Abstract
A new azole resistance mechanism in Aspergillus fumigatus consisting of a TR46/Y121F/T289A alteration in the cyp51A gene was recently described in the Netherlands. Strains containing these mutations are associated with invasive infection and therapy failure. This communication describes the first case of fatal invasive aspergillosis caused by TR46/Y121F/T289A outside the Netherlands, in the neighboring country of Belgium, suggesting geographical spread. TR46/Y121F/T289A leads to a recognisable phenotypic susceptibility pattern which should trigger cyp51A genotyping to monitor further spread.
Publication types
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Case Reports
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Comparative Study
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Research Support, Non-U.S. Gov't
MeSH terms
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Aspergillus fumigatus / drug effects
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Aspergillus fumigatus / genetics*
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Aspergillus fumigatus / isolation & purification
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Azoles / therapeutic use*
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Belgium
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Cytochrome P-450 Enzyme System / genetics*
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Drug Resistance, Multiple, Fungal*
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Fungal Proteins / genetics*
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Genotyping Techniques
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Humans
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Invasive Pulmonary Aspergillosis / diagnosis*
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Invasive Pulmonary Aspergillosis / drug therapy
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Invasive Pulmonary Aspergillosis / genetics
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Male
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Microbial Sensitivity Tests
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Middle Aged
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Mutation
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Netherlands
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Tandem Repeat Sequences
Substances
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Azoles
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Fungal Proteins
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Cytochrome P-450 Enzyme System
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cytochrome P-450 CYP51A, Aspergillus