Drug-Resistant Aspergillus flavus Is Highly Prevalent in the Environment of Vietnam: A New Challenge for the Management of Aspergillosis?

Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101671827 Publication Model: Electronic Cited Medium: Internet ISSN: 2309-608X (Electronic) Linking ISSN: 2309608X NLM ISO Abbreviation: J Fungi (Basel) Subsets: PubMed not MEDLINE

Original Publication: Basel, Switzerland : MDPI AG, [2015]-

The burden of aspergillosis, especially Chronic Pulmonary Aspergillosis, is increasingly recognized, and the increasing presence of azole-resistant environmental Aspergillus fumigatus has been highlighted as a health risk. However, a sizable minority of aspergillosis is caused by Aspergillus flavus , which is assumed to be sensitive to azoles but is infrequently included in surveillance. We conducted environmental sampling at 150 locations in a rural province of southern Vietnam. A. flavus isolates were identified morphologically, their identity was confirmed by sequencing of the beta-tubulin gene, and then they were tested for susceptibility to azoles and amphotericin B according to EUCAST methodologies. We found that over 85% of A. flavus isolates were resistant to at least one azole, and half of them were resistant to itraconazole. This unexpectedly high prevalence of resistance demands further investigation to determine whether it is linked to agricultural azole use, as has been described for A. fumigatus . Clinical correlation is required, so that guidelines can be adjusted to take this information into account.

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Keywords: Aspergillus flavus; azole resistance; environmental

Date Created: 20201121 Latest Revision: 20201226

20240628

PMC7711995

10.3390/jof6040296

33217930