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Azole-Resistant Aspergillus fumigatus Harboring the TR34/L98H Mutation: First Report in Portugal in Environmental Samples

2020-12-28Journal article Open access
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dc.contributor.authorGonçalves, Paulo
dc.contributor.authorMelo, Aryse
dc.contributor.authorDias, Marta
dc.contributor.authorAlmeida, Beatriz
dc.contributor.authorCaetano, Liliana Aranha
dc.contributor.authorVeríssimo, Cristina
dc.contributor.authorViegas, Carla
dc.contributor.authorSabino, Raquel
dc.date.accessioned2021-03-09T15:30:19Z
dc.date.available2021-03-09T15:30:19Z
dc.date.issued2020-12-28
dc.description.abstractIntroduction: The frequency in detection of azole-resistant Aspergillus fumigatus isolates has increased since 2010. In Portugal, the section Fumigati is one of the most frequent, and resistant strains to have been found in clinical and environmental contexts. Although several cryptic species within the Fumigati section show intrinsic resistance to azoles, one factor driving (acquired) resistance is selective pressure deriving from the extensive use of azoles. This is particularly problematic in occupational environments where high fungal loads are expected, and where there is an increased risk of human exposure and infection, with impact on treatment success and disease outcome. The mechanisms of resistance are diverse, but mainly associated with mutations in the cyp51A gene. Despite TR34/L98H being the most frequent mutation described, it has only been detected in clinical specimens in Portugal. Methods: We analyzed 99 A. fumigatus isolates from indoor environments (healthcare facilities, spas, one dairy and one waste sorting unit) collected from January 2018 to February 2019 in different regions of Portugal. Isolates were screened for resistance to itraconazole, voriconazole and posaconazole by culture, and resistance was confirmed by broth microdilution. Sequencing of the cyp51A gene and its promoter was performed to detect mutations associated with resistance. Results: Overall, 8.1% of isolates were able to grow in the presence of at least one azole, and 3% (isolated from the air in a dairy and from filtering respiratory protective devices in a waste sorting industry) were pan-azole-resistant, bearing the TR34/L98H mutation. Conclusion: For the first time in Portugal, we report environmental isolates bearing the TR34/L98H mutation, isolated from occupational environments. Environmental surveillance of the emergence of azole-resistant A. fumigatus sensu stricto strains is needed, to ensure proper and timely implementation of control policies that may have a positive impact on public and occupational health.pt_PT
dc.description.sponsorshipThis work was supported by: FCT—Fundação para Ciência e Tecnologia, for funding the project “EXPOsE—Establishing protocols to assess occupational exposure to microbiota in clinical settings” (02/SAICT/2016—Project no. 23222); Instituto Politécnico de Lisboa, Lisboa, Portugal, for funding the project “Waste Workers’ Exposure to Bio-burden through Filtering Respiratory Protective Devices” (IPL/2018/WasteFRPD_ESTeSL); and by Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal, for funding the project “Programa de Vigilância de Aspergillus”.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMicroorganisms. 2020 Dec 28;9(1):57. doi: 10.3390/microorganisms9010057pt_PT
dc.identifier.doi10.3390/microorganisms9010057pt_PT
dc.identifier.issn2076-2607
dc.identifier.urihttp://hdl.handle.net/10400.18/7368
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relation«sEpt_PT
dc.relation.publisherversionhttps://www.mdpi.com/2076-2607/9/1/57pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAspergillus fumigatuspt_PT
dc.subjectAzolespt_PT
dc.subjectAntifungal Resistancept_PT
dc.subjectCyp51A Genept_PT
dc.subjectEnvironmentpt_PT
dc.subjectOccupational Exposurept_PT
dc.subjectInfecções Sistémicas e Zoonosespt_PT
dc.subjectPortugalpt_PT
dc.titleAzole-Resistant Aspergillus fumigatus Harboring the TR34/L98H Mutation: First Report in Portugal in Environmental Samplespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage57pt_PT
oaire.citation.titleMicroorganismspt_PT
oaire.citation.volume9pt_PT
rcaap.embargofctAcesso de acordo com página web do editor da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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