Aspergillus section Fumigati isolates in Spanish medical institutions: a preliminary report from a multicentre study

Ref ID: 19195

Author:

T. Peláez*, S. ílvarez-Pérez, E. Bunsow, A. Pérez-Rivilla, T. Durán, M.J. González-Abad, B. Gama, E. Bouza Santiago

Author address:

Madrid, ES

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: The emergence and spread of antifungal resistance is a cause of concern in medical institutions worldwide. Novel Aspergillus species intrinsically resistant to multiple antifungal compounds and different mechanisms of acquired resistance to azoles in isolates from this genus have been recently described. We present a preliminary report on the prevalence of antifungal resistance among Aspergillus section Fumigati isolates recovered from clinical and environmental samples in 13 Spanish medical institutions participating in an ongoing multicenter project.
Methods: A sample of 106 isolates (93 clinical, 13 environmental) among those submitted for analysis by participant institutions were identified to the species level by molecular procedures. Susceptibility to amphotericin B (AMB), itraconazole (IZ), posaconazole (POS), voriconazole (VZ), terbinafine (TB), anidulafungin (AND), caspofungin (CAS) and micafungin (MYC) was evaluated by broth microdilution (CLSI method) for a subsample of 71 isolates. The following breakpoints (in mg/L) for reduced susceptibility were considered: AMB, >=4; IZ and VZ, >=2; POS, >=0.5.
Results: AF was the most prevalent species among clinical and environmental isolates (89.2% and 61.5%, respectively), followed by A. lentulus (AL, 6.5% and 15.4%), Neosartorya udagawae (NU, 2.1% and 15.4%), A. novofumigatus (AN, 1.1% and 7.7%) and A. fumigatiaffinis (1.1% and 0%). 10 isolates (1 AF, 7 AL, 1 AN, 1 NU) showed reduced susceptibility to VZ and 4 (2 AF, 1 AL, 1 AN) to POS. Regardless of the species, all isolates were susceptible to AMB and displayed low MECs for echinocandins (<= 0.06 mg/L for AND and MYC, <= 0.25 mg/L for CAS). Conclusion: Albeit at a low frequency, A. fumigatus-like species showing decreased susceptibility to azoles are recovered from clinical samples and the hospital environment. Resistance to VZ is particularly worrisome, as this compound is the current pillar of invasive aspergillosis treatment. Further sampling is required to obtain a clearer picture of the real incidence of section Fumigati species in the clinical setting. Acknowledgements: This work was partially supported by Gilead and Astellas Pharma. S.ílvarez-Pí©rez is recipient of a Sara Borrell contract (Instituto de Salud Carlos III, CD12/00419). on behalf of the RESACOM working group

Abstract Number: P979

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163239&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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