Appearance of Environment-Linked Azole Resistance in the Aspergillus fumigatus Complex in New Zealand.

IF 3.1 2区医学 Q1 DERMATOLOGY

Mycoses Pub Date : 2025-08-01 DOI:10.1111/myc.70104

Arthur J Morris, Wendy P McKinney, Sally A Roberts, Sasiharan Sithamparanathan, Zain Chaudhry, Matthew C Fisher

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Abstract

Background: Until 2020, azole resistance in Aspergillus fumigatus complex isolates in New Zealand was due to cyp51A hot spot mutations. This report details the appearance of environment-linked tandem repeat (TR)-related azole resistance genotypes since 2021.

Methods: Isolates were tested by broth micro-dilution. Clinical Laboratory Standards Institute criteria were used to define wild type (WT) and non-wild type (non-WT) isolates, which were identified by ß-tubulin gene sequencing and had their cyp51A genotype for azole resistance determined. Whole genome sequencing (WGS) was applied to two patient pairs of sequential WT and non-WT isolates.

Results: From January 2021 to June 2024, 15 of 147 (10.2%) A. fumigatus complex isolates were resistant or non-WT for one or more azole agents. Genotyping detected hot spot mutations in four and TR-associated resistance in nine. No mutations were detected in two isolates. Four of the five TR₄₆ mutations were TR₄₆/Y121F/T289A. Three of the four TR₃₄ mutations were different. WGS of the paired isolates showed that the non-WT isolates were distinct. Azole-containing fungicides are available for home use from garden centres. Patients with TR-associated resistance did not have any obvious exposure to azole-containing fungicides. There was no evidence for healthcare-acquired transmission.

Conclusions: A. fumigatus sensu stricto isolates with TR-mutations linked to environmental resistance are now present in New Zealand. Those at risk of invasive A. fumigatus infection should receive advice to avoid high-risk exposures. Reintroducing monitoring of azole-containing fungicides is recommended.

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新西兰烟曲霉复合体环境连锁唑抗性的出现。

背景：直到2020年，新西兰烟曲霉复合分离物的抗唑性是由于cyp51A热点突变。本报告详细介绍了自2021年以来环境连锁串联重复序列（TR）相关的唑类耐药基因型的出现。方法：采用微量肉汤稀释法对分离菌株进行检测。采用临床实验室标准学会的标准定义野生型（WT）和非野生型（non-WT）分离株，并通过ß-微管蛋白基因测序对其进行鉴定，并测定其cyp51A基因型对唑的耐药性。全基因组测序（WGS）应用于连续WT和非WT分离的两对患者。结果：2021年1月至2024年6月，147株烟曲霉复合菌株中有15株（10.2%）对一种或多种唑类药物耐药或无wt；基因分型检测到4例热点突变，9例耐药。两个分离株未检测到突变。5个TR46突变中有4个是TR46/Y121F/T289A。四个TR34突变中有三个是不同的。配对菌株的WGS结果表明，非wt菌株具有明显的差异。含唑的杀菌剂可在花园中心购买，供家庭使用。耐药耐药患者没有明显暴露于含唑杀菌剂。没有证据表明存在卫生保健获得性传播。结论：新西兰目前存在与环境抗性相关的tr突变的严格感烟曲霉分离株。那些有侵袭性烟殖梭菌感染风险的人应接受建议，避免高风险接触。建议重新引入对含唑杀菌剂的监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mycoses 医学-皮肤病学

CiteScore

10.00

自引率

8.20%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The journal Mycoses provides an international forum for original papers in English on the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans as well as on the biology of pathogenic fungi. Medical mycology as part of medical microbiology is advancing rapidly. Effective therapeutic strategies are already available in chemotherapy and are being further developed. Their application requires reliable laboratory diagnostic techniques, which, in turn, result from mycological basic research. Opportunistic mycoses vary greatly in their clinical and pathological symptoms, because the underlying disease of a patient at risk decisively determines their symptomatology and progress. The journal Mycoses is therefore of interest to scientists in fundamental mycological research, mycological laboratory diagnosticians and clinicians interested in fungal infections.