Volume 15, Number 7—July 2009
Frequency and Evolution of Azole Resistance in Aspergillus fumigatus Associated with Treatment Failure1
|Cyp51A codon||No. patients||No. isolates||Amino acid substitutions||MIC, mg/L†
|G54||4||5||E, R, V||>8||0.125–1||1–>8|
*RMLM, Regional Mycology Laboratory Manchester; TR, tandem repeat in cyp51A promoter; NA, not applicable. Synonymous mutations not shown. Some mutations are associated with resistance but may not be causal (see text).
†Putative cut-off values for resistance are itraconazole and voriconazole >2 mg/L and posaconazole >0.5 mg/L.
‡F46Y found with M172V and E427K in 4 isolates along with 3 silent mutations. E427G seen alone in 1 isolate. N248 and D255 found in combination with 46/172/427 in 1 isolate.
§Found with G448S in 1 of 2 isolates.
1These data were presented in part at the 2nd Advances Against Aspergillosis meeting, February 22–26, 2006, Athens, Greece; and 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, September 27–30, 2006, San Francisco, CA, USA.