is the leading cause of invasive aspergillosis. Treatment is hindered by the emergence of resistance to triazole antimycotic agents. Here, we present the prevalence of triazole resistance among clinical isolates at a major centralized medical mycology laboratory in London, United Kingdom, in the period 1998-2017. A large number ( = 1469) of clinical isolates from unselected clinical specimens were identified and their susceptibility against three triazoles, amphotericin B and three echinocandin agents was carried out. All isolates were identified phenotypically and antifungal susceptibility testing was carried out by using a standard broth microdilution method. Retrospective surveillance (1998-2011) shows 5/1151 (0.43%) isolates were resistant to at least one of the clinically used triazole antifungal agents. Prospective surveillance (2015-2017) shows 7/356 (2.2%) isolates were resistant to at least one triazole antifungals demonstrating an increase in incidence of triazole-resistant in our laboratory. Among five isolates collected from 2015 to 2017 and available for molecular testing, three harbored TR/L98H alteration in the gene that are associated with the acquisition of resistance in the non-patient environment. These data show that historically low prevalence of azole resistance may be increasing, warranting further surveillance of susceptible patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158360 | PMC |
| http://dx.doi.org/10.3389/fmicb.2018.02234 | DOI Listing |
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