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. 2012 Sep 15;206(6):981-5.
doi: 10.1093/infdis/jis442. Epub 2012 Jul 10.

In vivo emergence of Aspergillus terreus with reduced azole susceptibility and a Cyp51a M217I alteration

Maiken C Arendrup  1 , Rasmus H Jensen, Katharina Grif, Marianne Skov, Tacjana Pressler, Helle K Johansen, Cornelia Lass-Flörl
Affiliations

In vivo emergence of Aspergillus terreus with reduced azole susceptibility and a Cyp51a M217I alteration

Maiken C Arendrup et al. J Infect Dis. .

Abstract

Azole resistance in Aspergillus terreus isolates was explored. Twenty related (MB) and 6 unrelated A. terreus isolates were included. CYP51A sequencing and RAPD genotyping was performed. Five MB isolates were itraconazole susceptible, whereas the minimum inhibitory concentrations (MICs) for 15 MB isolates were elevated (1-2 mg/L). Voriconazole and posaconazole MICs were 0.5-4 and 0.06-0.5 mg/L, respectively, for MB isolates but 0.25-0.5 and <0.03-0.06 mg/L, respectively, for controls. Sequencing identified a Cyp51Ap M217I alteration in all 15 isolates with elevated itraconazole MICs. Genotyping showed that 18 of 20 MB isolates were identical and unique, suggesting endogenous origin. In conclusion, itraconazole resistance in A. terreus was linked to an M217I Cyp51A alteration.

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