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- Title
Molecular identification and In vitro antifungal susceptibility of clinical and environmental isolates of Aspergillus nidulans complex collected from different countries.
- Authors
Tavakoli, Mahin; Hedayati, Mohammad Taghi; Alaustrey, Ana; Seyedmousavi, Seyed Mojtaba; Siopi, Marisa; Sabino, Raquel; Zarrinfar, Hossein; Nouripour-Sisakht, Sadegh
- Abstract
Introduction: Aspergillus species are globally as one of the most important fungal pathogens caused a wide spectrum of infections, especially at high risk patients, ranging from allergic to invasive aspergillosis (IA). Among the pathogenic aspergilli, A. fumigatus, ranks the first etiologic agent implicated in aspergillosis. In the last two decades, however, a marked shift in the etiology of aspergillosis occurred led to emerge less common pathogens in diverse clinical settings including A. niger, A. tereus, and A. nidulans. The main reasons for this shift seems to be the frequent use of empirical therapy or antifungal prophylaxis. A. nidulans has been currently reported as a common etiologic agent of IA in patients with chronic granulomatosis disease (CGD). The use of amphotericin B (AMB) as empirical and the first line treatments in high risk patients and its low intrinsic susceptibility may be the main causes for increased incidence of infection by this species. The aim of this study was to assess the in vitro antifungal susceptibility of A. nidulans strains collected from different countries against nine antifungal agents. Materials and Methods: A total of 28 clinical and environmental isolates of A. nidulans collected from Iran and European countries including, The Netherlands, Portugal, and Greece were studied. These strains, which were previously determined morphologically, were subjected to molecular analysis of ß-tubulin gene. Subsequently, the minimum inhibitory concentration (MICS) of various antifungal agents including azoles (itraconazole (IZ), posaconazole (PZ), voriconazole (VZ), and isavaconazole (ISV), AMB, terbinafine (TB) and the minimal effective concentration (MECs) of the echinocandins (anidulafungin (AFG), caspofungin (CPF), and micafungin (MCF) was evaluated against these strains using of EUCAST guidelines of filamentous fungi. There is no ECV (epidemiological cutoff value) for aforementioned antifungals against A. nidulans, exception for IZ and ISV. Result: The results of sequence data due to ß-tubulin gene confirmed that all 28 isolates belonged to A. nidulans complex. According to the EUCAST-proposed breakpoints, a high MIC values for AMB (MIC=16 mg/L) was found in 25% of the clinical and environmental isolates of A. nidulans. The remaining isolates (67.9%) showed the MIC values of 1 mg/L (17.8%), 2 mg/L (35.7%), 4 mg/L (10.8%), and 8 mg/L (3.6%), respectively. Moreover, 25% of the isolates were resistant to IZ with MIC values between 2 mg/L and = 8 mg/L. TB exhibited a high MIC (>16.0mg/L) against 14.3% of the isolates. The MICs of >8.0 mg/L and >1.0 mg/L for VZ were also found in 10.7 and 3.6% isolates, respectively. Of note, 64.3% of all isolates were resistant to ISV with a MIC value of >0.5 mg/L. Compared to MCF and AFG, CPF showed higher MICs of 1.0 mg/L and 4.0 mg/L against 35.7% of the isolates. Conclusion: Our finding revealed a high rate of resistance of A. nidulans against main antifungal agents in treatment of aspergillosis. Our study also indicates that in vitro antifungal susceptibility, is necessary for establishing a response profile against the different classes of antifungals, in order to prevent the spread of antifungal-resistance isolates.
- Subjects
IRAN; ASPERGILLUS; CONFERENCES &; conventions; MICROBIAL sensitivity tests
- Publication
Current Medical Mycology, 2018, Vol 4, p103
- ISSN
2423-3439
- Publication type
Article
- DOI
10.18502/cmm.4.S1.2018.180