Itraconazole resistance and screening of M220 mutation in Cuban Aspergillus fumigatus isolates

Author:

JLSJG San Juan-Galán, CMFA Fernández, GFMM Martínez, MTIZ Illnait, MRPL Perurena, REVM Velar

Author address:

Bacteriology – Mycology, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba

Full conference title:

9th Advances Against Aspergillosis

Date: 27 February 2020

Abstract:

Purpose: Aspergillosis is a fungal disease caused by different Aspergillus species and have high morbidity and mortality rates. Within the genus, A. fumigatus is the main aetiological agent related to most of Aspergillus infections. For management of aspergillosis the use of triazoles is recommended as first line of treatment, however, in the last few decades the reports of azole-resistant Aspergillus fumigatus due to mutation M220 and other aminoacidic substitutions in CYP51 have increased around the world. The goals of this study is to determine the antifungal susceptibility patterns for triazoles in 30 A. fumigatus isolates from clinical and environmental samples and to detect mutation M220 in the resistant ones.

Methods: With this purpose, the determination of minimum inhibitory concentrations of every isolate was performed by using the Etest commercial method (Biomérieux, France) for itraconazole, voriconazole and posaconazole. In the resistant isolates, a PCR was performed for amplifying a 173 bp fragment of cyp51A with chance of carrying the M220 mutation and the resulting amplicons were sequenced using Sanger methodology (Beckman Coulter, USA).

Results: Nine out of 30 isolates were resistant to itraconazole and none were resistant to voriconazole neither posaconazole. The sequences alignment with a CYP51 A. fumigatus wild type strain (Access number: Af293) did not show any modifications at codon 220.

Conclusion: Other molecular mechanisms of resistance must be evaluated according to the source of the isolates and new associations should be determine between epidemiological/ecological variables.

Abstract Number: 10

Link to conference website:

Link Conference abstract: 

AAAM 2020

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