Clonal Expansion of Environmental Triazole Resistant Aspergillus fumigatus in Iran

Fatemeh Ahangarkani; Hamid Badali; Kiana Abbasi; Mojtaba Nabili; Sadegh Khodavaisy; Theun de Groot; Jacques F Meis

doi:10.3390/jof6040199

Clonal Expansion of Environmental Triazole Resistant Aspergillus fumigatus in Iran

J Fungi (Basel). 2020 Oct 1;6(4):199. doi: 10.3390/jof6040199.

Authors

Fatemeh Ahangarkani^{1

2}, Hamid Badali^{3

4}, Kiana Abbasi⁵, Mojtaba Nabili⁶, Sadegh Khodavaisy⁷, Theun de Groot¹, Jacques F Meis^{1

8

9}

Affiliations

¹ Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands.
² Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, 4815733971 Sari, Iran.
³ Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, 4815733971 Sari, Iran.
⁴ Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
⁵ Department of Microbiology, Zanjan Branch, Islamic Azad University, 4515658145 Zanjan, Iran.
⁶ Department of Medical Sciences, Sari Branch, Islamic Azad University, 4815733971 Sari, Iran.
⁷ Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, 1411734143 Tehran, Iran.
⁸ ECMM Excellence Center for Medical Mycology, Centre of Expertise in Mycology Radboudumc, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands.
⁹ Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, 80010 Curitiba, Paraná, Brazil.

Abstract

Azole-resistance in Aspergillus fumigatus is a worldwide medical concern complicating the management of aspergillosis (IA). Herein, we report the clonal spread of environmental triazole resistant A. fumigatus isolates in Iran. In this study, 63 A. fumigatus isolates were collected from 300 compost samples plated on Sabouraud dextrose agar supplemented with itraconazole (ITR) and voriconazole (VOR). Forty-four isolates had the TR₃₄/L98H mutation and three isolates a TR₄₆/Y121F/T289A resistance mechanism, while two isolates harbored a M172V substitution in cyp51A. Fourteen azole resistant isolates had no mutations in cyp51A. We found that 41 out of 44 A. fumigatus strains with the TR₃₄/L98H mutation, isolated from compost in 13 different Iranian cities, shared the same allele across all nine examined microsatellite loci. Clonal expansion of triazole resistant A. fumigatus in this study emphasizes the importance of establishing antifungal resistance surveillance studies to monitor clinical Aspergillus isolates in Iran, as well as screening for azole resistance in environmental A. fumigatus isolates.

Keywords: Aspergillus fumigatus; TR34/L98H; TR46/Y121F/T289A; azole resistance; compost.