title: Prospective evaluation of azole resistance in Aspergillus fumigatus clinical isolates in France.
abstract: OBJECTIVE
  Several studies, especially in Europe, have recently reported the emerging phenomenon of azole resistance in Aspergillus fumigatus, but very few data are available in France. Our study aimed to determine the resistance prevalence in A. fumigatus isolates recovered from clinical samples over a 1-year period in two university hospital centers.
  
  
  METHODS
  All A. fumigatus isolates were screened for azole resistance using RPMI agar plates supplemented with itraconazole and voriconazole. Resistance was then confirmed by the EUCAST method. A part of the beta-tubulin gene was amplified for resistant isolates to confirm the A. fumigatus species, and the Cyp51A gene and its promoter were afterward sequenced to detect mutations potentially responsible for this resistance.
  
  
  RESULTS
  One hundred sixty-five A. fumigatus isolates were recovered from 134 patients. Three isolates recovered from three patients were found resistant with MICs of >8 mg/l, 4 mg/l, and 1 mg/l for itraconazole, voriconazole, and posaconazole, respectively. The TR34/L98H mutation, previously and largely described in other countries, was detected in the three isolates.
  
  
  CONCLUSIONS
  Our study demonstrated the occurrence of azole resistance among unselected A. fumigatus clinical isolates, with an overall prevalence of 1.8%.
authors.affiliation: Unité de Parasitologie-Mycologie, Service de Microbiologie, DHU VIC, APHP; Hôpital Henri Mondor, Créteil, France Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Choukri
authors.affiliation: Unité de Parasitologie-Mycologie, Service de Microbiologie, DHU VIC, APHP; Hôpital Henri Mondor, Créteil, France Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Botterel
authors.affiliation: Unité de Parasitologie-Mycologie, Service de Microbiologie, DHU VIC, APHP; Hôpital Henri Mondor, Créteil, France Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France.
authors.forename: E
authors.initials: E
authors.lastname: Sitterlé
authors.affiliation: Centre Hospitalier Intercommunal Créteil, Service de Pneumologie, Créteil, France.
authors.forename: L
authors.initials: L
authors.lastname: Bassinet
authors.affiliation: Unité de Parasitologie-Mycologie, Service de Microbiologie, DHU VIC, APHP; Hôpital Henri Mondor, Créteil, France Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Foulet
authors.affiliation: Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France Unité de Parasitologie-Mycologie, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France.
authors.forename: J
authors.initials: J
authors.lastname: Guillot
authors.affiliation: Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France Laboratoire Cerba, Saint Ouen L'Aumône, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Costa
authors.affiliation: Laboratoire de Microbiologie, Centre Hospitalier Intercommunal Créteil, Créteil, France.
authors.forename: N
authors.initials: N
authors.lastname: Fauchet
authors.affiliation: Dynamyc Research Group, UPEC, EnvA, UPE, Créteil, France Unité de Parasitologie-Mycologie, Service de Microbiologie, Université Paris-Descartes; Faculté de Médecine; APHP; Hôpital Européen Georges Pompidou, Paris, France eric.dannaoui@egp.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Dannaoui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D001228:Aspergillosis / Q000453:epidemiology / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000235:genetics; D001393:Azoles / Q000494:pharmacology*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000235:genetics*; D005602:France / Q000453:epidemiology; D005656:Fungal Proteins / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D005656:Fungal Proteins; D003577:Cytochrome P-450 Enzyme System; C465526:cytochrome P-450 CYP51A, Aspergillus
keywords: Aspergillus fumigatus; Cyp51A; TR34/L98H; azole resistance