Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets

Background: The global epidemiology of aspergillosis varies and is influenced by various factors. To elucidate the disease burden and identify effective control strategies, the epidemiological characteristics of Aspergillus infections have to be investigated. The aim of this study was to assess the...

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Main Authors: Wei Zhang, Hongxia Zhang, Minghua Zhan, Ran Jing, Xinsheng Wang, Zhihua Zhang
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034124003460
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author Wei Zhang
Hongxia Zhang
Minghua Zhan
Ran Jing
Xinsheng Wang
Zhihua Zhang
author_facet Wei Zhang
Hongxia Zhang
Minghua Zhan
Ran Jing
Xinsheng Wang
Zhihua Zhang
author_sort Wei Zhang
collection DOAJ
description Background: The global epidemiology of aspergillosis varies and is influenced by various factors. To elucidate the disease burden and identify effective control strategies, the epidemiological characteristics of Aspergillus infections have to be investigated. The aim of this study was to assess the epidemiological characteristics of various Aspergillus species, including their morphological features, species identification, and in vitro susceptibility to nine antifungal agents in a large tertiary hospital in northern China. Methods: Ninety-five clinical isolates of Aspergillus were collected from patients. Aspergillus species identification was performed using conventional morphological methods, MALDI-TOF MS, and gene sequencing. In vitro susceptibility to nine antifungal agents was evaluated using the Sensititre YeastOne system. Target genes (cyp51A and cyp51b) of A. tubinazole were sequenced using the Sanger method. Results: Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, Aspergillus tubingensis, and Aspergillus terreus were the most common isolated species. Rare species included Aspergillus tamarii, Aspergillus usamil, Aspergillus versicolor, Aspergillus udagawae, Aspergillus lentulus, Aspergillus sydowii, and Aspergillus quadrilineatus. Pulmonary infections accounted for 86.3 % (82/95) of collected cases, and the in-hospital mortality rate was 22.1 %. The median minimum inhibitory concentration (MIC) range of amphotericin B was 1.5–4 mg/L. The MIC range of triazoles against Aspergillus species, excluding Aspergillus udagawae and Aspergillus lentulus, was 0.12–0.5 mg/L. The median minimum effective concentration range of echinocandins was < 0.008–0.03 mg/L. Non-wild-type resistance to amphotericin B was observed in 29.6 % (16/54) of Aspergillus fumigatus isolates, and non-wild-type resistance to voriconazole was observed in 11.1 % (1/9) of Aspergillus tubingensis isolates. Moreover, CYP51A and CYP51b of Aspergillus tabinensis had 2–29 and 10–13 nucleotide mutations, respectively. Conclusion: Patients with non- Aspergillus fumigatus infection accounted for 43.2 %. The T256A amino acid substitution in CYP51A of Aspergillus tabinensis did not lead to increased azole drug MICs.
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spelling doaj-art-9ebaec2ead0943ed8f41a042de5a44b62024-12-29T04:47:02ZengElsevierJournal of Infection and Public Health1876-03412025-01-01181102612Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targetsWei Zhang0Hongxia Zhang1Minghua Zhan2Ran Jing3Xinsheng Wang4Zhihua Zhang5Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of ChinaClinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of ChinaBeijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China; Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of ChinaCentral Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of China; Corresponding authors.Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of China; Corresponding authors.Background: The global epidemiology of aspergillosis varies and is influenced by various factors. To elucidate the disease burden and identify effective control strategies, the epidemiological characteristics of Aspergillus infections have to be investigated. The aim of this study was to assess the epidemiological characteristics of various Aspergillus species, including their morphological features, species identification, and in vitro susceptibility to nine antifungal agents in a large tertiary hospital in northern China. Methods: Ninety-five clinical isolates of Aspergillus were collected from patients. Aspergillus species identification was performed using conventional morphological methods, MALDI-TOF MS, and gene sequencing. In vitro susceptibility to nine antifungal agents was evaluated using the Sensititre YeastOne system. Target genes (cyp51A and cyp51b) of A. tubinazole were sequenced using the Sanger method. Results: Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, Aspergillus tubingensis, and Aspergillus terreus were the most common isolated species. Rare species included Aspergillus tamarii, Aspergillus usamil, Aspergillus versicolor, Aspergillus udagawae, Aspergillus lentulus, Aspergillus sydowii, and Aspergillus quadrilineatus. Pulmonary infections accounted for 86.3 % (82/95) of collected cases, and the in-hospital mortality rate was 22.1 %. The median minimum inhibitory concentration (MIC) range of amphotericin B was 1.5–4 mg/L. The MIC range of triazoles against Aspergillus species, excluding Aspergillus udagawae and Aspergillus lentulus, was 0.12–0.5 mg/L. The median minimum effective concentration range of echinocandins was < 0.008–0.03 mg/L. Non-wild-type resistance to amphotericin B was observed in 29.6 % (16/54) of Aspergillus fumigatus isolates, and non-wild-type resistance to voriconazole was observed in 11.1 % (1/9) of Aspergillus tubingensis isolates. Moreover, CYP51A and CYP51b of Aspergillus tabinensis had 2–29 and 10–13 nucleotide mutations, respectively. Conclusion: Patients with non- Aspergillus fumigatus infection accounted for 43.2 %. The T256A amino acid substitution in CYP51A of Aspergillus tabinensis did not lead to increased azole drug MICs.http://www.sciencedirect.com/science/article/pii/S1876034124003460EpidemiologyGene mutationDrug resistance mechanismAntifungal susceptibilitySanger sequencing
spellingShingle Wei Zhang
Hongxia Zhang
Minghua Zhan
Ran Jing
Xinsheng Wang
Zhihua Zhang
Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
Journal of Infection and Public Health
Epidemiology
Gene mutation
Drug resistance mechanism
Antifungal susceptibility
Sanger sequencing
title Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
title_full Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
title_fullStr Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
title_full_unstemmed Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
title_short Epidemiological characteristics of invasive Aspergillus isolates: Morphology, drug susceptibility, and mutations in azole drug targets
title_sort epidemiological characteristics of invasive aspergillus isolates morphology drug susceptibility and mutations in azole drug targets
topic Epidemiology
Gene mutation
Drug resistance mechanism
Antifungal susceptibility
Sanger sequencing
url http://www.sciencedirect.com/science/article/pii/S1876034124003460
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