showed that two strains had the same allele across all nine examined microsatellite loci and were genotypically related to Indian azole-resistant strains. The other isolate had a different genotype.
This is the first report of A fumigatus with TR /Y121F/T289A mutation from the region. Monitoring and surveillance of antifungal susceptibility of clinical A fumigatus is warranted in Iran and elsewhere in the region.
烟曲霉的唑类耐药性是一个新兴问题，在各大洲均有报道。由于三唑类抗真菌药物是治疗侵袭性曲霉病的主要药物，因此唑类耐药烟曲霉已成为一个主要的医学关注点，其临床管理也变得复杂。
在伊朗筛查环境中唑类耐药烟曲霉的存在情况。
2017 年至 2018 年采集伊朗北部的堆肥，用含唑类药物的琼脂筛选唑类耐药烟曲霉。从分子确证的分离株中选择获得表型 MIC 值。对唑类耐药分离株进行 cyp51A 基因测序和基因分型。
在 300 个堆肥样本中，有三个烟曲霉分离株对伏立康唑 MIC 值较高（≥16mg/L），并且 cyp51A 基因中存在 TR / Y121F/T289A 突变。这些分离株的微卫星分型显示，两个菌株在所有 9 个检测微卫星位点上具有相同的等位基因，与印度的唑类耐药菌株在基因型上相关。另一个分离株则具有不同的基因型。
这是该地区首次报道烟曲霉具有 TR / Y121F/T289A 突变。有必要在伊朗和该地区其他地方监测和调查临床烟曲霉的抗真菌药敏性。
