Antifungal Susceptibility Pattern of Aspergillus fumigatus isolated from Clinical Specimens in Detroit Medical Center (DMC): Rising frequency of High MIC of azoles (2003-06)

Ref ID: 15157

Author:

S. KRISHNAN-NATESAN, S. SWAMINATHAN, J. CUTRIGHT, C. SUBRAMANIAN, N. GOYAL, R. GEORGE, P. H. CHANDRASEKAR

Author address:

1Wayne State Univ., Detroit, MI, 2John D. Dingell VA Med. Ctr., Detroit, MI.

Full conference title:

50th Annual ICAAC

Date: 12 September 2014

Abstract:

Background: Invasive aspergillosis is associated with a high mortality despite appropriate antifungal therapy. Reports of azole-R continue to emerge from institutions around the world and may contribute to clinical failures. Aim: To evaluate the antifungal susceptibility of A fumigatus at DMC (January 2003- December 2006). Methods: Clinical isolates of Aspergilus spp. were obtained from DMC laboratory, fresh conidial suspensions prepared (2 X104 conidia/ml) and MICs of itraconazole (ITZ), voriconazole (VCZ) and posaconazole (POS) were determined (CLSI M38-A2). Results: A total of 223 isolates of Aspergillus spp. were recovered from sputum (127), bronchoalveolar fluid (37), lung (9), ear (7), sinus (5), blood (3) and others (32): A. fumigatus (174; 78%), A. flavus (20; 9%), A. niger (17; 8%) and others (13; 5%). Frequency of A. fumigatus with azole-MIC ≥ 1 mcg/ml was 24% (’03), 14% (’04), 51% (’05) and 49% (’06). MICs of azoles were high (≥ 1 mcg/ml) in 60/174 isolates of A. fumigatus.;14/14 ITZ-R isolates (MIC ≥ 2 mcg/ml) and 1/6 VCZ-R isolates (MIC >2) were POS-R as well.
Table: A. fumigatus MIC (minimum inhibitory concentration) distribution.

Conclusion: Our study shows a trend in increased frequency of “œazole-R” A. fumigatus compared to our data from the 1990s. Resistance to ITZ and POS were more common; Our data mirror reports from Europe and underscore the need for large scale surveillance of azole-susceptibility in A. fumigatus.

Abstract Number: M-389

Conference Year: 2010

Link to conference website: NULL

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