Continued increase of azole resistance in Aspergillus fumigatus (Af) in Dutch Hospitals

Ref ID: 18747


D. Versteeg, MD, PhD – consultant microbiologist, E. Snelders, PhD – molecular microbiologist, T. Rijs, BSc – research assistant, W. Melchers, PhD – medical molecular microbiologist, P. Verweij, MD, PhD – professor of medical microbiology;

Author address:

Radboud Univ. Nijmegen Med. Ctr., Nijmegen, Netherlands.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014


Background: Azole resistance is an emerging problem. In the Netherlands an environmental route of resistance development is dominant, with the TR34/L98H resistance mechanism in Af accounting for >90% of resistant isolates. In 2009 a new resistance mechanism (TR46/Y121F/T289A) was observed that appeared to be from environmental origin. We investigated trends in the prevalence of resistance in Af and the distribution of resistance mechanisms in the Radboud University Medical Center (RUNMC), the Netherlands. Methods: All Af isolates that are processed by the microbiology laboratory of the RUNMC were screened for azole resistance using a agar supplemented with azoles. Any isolate growing on the agar plates were characterized by molecular identification, MIC testing and sequence analysis of the Cyp51A-gene. Furthermore sequence analysis was performed on Af isolates send from multiple Dutch hospitals for MIC-testing. Results: The increasing trend observed since 2000 continued in most recent years (2007 to 2011-Figure). The prevalence increased from 4.3% in 2008 to 10.1% in 2010. TR46/Y121F/T289A was found in 10% of RUNMC isolates in 2010 and in 20% of isolates in 2011. Sequence analysis of 55 azole resistant Af isolates sent to Nijmegen in 2010 and 2011 from various primary and secondary Dutch referral hospitals revealed 35 (64%) isolates with TR34/L98H and 20 (36%) isolates with TR46/Y121F/T289A. Conclusions: There is an increasing trend in azole resistance in Af enhanced by the emergence and spread of new resistance mechanisms.

Abstract Number: M-319

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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