Acquired resistance to voriconazole and itraconazole in a patient with pulmonary aspergilloma.
We describe the development of resistance in an Aspergillus fumigatus strain, originally sensitive to itraconazole and voriconazole, recovered from a case of pulmonary aspergilloma treated with voriconazole. A G448S mutation on the cyp51A gene was detected by sequencing. Frequent culture and in vitro antifungal susceptibility testing is suggested for early detection of the development of multi-azole resistance in patients on long-term therapy for A. fumigatus infections.
Bellete
Bahrie
B
Laboratoire de Parasitologie-Mycologie, CHU de Saint Etienne, Hôpital Nord, Saint Etienne, France.
Raberin
Helene
H
Morel
Jerome
J
Flori
Pierre
P
Hafid
Jamal
J
Manhsung
Roger Tran
RT
D019943:Amino Acid Substitution / Q000235:genetics; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000302:isolation & purification*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D005656:Fungal Proteins / Q000235:genetics; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D055732:Pulmonary Aspergillosis / Q000382:microbiology*; D011743:Pyrimidines / Q000494:pharmacology* / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D014230:Triazoles / Q000494:pharmacology* / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D004271:DNA, Fungal; D005656:Fungal Proteins; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D003577:Cytochrome P-450 Enzyme System; C465526:cytochrome P-450 CYP51A, Aspergillus; D065819:Voriconazole