Kang Yuting, Ma Wanting, Li Qiujie, Wang Pengtao, Jia Wei
First Clinical Medical College, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
Sci Rep. 2025 May 15;15(1):16906. doi: 10.1038/s41598-025-00187-z.
Azole resistance in Aspergillus fumigatus poses a significant clinical challenge globally. In this study, we analyzed 307 clinical A. fumigatus isolates from General Hospital of Ningxia Medical University in China, collected between July 2023 and July 2024, to explore their susceptibility profiles, genotypic characteristics and biological traits. The overall frequency of azole resistance among clinical isolates in Ningxia province was found to be 1.20% (7 azole-resistant A. fumigatus, designated AF1-AF7), each exhibiting distinct phenotypes in terms of azole resistance, spore viability, and resilience to environmental stress. Among these strains, the cyp51A mutations predominantly included TR43/L98H, while the hmg1 mutations were primarily S212P/Y564H. Additionally, novel mutations were discovered in cyp51B, specifically the t-215c point mutation and a base deletion (gatgccta) in the - 213 to - 206 region. The AF3 strain demonstrated the highest spore activity and anti-SDS efficacy. In contrast, the AF1 and AF2 strains were resistant to three azoles and also exhibited resistance to Menadione, similar to AF7. Notably, six out of the seven strains displayed resistance to NaCl and KCl, indicating a strong tolerance to saline conditions. These findings suggest that azole-resistant strains possess varying degrees of resistance to environmental stressors, implying that they may adapt to their surroundings through different evolutionary pathways, which could complicate clinical treatment strategies. Effective surveillance and control strategies are essential to control the widespread prevalence of azole-resistant A. fumigatus and to reduce the risk of infection in patients.
烟曲霉中的唑类耐药性在全球范围内构成了重大的临床挑战。在本研究中，我们分析了2023年7月至2024年7月期间从中国宁夏医科大学总医院收集的307株临床烟曲霉分离株，以探究它们的药敏谱、基因型特征和生物学特性。结果发现，宁夏临床分离株中唑类耐药的总体频率为1.20%（7株唑类耐药烟曲霉，命名为AF1 - AF7），每株在唑类耐药性、孢子活力和对环境应激的耐受性方面都表现出不同的表型。在这些菌株中，cyp51A突变主要包括TR43/L98H，而hmg1突变主要是S212P/Y564H。此外，在cyp51B中发现了新的突变，具体为t - 215c点突变以及 - 213至 - 206区域的一个碱基缺失（gatgccta）。AF3菌株表现出最高的孢子活性和抗SDS效力。相比之下，AF1和AF2菌株对三种唑类耐药，并且对甲萘醌也表现出耐药性，与AF7类似。值得注意的是，7株菌株中有6株对NaCl和KCl耐药，表明它们对盐胁迫具有很强的耐受性。这些发现表明，唑类耐药菌株对环境应激源具有不同程度的抗性，这意味着它们可能通过不同的进化途径适应周围环境，这可能会使临床治疗策略复杂化。有效的监测和控制策略对于控制唑类耐药烟曲霉的广泛传播以及降低患者感染风险至关重要。
