In vitro survey of triazole cross-resistance among more than 700 clinical isolates of Aspergillus species

M A Pfaller; S A Messer; L Boyken; C Rice; S Tendolkar; R J Hollis; D J Diekema

doi:10.1128/JCM.00535-08

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In vitro survey of triazole cross-resistance among more than 700 clinical isolates of Aspergillus species

Journal article

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In vitro survey of triazole cross-resistance among more than 700 clinical isolates of Aspergillus species

M A Pfaller, S A Messer, L Boyken, C Rice, S Tendolkar, R J Hollis and D J Diekema

Journal of clinical microbiology, Vol.46(8), pp.2568-2572

08/2008

DOI: 10.1128/JCM.00535-08

PMCID: PMC2519461

PMID: 18562581

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Abstract

Few data exist to describe in vitro patterns of cross-resistance among large collections of clinical Aspergillus isolates, including those of species other than Aspergillus fumigatus. We examined 771 Aspergillus spp. clinical isolates collected from 2000 to 2006 as part of a global antifungal surveillance program (553 A. fumigatus, 76 A. flavus, 59 A. niger, 35 A. terreus, and 24 A. versicolor isolates and 24 isolates of other Aspergillus species). Antifungal susceptibility testing was performed by the Clinical and Laboratory Standards Institute (CLSI) M38-A broth dilution method with itraconazole (ITR), posaconazole (POS), ravuconazole (RAV), and voriconazole (VOR). We examined the potential for cross-resistance by using measures of correlation overall and by species. For most Aspergillus isolates (from 88% of isolates for ITR to 98% of isolates for VOR and POS), MICs of each triazole were < or = 1 microg/ml. When all 771 isolates were examined, there were statistically significant correlations for all six triazole-triazole pairs. For A. fumigatus, the strongest correlations seen were those between VOR and RAV MICs (r = 0.7) and ITR and POS MICs (r = 0.4). Similarly, for A. flavus, only VOR and RAV MICs and ITR and POS MICs demonstrated statistically significant positive correlations. We have demonstrated correlations among triazole MICs for Aspergillus, which for the most common species (A. fumigatus and A. flavus) were strongest between VOR and RAV MICs and ITR and POS MICs. However, Aspergillus species for which MICs of VOR or POS were >2 microg/ml remain extremely rare (<1% of isolates).

Antifungal Agents - pharmacology

Microbial Sensitivity Tests

Triazoles - pharmacology

Aspergillus - classification

Humans

Aspergillosis - microbiology

Aspergillus - isolation & purification

Statistics as Topic

Drug Resistance, Fungal

Aspergillus - drug effects

Details

Title: Subtitle: In vitro survey of triazole cross-resistance among more than 700 clinical isolates of Aspergillus species
Creators: M A Pfaller - Departments of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA. michael-pfaller@uiowa.edu
S A Messer
L Boyken
C Rice
S Tendolkar
R J Hollis
D J Diekema
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.46(8), pp.2568-2572
DOI: 10.1128/JCM.00535-08
PMID: 18562581
PMCID: PMC2519461
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 08/2008
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986371902771

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