Clinical Implications of Azole Resistance in Aspergillus fumigatus, the Netherlands, 2007–2009

The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%–9.5%). Patients wi... Mehr ...

Verfasser: Jan W.M. van der Linden
Eveline Snelders
Greetje A. Kampinga
Bart J.A. Rijnders
Eva Mattsson
Yvette J. Debets-Ossenkopp
Ed J. Kuijper
Frank H. Van Tiel
Willem J.G. Melchers
Paul E. Verweij
Dokumenttyp: Artikel
Erscheinungsdatum: 2011
Reihe/Periodikum: Emerging Infectious Diseases, Vol 17, Iss 10, Pp 1846-1854 (2011)
Verlag/Hrsg.: Centers for Disease Control and Prevention
Schlagwörter: Aspergillosis / fungal infections / aspergillus / antifungal drug resistance / outcome assessment / prevalence / Medicine / R / Infectious and parasitic diseases / RC109-216
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29586656
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.3201/eid1710.110226

The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%–9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azole-resistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate for patients with invasive aspergillosis.