Background. Invasive aspergillosis represents an important cause of mortality and morbidity in patients under immunosupressive therapy, particularly in neutropenic patients under Hematopoietic Stem Cell transplantation. Local epidemiological prevalence of different Aspergillus species and their susceptibility to antifungal are useful for the management of these patients, allowing the administration of adequate antifungal therapy. Additionally, resistance to azoles on Aspergillus isolates from environmental samples has been reported. Objectives. The study aims to describe the prevalence of Aspergillus fumigatus and susceptibility profile to antifungals in the environment and in clinical samples of inpatients of a university Hospital of São Paulo, Brazil. Casuistic and Methods. Clinical isolates of Aspergillus sp from 69 patients of Hospital das Clínicas, Faculdade de Medicina, University of São Paulo in São Paulo, Brazil, and during the period between September of 2013 and July of 2014, 18 environmental samples of this hospital were analyzed. Aspergillus isolates were analysed by in vitro susceptibility tests according to NCLSI guidelines (2008). Phenotypic tests were employed to identify Aspergillus fumigatus. Antifungal susceptibility was expressed as resistant MIC ≥ 4μg/ml, intermediate MIC >1 < 4 μg/ml and sensitive MIC ≤ 1 μg/ml. Results. About 1/2 of isolates from patients with invasive aspergillosis and 2/3 of colonized patients isolates were A. fumigatus while 2/3 of environmental isolates were Aspergillus non-fumigatus. Susceptibility profile for Amphotericin B in clinical samples showed 0% of resistance in patients with invasive aspergillosis and environmental samples and 6.7% of resistance to Amphotericin B, voriconazole and caspofungin in colonized isolates. Conclusion: Resistance to antifungals was observed in samples from colonized patients, emphasizing the need of knowledge of local epidemiology of Aspergillus susceptibility to antifungals. Financial support: FAPESP 12/50212-1; LIM 48 HCFMUSP; F. Faculdade Medicina.
Full conference title:
- ISHAM 19th (2015)