Surveillance of Aspergillus section Nigri in a general hospital during two decades
Abstract number: P1099
Pelaez T., Gama B., Lopez Roa P., Espinel-Ingroff A., Gijon P., Escribano P., Alcala L., Guinea J., Muñoz P., Bouza E.
Background:Aspergillus fumigatus, A. flavus and A. niger cause >95% of invasive & non-invasive aspergillosis. However, antifungal susceptibilities for most species within the section Nigri have been poorly investigated; their identification and susceptibility profiles have clinical interest since 7 pts had invasive A. section Nigri aspergillosis at our institution.
Methods: A total 211 Aspergillus section Nigri strains (collection of the Hospital General Universitario Gregorio Marañón) were found since 1988 by reviewing clinical data. MICs were determined by the CLSI M38-A method with amphotericin B (AMB), itraconazole (IZ), voriconazole (VZ), posaconazole (POS), terbinafine (TB), caspofungin (CAS) and micafungin (MF). Modal MICs & epidemiological cut-off values (ECVs encompassing >95% of isolates) were obtained by defining wild-type (WT) distributions.
Results: The 211 Aspergillus section Nigri isolates were recovered between 19882009 from 184 patients (respiratory tract , ear , cutaneous , other sites ). MICs/MECs ranges/modes (mg/ml) were: AMB (0.54/1), IZ (0.12532/1), VZ (0.12532/0.5), POS (0.1252/0.5), TB (0.030.5/0.03), CAS (0.061/(0.06) and MF (0.060.125/0.06). ECVs & (% of isolates encompassed) were: AMB 2 (96.7%), IZ 2 (95.1%), VZ 2 (99.2%), POS 2 (99.2%), TB 0.25 (97.6), CAS 0.5 (97.6%) and MF (98.4%). Azole values were slightly higher than those for other Aspergillus spp. One strain of A. foetidus was highly resistant to azole drugs, it was isolated from one patient with chronic obstructive pulmonary disease.
Conclusions: During the study period, there was a significant increase of patients with Aspergillus of the Nigri group in our institution. These isolates exhibited lower susceptibility to azoles than other Aspergillus spp., but their susceptibilities were good to amphotericin B, echinocandins and terbinafine.
|Session name:||Abstracts of 21st ECCMID / 27th ICC|
|Location:||Milan, Italy, 7 - 10 May 2011|
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