title: Triazole resistance in Aspergillus fumigatus isolates from patients with cystic fibrosis in Italy.
abstract: Aspergillus fumigatus is frequently recovered from respiratory secretions of cystic fibrosis (CF) patients. Azole resistance has been increasingly reported.
  
  
  
  To assess the prevalence of azole resistance in A. fumigatus isolates from patients followed by two CF centers of northern Italy.
  
  
  
  423 isolates (220 patients) were screened for azole resistance. Resistance was confirmed with the EUCAST method and cyp51A gene sequencing. Microsatellite genotyping was performed and results were compared with those of environmental resistant isolates.
  
  
  
  No resistance was detected in one center, while 8.2% of the patients of the other center harbored resistant isolates. The TR34/L98H alteration in the cyp51A gene, present in seven cases, resulted associated with poor in-vitro activity of all tested azoles.
  
  
  
  The environmental origin of the resistance seems to be probable since azole resistance was found also in naïve patients and an identical microsatellite genotype in clinical and environmental isolates was observed.
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Prigitano
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Esposto
authors.affiliation: Cystic Fibrosis Microbiology Laboratory and Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Via Francesco Sforza 35, 20122 Milano, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Biffi
authors.affiliation: Department of Agricultural and Environmental Sciences - Production, Landscape, Agroenergy, Università degli Studi di Milano, Via Celoria 2, 20133 Milano, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Lorenzis
authors.affiliation: Pathological Anatomy Unit, Department of Diagnostic and Public Health, Università di Verona, Policlinico G.B. Rossi - P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Favuzzi
authors.affiliation: Microbiology and Virology Unit, Department of Diagnostic and Public Health, Università di Verona, Policlinico G.B. Rossi - P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Koncan
authors.affiliation: Microbiology and Virology Operating Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata, Policlinico G.B. Rossi - P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Lo Cascio
authors.affiliation: Cystic Fibrosis Center, Azienda Ospedaliera Universitaria Integrata, Policlinico G.B. Rossi - P.le L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Marisol
authors.initials: M
authors.lastname: Barao Ocampo
authors.affiliation: Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via Francesco Sforza 35, 20122 Milano, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Colombo
authors.affiliation: Respiratory Disease Department, Cystic Fibrosis Center Adult Section, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Via Francesco Sforza 35, 20122 Milano, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pizzamiglio
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Romanò
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy. Electronic address: annamaria.tortorano@unimi.it.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Tortorano
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology; D001232:Aspergillus fumigatus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D025141:Drug Resistance, Fungal / Q000235:genetics; D004777:Environment; D005260:Female; D005656:Fungal Proteins / Q000235:genetics*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D017354:Point Mutation; D015995:Prevalence; D055732:Pulmonary Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D014230:Triazoles / Q000494:pharmacology*
chemical_list: D000935:Antifungal Agents; D005656:Fungal Proteins; D014230:Triazoles; D003577:Cytochrome P-450 Enzyme System; C465526:cytochrome P-450 CYP51A, Aspergillus
keywords: Aspergillus fumigatus; Azole resistance; Cystic fibrosis; Italy