title: First clinical isolation report of azole-resistant Aspergillus fumigatus with TR34/L98H-type mutation in Japan.
abstract: Recently, azole-resistant Aspergillus fumigatus containing a 34-bp or 46-bp tandem repeat in the promoter region of cyp51A combined with amino acid substitution(s) has appeared in the environment worldwide, including several Asian countries. In this study, we isolated the 34-bp tandem repeat-containing azole-resistant A. fumigatus strain OKH50 from a patient in Japan in May 2016. The patient had not been treated with medical azoles before the strain isolation, suggesting that the resistant property was acquired before infection. In addition, the patient had not traveled overseas. Our analysis of short tandem repeats of the strain indicates that the strain is strongly related to the 34-bp tandem repeat-containing isolates from European countries and Asia-Oceania countries but not to susceptible isolates from Japan, suggesting that the strain was introduced from overseas and might spread in Japan.
authors.affiliation: Diagnostic Center for Animal Health and Food Safety, Obihiro University of Agriculture and Veterinary Medicine, Nishi 2-11, Inada-cho, Obihiro, Hokkaido 080-8555, Japan; Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8673, Japan. Electronic address: tome@obihiro.ac.jp.
authors.forename: Takahito
authors.initials: T
authors.lastname: Toyotome
authors.affiliation: Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8673, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hagiwara
authors.affiliation: Department of Medical Technologist, Obihiro-Kosei General Hospital, West 6 South 8-1, Obihiro, Hokkaido 080-0016, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kida
authors.affiliation: First Department of Internal Medicine, Obihiro-Kosei General Hospital, West 6 South 8-1, Obihiro, Hokkaido 080-0016, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ogi
authors.affiliation: Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8673, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Medical Technologist, Obihiro-Kosei General Hospital, West 6 South 8-1, Obihiro, Hokkaido 080-0016, Japan.
authors.forename: Terumi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Department of Medical Technologist, Obihiro-Kosei General Hospital, West 6 South 8-1, Obihiro, Hokkaido 080-0016, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Komatsu
authors.affiliation: Division of Clinical Research, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8673, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kamei
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D001232:Aspergillus fumigatus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D001393:Azoles / Q000494:pharmacology*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000235:genetics*; D005656:Fungal Proteins / Q000235:genetics; D006801:Humans; D007564:Japan; D008297:Male; D009154:Mutation / Q000235:genetics; D055732:Pulmonary Aspergillosis / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology
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; Azole; TR(34)/L98H; cyp51A