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- Title
TR34/L98H Mutation in CYP51A Gene in Aspergillus fumigatus Clinical Isolates During Posaconazole Prophylaxis: First Case in Korea.
- Authors
Lee, Hyeon-Jeong; Cho, Sung-Yeon; Lee, Dong-Gun; Park, Chulmin; Chun, Hye-Sun; Park, Yeon-Joon
- Abstract
Azole resistance in Aspergillus fumigatus is an emerging problem, especially in immunocompromised patients. It has been reported worldwide, including in Asia, but has not yet been reported in Korea. Here, we report a case of invasive pulmonary aspergillosis (IPA) caused by azole-resistant A. fumigatus that developed in a hematopoietic stem cell transplantation recipient during posaconazole prophylaxis for immunosuppressive therapy of graft-versus-host diseases. We identified TR34/L98H/S297T/F495L mutation in the CYP51A gene of A. fumigatus clinical isolate obtained from bronchial washing fluid. Minimal inhibitory concentrations for itraconazole, voriconazole, and posaconazole were > 16, 1, and 4 μg/mL, respectively. While IPA improved partially under voriconazole treatment, the patient died from carbapenemase-producing Klebsiella pneumoniae bacteremia. Further epidemiological surveillance studies are warranted.
- Subjects
ASPERGILLUS fumigatus; ASPERGILLUS toxins; CANCER chemotherapy; IMMUNOCOMPROMISED patients; INTERNAL medicine
- Publication
Mycopathologia, 2018, Vol 183, Issue 4, p731
- ISSN
0301-486X
- Publication type
Article
- DOI
10.1007/s11046-018-0271-8