Background: A 3-month survey was conducted at 4 university hospitals in order to determine the Aspergillus incidence and susceptibility pattern, and the effect of extended incubation of airway samples. Methods: Airway samples received in Jan-Mar 2007 was examined for Aspergillus following routine procedures (2-3 days incubation) and extended incubation 5 day. The first Aspergillus positive sample per patient (pt) was included. MIC was determined by the EUCAST microbroth dilution for azoles and by Etest for Amphotericin B. Sample number and positive rate for Jan-Mar 2006 were retrieved from the laboratory data systems. Rates were compared by Fisher’s Exact Test. Results: A total of 11,368 and 10,593 airway samples were received in 2007 and 2006, respectively. Aspergillus was found in 121 samples in 2006 (1.14%), 138 (1.21%) and 169 (1.49%) in 2007 by routine and 5-day incubation, respectively (P 0.05). Underlying risk factors were CF in 86, COPD in 10, other lung disease in 19, hematologic in 1, and rheumatologic in 7 pts. 16 pts were at ICU. In 68 CF pts the clinical significance was evaluated. 19 pts (28%) were found to have aspergillus infection 3 of whom were only found by extended incubation (16%). Five isolates had itraconazole MIC >2 Âµg/ml (3 A. fumigatus, 2 A. terreus), two had MIC >4 Âµg/ml (both A. fumigatus) and two had posaconazole MIC > 2 Âµg/ml (1 A. fumigatus, 1 A. terreus). Three isolates had voriconazole MIC >2 Âµg/ml (2 A. fumigatus, 1 A. terreus) One isolate was highly multi-azole resistant. Four isolates had amphotericin B MIC >1 Âµg/ml (3 A. fumigatus, 1 A. terreus). Conclusion: Aspergillus appears to be an important pathogen in Denmark. Elevated itraconazole MICs and multi-azole resistant isolates has been detected. Extended incubation is valuable in selected patient groups.
Full conference title:
47th Interscience Conference on Antimicrobial agents and Chemotherapy
- ICAAC 47th