Aspergillus fumigatus in an Irish Cystic Fibrosis Patient Cohort ; Epidemiology and Antifungal Suscetibility 

Ref ID: 19497

Author:

Suscetibility K Dunne1,2*, J Renwick2, NG McElvaney3, S Chotirmall3, JF Meis4,5, CHW Klaassen4, P Murphy2,
TR Rogers1

Author address:

1Department of Clinical Microbiology, Sir Patrick Dun Laboratory, Trinity College Dublin, St. James’
Hospital, Dublin, Ireland
2Department of Clinical Microbiology, Trinity Centre, Trinity College Dublin, Tallaght Hospital, Dublin,
Ireland
3Royal

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Introduction:
Aspergillus fumigatus is an opportunistic pathogen known to cause a spectrum of diseases including
Allergic Bronchopulmonary Aspergillosis (ABPA) and life-threatening angioinvasive pulmonary
disease. A. fumigatus is the most common agent causing fungal infections in chronic lung disease
such as Cystic Fibrosis (CF), most often presenting as ABPA. There are a number of antifungal
agents available for the treatment of A. fumigatus infections but resistance to triazole antifungals
in A. fumigatus isolates from CF patients has been reported. In this study the epidemiology of
A. fumigatus in an Irish patient population that included CF patients pre and/or post itraconazole
treatment in a major CF Centre (Hospital 1) and a non-CF patient population from a University
Teaching Hospital (Hospital 2) was investigated and the antifungal drug susceptibility of all isolates
collected was determined.
Methods:
A. fumigatus isolates from colonized adult CF patients (n=19) and from non-CF patients were
collected (n=37). All isolates from the study were confirmed as A. fumigatus by PCR and sequencing
of the ITS region. Isolates were genotyped using the Short Tandem Repeat assay for A. fumigatus
(STRAf assay). Minimum Inhibitory Concentrations (MICs) of all A. fumigatus isolates to nine antifungal
drugs were tested using the Sensititre Plate system (TREK Diagnostic Systems)
Results:
Three distinct A. fumigatus colonization patterns were observed in the CF cohort, (1) persistent
colonization over time with the same genotype ( >2 consecutive samples with indistinguishable
genotypes), (2) non-persistent colonization with distinguishable genotypes over time and (3)
patients sharing an indistinguishable genotype suggesting the possibility of a common source of
acquisition. No shared genotypes between the two hospitals were found. These colonization patterns
were observed in both CF and non-CF patients. No antifungal drug resistance was observed from
any study isolate, even for isolates collected following exposure to itraconazole for 6 weeks. Twelve
of 56 A. fumigatus isolates had MICs of 2μg/ml for amphotericin B and further investigation is
required here.
Conclusion:
No A. fumigatus genotype was linked with any one colonisation pattern. This suggests that
A. fumigatus infection of CF patients may be a host trait. Some patients shared indistinguishable
genotypes suggesting a common source. No triazole antifungal drug resistant strains of A. fumigatus
were detected during this study.

Abstract Number: 25

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

New link: NULL

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