First Investigative Study of Azole-Resistant in the Environment in Burkina Faso.

Azole-resistant (ARAF) strains have been reported on all continents, however, limited data exist on these strains in Africa, while several factors, mainly environmental ones, suggest their presence on this continent. This study aimed to assess the environmental prevalence of ARAF strains in Burkina Faso, a country situated in the West African region where data on ARAF is non-existent. In total, 120 environmental samples (soil) were collected and analyzed. Samples were screened for resistance using three azole-containing agar plates; one without azole antifungal (growth control) and two supplemented with either itraconazole (4 mg/L) or voriconazole (2 mg/L). The EUCAST susceptibility testing method was used to confirm the azole-resistant phenotype of sensu-stricto isolates. Mutations in the gene were determined by sequencing. Of the 120 samples, 51 positive samples showed growth of isolates on control medium. One ARAF (2%; 1/51) isolate was found amongst positive samples and harbored the F46Y/M172V/E427K mutations. No TR34/L98H or TR46/Y121F/T289A mutations were observed. Our study described the first isolate resistant to an azole antifungal in Burkina Faso.