title: Azole-resistant Aspergillus fumigatus due to TR46/Y121F/T289A mutation emerging in Belgium, July 2012.
abstract: A new azole resistance mechanism in Aspergillus fumigatus consisting of a TR46/Y121F/T289A alteration in the cyp51A gene was recently described in the Netherlands. Strains containing these mutations are associated with invasive infection and therapy failure. This communication describes the first case of fatal invasive aspergillosis caused by TR46/Y121F/T289A outside the Netherlands, in the neighboring country of Belgium, suggesting geographical spread. TR46/Y121F/T289A leads to a recognisable phenotypic susceptibility pattern which should trigger cyp51A genotyping to monitor further spread.
authors.affiliation: Catholic University of Leuven, Department of Microbiology and Immunology, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Vermeulen
authors.forename: J
authors.initials: J
authors.lastname: Maertens
authors.forename: H
authors.initials: H
authors.lastname: Schoemans
authors.forename: K
authors.initials: K
authors.lastname: Lagrou
mesh_terms: D001232:Aspergillus fumigatus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D001393:Azoles / Q000627:therapeutic use*; D001530:Belgium; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D026141:Drug Resistance, Multiple, Fungal; D005656:Fungal Proteins / Q000235:genetics*; D060005:Genotyping Techniques; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D009426:Netherlands; D020080:Tandem Repeat Sequences
chemical_list: D001393:Azoles; D005656:Fungal Proteins; D003577:Cytochrome P-450 Enzyme System; C465526:cytochrome P-450 CYP51A, Aspergillus