Antifungal Susceptibility and Clinical Significance of Aspergillus Section Usti in a Spanish Hospital

Ref ID: 15160

Author:

T. PELíEZ, C. PADILLA, B. GAMA, P. ESCRIBANO, E. REIGADAS, P. LOPEZ ROA, A. ESPINEL-INGROFF, R. FLORES, J. GUINEA, P. MUí‘OZ, E. BOUZA

Author address:

1Hosp. Gregorio Marañón. Univ. of Madrid, Madrid, Spain, 2VCU Med. Ctr., Richmond, VA.

Full conference title:

50th Annual ICAAC

Date: 12 September 2014

Abstract:

Background: Aspergillus section Usti are a rare group of pathogens that can cause invasive infections in immunocompromised hosts. We studied the epidemiology and antifungal susceptibility of A. section Usti. Methods: A. section Usti strains (2003 to February 2010) were analyzed. Charts were reviewed for clinical data (eg, underlying disease, antifungal therapy, outcome). Strains were identified by PCR amplification of β -tubulin. Antifungal susceptibility to amphotericin B (AMB), itraconazole (IZ), voriconazole (VZ), caspofungin (CAS), anidulafungin (AND), micafungin (MF), and terbinafine (TB) was determined by CLSI M38-A2. Results: We recovered 34 isolates of A. section Usti:( 22 clinical [14 pts] & 12 environmental from hospital areas). Clinical isolates belonged to A. calidoustus (11), A. insuetus (1), A. pseudodeflectus (1), & A. puniceus (1); environmental isolates belonged to A. puniceus (6), A. calidoustus (5), & A. pseudodeflectus (1). Global MIC ranges (µg/ml) of the isolates were AMB (0.25-4), IZ (2-32), VZ (2-8), CAS (0.06-4), AND (0.007-2), MF (0.06-0.25), & TB (0.06-0.25). The geometric mean/MIC90 (µg/ml) was AMB (2.31/4), IZ (7.84/16), VZ (4.33/8), CAS (0.37/4), AND (0.03/0.25), MF (0.07/0.125) and TB (0.09/0.125). Of 14 pts with ≥ 1 isolates of A. section Usti, 12 were only colonized (11 COPD pts), & the other 2 pts had probable aspergillosis (pulmonary tuberculosis and hematopoietic stem cell transplant). Conclusions: This is one of the largest A. section Usti studies. Isolates were resistant to azoles and decreased susceptibility to amphotericin B. The activity of echinocandins was variable. Microbiology departments must be aware that A. section Usti may be resistant to one or more of the antifungal agents used to treat invasive aspergillosis.

Abstract Number: M-376

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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