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Volume 17, Number 10—October 2011

CME ACTIVITY - Research

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

Jan W.M. van der LindenComments to Author , 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, and Kuijper

Author affiliations: Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands (J.W.M. van der Linden, E. Snelders, W.J.G. Melchers, P.E. Verweij); Groningen University Medical Centre, Groningen, the Netherlands (G.A. Kampinga); Erasmus Medical Centre, Rotterdam, the Netherlands (B.J.A. Rijnders); Utrecht University Medical Centre, Utrecht, the Netherlands (E. Mattsson); Vrije University Medical Centre, Amsterdam, the Netherlands (Y.J. Debets-Ossenkopp); Leiden University Medical Centre, Leiden, the Netherlands (E.J. Kuijper); Maastricht University Medical Centre, Maastricht, the Netherlands (F.H. van Tiel)

Main Article

Table 2

Characteristics of itraconazole-positive Aspergillus fumigatus isolates, the Netherlands, 2007–2009*

No. isolates Mutations in the Cyp51A gene Median MIC, mg/L (range)
Itraconazole Voriconazole Posaconazole
74 TR/L98H† >16 (16–>16) 8 (1–16) 0.5 (0.25–2)
1 G54W† >16 0.5 >16
1 P216L† 16 2 0.5
1 F219I† >16 0.25 0.25
1 Series‡ >16 >16 1
4 None >16 (16–>16) 4 (0.5–4) 0.2 (0.125–1)

*In vitro susceptibility testing was performed according to the Clinical and Laboratory Standards Institute M38A2 method (32).
†Mutations that have previously been shown to be associated with azole resistance in A. fumigatus (7,20,21).
‡Series of mutations in Cyp51A-gene: F46Y, G89G, M172V, N248T, D255E, L358L, E427K, and C454C (8).

*In vitro susceptibility testing was performed according to the Clinical and Laboratory Standards Institute M38A2 method (32).
†Mutations that have previously been shown to be associated with azole resistance in A. fumigatus (7,20,21).
‡Series of mutations in Cyp51A-gene: F46Y, G89G, M172V, N248T, D255E, L358L, E427K, and C454C (8).

*In vitro susceptibility testing was performed according to the Clinical and Laboratory Standards Institute M38A2 method (32).
†Mutations that have previously been shown to be associated with azole resistance in A. fumigatus (7,20,21).
‡Series of mutations in Cyp51A-gene: F46Y, G89G, M172V, N248T, D255E, L358L, E427K, and C454C (8).

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