First itraconazole resistant Aspergillus fumigatus clinical isolate harboring a G54E substitution in Cyp51Ap in South America.

LEONARDELLI, FLORENCIA; THEILL, LAURA; NARDIN, MARíA ELENA; MACEDO, DAIANA; DUDIUK, CATIANA; MENDEZ, EMILCE; GAMARRA, SOLEDAD; GARCIA, GUILLERMO

REVISTA IBEROAMERICANA DE MICOLOGIA

ASOCIACION ESPANOLA MICOLOGIA-AEM

Lugar: Londres; Año: 2017

1130-1406

Background: A 27-year-old male rural worker was hospitalized with a fungal keratitis due to a traumatism with a vegetal detritus. Materials and methods: Specimens for microscopy examination and culture were collected. The isolate was identified by morphological and molecular criteria. Susceptibility testing was done according to CLSI methods. CYP51A gene was PCR amplified and sequenced. Results: An Aspergillus fumigatus strain resistant to itraconazole (MIC > 8.0 ìg/ml) was isolated. The isolate was susceptible to amphotericin B, posaconazole, voriconazole and caspofungin. CYP51A sequencing showed two mutations leading on the G54E substitution. The patient received natamycin as treatment. Conclusions: This is the first report in South-America of a clinical A. fumigatus strain carrying the substitution G54E at Cyp51Ap linked for itraconazole resistance. Considering the patient was azole-naive, he might have acquired this resistant isolate from the environment.