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Nationwide Surveillance of Azole Resistance in Aspergillus Diseases

Edith Vermeulen1, Johan Maertens2, Annelies De Bel3

  • 1Department of Microbiology and Immunology, Catholic University Leuven, Leuven, Belgium.

Antimicrobial Agents and Chemotherapy
|May 20, 2015
PubMed

Insights

Azole resistance in Aspergillus diseases is uncommon, affecting 5.5% of patients. This study found limited clinical impact of azole resistance in Belgian patients with various Aspergillus conditions.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Epidemiology

Background:

  • Aspergillus diseases impact diverse patient groups, including those with asthma and immunocompromised individuals.
  • Increasing reports of azole resistance in Aspergillus strains necessitate understanding its prevalence and clinical significance.
  • Data on azole resistance in different patient populations with Aspergillus disease is currently limited.

Purpose of the Study:

  • To determine the epidemiological data of azole resistance in Aspergillus diseases within Belgium.
  • To assess the prevalence and clinical impact of azole resistance across various Aspergillus-related conditions.

Main Methods:

  • A 1-year prospective multicenter cohort study involving 18 hospitals in Belgium.
  • Collection of 220 Aspergillus isolates from 182 patients for susceptibility testing.
  • Clinical data and treatment information were gathered via questionnaires, with outcomes tracked for 1 year.

Main Results:

  • The overall prevalence of azole resistance was 5.5% (95% CI, 2.8 to 10.2%).
  • Azole resistance was 7.0% in patients with allergic bronchopulmonary aspergillosis, bronchitis, aspergilloma, or chronic aspergillosis, and 4.6% in invasive aspergillosis.
  • Azole resistance was detected in only 2 of 58 deceased patients with invasive aspergillosis, suggesting a limited clinical impact.

Conclusions:

  • The prevalence of azole resistance in Aspergillus diseases in Belgium was found to be relatively low during the study period.
  • The clinical impact of azole resistance, particularly in invasive aspergillosis, appeared limited in this patient cohort.
  • Further monitoring is warranted to track trends in azole resistance and its clinical implications in Aspergillus diseases.

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