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Inicio Enfermedades Infecciosas y Microbiología Clínica (English Edition) Prevalence and in vitro antifungal susceptibility of cryptic species of the genu...
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Vol. 37. Issue 5.
Pages 287-358 (May 2019)
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Vol. 37. Issue 5.
Pages 287-358 (May 2019)
Original article
DOI: 10.1016/j.eimce.2018.07.017
Prevalence and in vitro antifungal susceptibility of cryptic species of the genus Aspergillus isolated in clinical samples
Prevalencia y sensibilidad antifúngica in vitro de especies crípticas del género Aspergillus aisladas en muestras clínicas
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María Reyes Vidal-Acuñaa,
Corresponding author
kitana_1984@hotmail.com

Corresponding author.
, Maite Ruiza,b, María José Torresb,c,1, Javier Aznara,b,c,1
a Infectious Diseases, Clinical Microbiology and Preventive Medicine Unit, University Hospital Virgen del Rocío, Seville, Spain
b Instituto de Biomedicina de Sevilla (IBIS), University Hospital Virgen del Rocío, CSIC, University of Seville, Spain
c Molecular Microbiology Division, Microbiology Department, University of Seville, Spain
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Tables (3)
Table 1. Distribution of Aspergillus species (n=379) and number of isolates.
Table 2. Clinical relevance of Aspergillus spp. in different types of samples according to the information recorded in the medical history.
Table 3. Antifungal susceptibility of Aspergillus spp. recovered in this study.
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Abstract
Introduction

The genus Aspergillus contains more than 300 species, which are divided into closely related groups called sections. Molecular studies have revealed numerous cryptic species within different sections of this genus, which have different profiles of antifungal susceptibility and lack diagnostic morphological features. However, there are few studies on the prevalence and in vitro antifungal susceptibility of the cryptic species of this genus. The aim of this study was to investigate the distribution of Aspergillus spp. among clinical samples, and to study their in vitro susceptibility to different antifungal drugs.

Method

Over a period of 2-years (2014–2015), a total of 379 strains of the genus Aspergillus were isolated. Most of the isolates were classified as respiratory colonizations; no cases of invasive aspergillosis were found. The strains were identified by MALDI-TOF mass spectrometry, and susceptibility testing was performed by the EUCAST reference procedure.

Results

Twenty species belonging to 8 sections were identified, being A. fumigatus the most prevalent (44.1%). The prevalence of cryptic species was 15.3%, with a clear predominance of A. tubingensis. Among the tested antifungal drugs, amphotericin B was the less active in vitro, followed by triazole drugs and echinocandins. The cryptic species had minimun inhibitory concentrations (MICs) higher than the corresponding type species.

Conclusions

Accurate identification of the genus Aspergillus at the species level and in vitro antifungal susceptibility testing are necessary because, as it has been shown, some species of this genus may show resistance profiles against available antifungal drugs.

Keywords:
Aspergillus
Prevalence
Cryptic species
Antifungal susceptibility testing
Resumen
Introducción

El género Aspergillus contiene más de 300 especies, que se dividen en grupos estrechamente relacionados llamados secciones. Los estudios moleculares han revelado la existencia de numerosas especies crípticas dentro de las diferentes secciones de este género, las cuales tienen diferentes perfiles de sensibilidad antifúngica y carecen de características morfológicas diferenciales de diagnóstico. Sin embargo, hay pocos estudios sobre la prevalencia y la sensibilidad antifúngica in vitro de las especies crípticas de este género. El objetivo de este estudio fue investigar la distribución de Aspergillus spp. en muestras clínicas, y estudiar su sensibilidad in vitro a diferentes fármacos antimicóticos.

Métodos

Durante un período de 2 años (2014-2015), se aislaron un total de 379 cepas del género Aspergillus. La mayoría de los aislamientos se clasificaron como colonizaciones respiratorias; no encontrándose casos de aspergilosis invasiva. Las cepas se identificaron mediante espectrometría de masas MALDI-TOF, y las pruebas de sensibilidad antifúngica se realizaron mediante el procedimiento de referencia EUCAST.

Resultados

Se identificaron 20 especies pertenecientes a 8 secciones, siendo A. fumigatus la más prevalente (44,1%). La prevalencia de especies crípticas fue del 15,3%, con un claro predominio de A. tubingensis. Entre los fármacos antimicóticos probados, la anfotericina B fue la menos activa in vitro, seguida de los fármacos triazoles y las equinocandinas. Las concentraciones mínimas inhibitorias (CMIs) de los antifúngicos fueron más elevadas frente a las especies crípticas que frente a las especies tipo correspondientes.

Conclusiones

La identificación precisa de Aspergillus a nivel de especie y las pruebas de sensibilidad a antifúngicos in vitro son necesarias porque, como se ha demostrado, algunas especies de este género presentan diferentes perfiles de resistencia frente a los fármacos antimicóticos disponibles.

Palabras clave:
Aspergillus
Prevalencia
Especies crípticas
Prueba de sensibilidad antifúngica

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