Author:
C Viegas1,2,3*, B Almeida1, B Gomes1, M Dias1, R Cervantes1, L Aranha Ceatano1,4
Author address:
1H&TRC – Health & Technology Research Center, ESTeSL – Escola Superior de Tec, IPL-ESTeSL, Lisbon, Portugal
2NOVA National School of Public Health, Public Health Research Centre, Unive, IPL-ESTeSL, Lisbon, Portugal
3Comprehensive Health Research Center (CHRC), 1169–056 Lisbon, Portugal, IPL-ESTeSL, Lisbon, Portugal
4Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Unive, IPL-ESTeSL, Lisbon, Portugal
Full conference title:
10th Advances Against Aspergillosis and Mucormycosis
Date: 2 February 2022
Abstract:
Purpose:
Analyze the importance of including the characterization of the azole resistance profile in indoor air quality assessments.
Methods:
Azole resistance was screened in two different indoor environments – primary health care centers (N=10) and firefighters headquarters (N=11) with 4 mg/ml itraconazole (ITR), 2 mg/ml voriconazole (VOR), or 0.5 mg/ml posaconazole (POS) supplemented Sabouraud (SAB) media, according with the proposed values of EUCAST guidelines. Aspergillus section Fumigati antifungal susceptibility was evaluated as minimal inhibitory concentration (MIC) values by E-test gradient trips.
Results:
In six primary health care centers, four fungal species, collected from the HVAC filters, were observed in at least one azole-supplemented media: Chrysosporium sp., Cladosporium sp., Mucor sp. and Penicillium sp.. The most prevalent species were Cladosporium sp. (91.5%, 50%, and 81.3%) and Penicillium sp. (6.4%, 45.5%, and 18.8%) on ITR-, VOR- and POS-media, respectively. No Aspergillus sp. was observed in azole-supplemented media. In firefighters, the highest Cladosporium sp. prevalence among passive sampling (electrostatic dust cloths – EDC, cleaning cloths, mops, uniform name tags, filters, and settled dust) was observed on filters (91.1%, 72.1%, and 77.9%) on ITR-, VOR- and POS-media, respectively. Aspergillus sp. low frequencies (0.1% to 1.1%) were observed, mostly from EDC (3.4% and 3.2% on ITR- and VOR-media, respectively), and in filters (0.03% on ITR). Six Aspergillus sections were observed on SAB (80.6% Candidi: 8.9% Fumigati; 3.3% Nidulantes; 3.3% Circumdati; 2.9% Nigri; 1.2% Flavi;); 100% Fumigati on ITR; and 97.1% Fumigati and2.9% Nidulantes on VOR. Considering considering the MIC values of >2 μg/ml for amphotericin B, ITR or VOR, or > 0.25 μg/ml for POS as cutoff values, 36% Fumigati isolates could be considered resistant.
Conclusions:
The occurrence of fungi with reduced azole susceptibility in primary health care centers and firefighters’ headquarters raises awareness and concern about antifungal resistance in these
settings. Other indoor environments besides health care facilities should be assessed for azole resistance when performing IAQ assessments.
Abstract Number: 58
Conference Year: 2022
Link to conference website: https://aaam2022.org/
URL Conference abstract: