Home Environment as a Source of Life-Threatening Azole-Resistant Aspergillus fumigatus in Immunocompromised Patients

Clin Infect Dis. 2017 Jan 1;64(1):76-78. doi: 10.1093/cid/ciw664. Epub 2016 Sep 28.

Abstract

A case of fatal aspergillosis due to a TR46/Y121F/T289A azole-resistant Aspergillus fumigatus is reported. Environmental investigations at the patient's residence led to the recovery of TR46/Y121F/T289A isolates, genotypically indistinguishable from the clinical isolate, supporting for the first time the direct role of household as potential source of azole-resistant invasive aspergillosis.

Keywords: Aspergillus fumigatus; TR46/Y121F/T289A; azole resistance; environment; invasive aspergillosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Aspergillosis / drug therapy*
  • Aspergillosis / etiology*
  • Aspergillus fumigatus / drug effects*
  • Aspergillus fumigatus / genetics
  • Azoles / pharmacology
  • Azoles / therapeutic use*
  • Cytochrome P-450 Enzyme System / genetics
  • Drug Resistance, Fungal*
  • Fatal Outcome
  • Fungal Proteins / genetics
  • Humans
  • Immunocompromised Host*
  • Infliximab / adverse effects
  • Infliximab / therapeutic use
  • Microbial Sensitivity Tests
  • Mutation

Substances

  • Antifungal Agents
  • Azoles
  • Fungal Proteins
  • Cytochrome P-450 Enzyme System
  • Infliximab
  • cytochrome P-450 CYP51A, Aspergillus