ArticleAntimicrobial agents and chemotherapy2014
First detection of TR46/Y121F/T289A and TR34/L98H alterations in Aspergillus fumigatus isolates from azole-naive patients in Denmark despite negative findings in the environment.
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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Who cites it
48 citing papers in PubMed.
- Global epidemiology of azole resistance inJAC-antimicrobial resistance · 2026Review
- Repositioning Antimicrobial Peptides Against WHO-Priority Fungi.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Pathogenic Aspergillus spp. and Candida spp. in coastal waters from southern Brazil: an one health approach.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2025Article
- Comprehensive Review of Environmental Surveillance for Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- Land use drives drug resistance in an airborne human fungal pathogen.The ISME journal · 2025Article
- Understanding the clinical and environmental drivers of antifungal resistance in the One Health context.Microbiology (Reading, England) · 2024Review
- Environmental Hot Spots and Resistance-Associated Application Practices for Azole-Resistant Aspergillus fumigatus, Denmark, 2020-2023.Emerging infectious diseases · 2024Article
- Aspergillus Species Causing Invasive Fungal Disease in Queensland, Australia.Mycopathologia · 2023Article
- A Whole Genome Sequencing-Based Approach to Track down Genomic Variants in Itraconazole-Resistant Species ofJournal of fungi (Basel, Switzerland) · 2022Article
- Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications.The Journal of antimicrobial chemotherapy · 2022Review
- Azole resistance in Aspergillus fumigatus. The first 2-year's Data from the Danish National Surveillance Study, 2018-2020.Mycoses · 2022Article
- Genetic Diversity and Dispersal ofGenes · 2021Article
- Fungicide effects on human fungal pathogens: Cross-resistance to medical drugs and beyond.PLoS pathogens · 2021Review
- Selection and Amplification of Fungicide Resistance inMicroorganisms · 2021Review
- Long Terminal Repeat RetrotransposonAntimicrobial agents and chemotherapy · 2021Article
- Emerging Fungal Threats in Cystic Fibrosis.Mycopathologia · 2021Review
- Review
- Trends in Agricultural Triazole Fungicide Use in the United States, 1992-2016 and Possible Implications for Antifungal-Resistant Fungi in Human Disease.Environmental health perspectives · 2021Article
- Characterization ofApplied and environmental microbiology · 2021Article
- Absence of Azole Antifungal Resistance inJournal of fungi (Basel, Switzerland) · 2020Article
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9 authors.
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Abstract
Azole-resistant Aspergillus fumigatus harboring the TR34/L98H or TR46/Y121F/T289A alterations is increasingly found in Europe and Asia. Here, we present the first clinical cases of TR46/Y121/T289A and three cases of TR34/L98H outside the cystic fibrosis (CF) population in Denmark and the results of environmental surveys. Four patients (2012 to 2014) with 11 A. fumigatus and 4 Rhizomucor pusillus isolates and 239 soil samples (spring 2010 and autumn 2013, respectively) with a total of 113 A. fumigatus isolates were examined. Aspergillus isolates were screened for azole resistance using azole-containing agar. Confirmatory susceptibility testing was done using the EUCAST microbroth dilution EDEF 9.1 reference method. For relevant A. fumigatus isolates, CYP51A sequencing and microsatellite genotyping were performed. Three patients harbored TR34/L98H isolates. Two were azole naive at the time of acquisition and two were coinfected with wild-type A. fumigatus or R. pusillus isolates, complicating and delaying diagnosis. The TR46/Y121F/T289A strain was isolated in 2014 from a lung transplant patient. Genotyping indicated that susceptible and resistant Aspergillus isolates were unrelated and that no transmission between patients occurred. Azole resistance was not detected in any of the 113 soil isolates. TR34/L98H and TR46/Y121F/T289A alterations appear to be emerging in the clinical setting in Denmark and now involve azole-naive patients. Two recent soil-sampling surveys in Denmark were unable to indicate any increased prevalence of azole-resistant A. fumigatus in the environment. These findings further support the demand for real-time susceptibility testing of all clinically relevant isolates and for studies investigating the seasonal variation and ecological niches for azole-resistant environmental A. fumigatus.
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