Gonzalez-Jimenez Irene, Lucio Jose, Menéndez-Fraga Maria Dolores, Mellado Emilia, Peláez Teresa
Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), 28222 Majadahonda, Madrid, Spain.
Hospital Universitario Central de Asturias, Fundación para la Investigación Biosanitaria del Principado de Asturias (FINBA), 33011 Oviedo, Asturias, Spain.
J Fungi (Basel). 2021 Jan 2;7(1):22. doi: 10.3390/jof7010022.
Azole-resistant is an emerging worldwide problem with increasing reports of therapy failure cases produced by resistant isolates. A case of azole-resistant hospital colonization in a patient is reported here. Investigations of the hospital environment led to the recovery of strains harboring the TR34/L98H and the G448S Cyp51A azole resistance mechanisms. Isolate genotyping showed that one strain from the environment was isogenic with the patient strains. These are the first environmental azole resistant strains collected in a hospital in Spain; it supports the idea of the hospital environment as a source of dissemination and colonization/infection by azole resistant in patients. The isolation of an azole-resistant strain from an azole-naïve patient is an interesting finding, suggesting that an effective analysis of clinical and environmental sources must be done to detect azole resistance in . The emergence and spread of these resistance mechanisms in is of major concern because it confers high resistance to voriconazole and is associated with treatment failure in patients with invasive aspergillosis.
唑类耐药是一个日益严重的全球性问题，耐药菌株导致治疗失败的病例报告不断增加。本文报告了一例患者发生唑类耐药医院定植的病例。对医院环境的调查导致分离出携带TR34/L98H和G448S Cyp51A唑类耐药机制的菌株。分离株基因分型显示，一株来自环境的菌株与患者菌株同源。这些是在西班牙一家医院收集到的首批环境唑类耐药菌株；这支持了医院环境是患者中唑类耐药菌株传播和定植/感染来源的观点。从未接触过唑类的患者中分离出唑类耐药菌株是一个有趣的发现，表明必须对临床和环境来源进行有效分析以检测曲霉中的唑类耐药情况。这些耐药机制在曲霉中的出现和传播是一个主要问题，因为它赋予对伏立康唑的高度耐药性，并与侵袭性曲霉病患者的治疗失败有关。
