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Drug Sensitivity and Resistance Mechanism in Aspergillus Section Nigri Strains from Japan
Aki Hashimoto1, Daisuke Hagiwara1, Akira Watanabe2
1Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, Japan.
Abstract:
Aspergillus niger and its related species, known as Aspergillus section Nigri, are ubiquitously distributed across the globe and are often isolated from clinical specimens. In Japan, Aspergillus section Nigri is second most often isolated from clinical specimens following Aspergillus fumigatus We determined the species of Aspergillus section Nigri isolated in Japan by DNA sequencing of partial β-tubulin genes and investigated drug susceptibility by the CLSI M38-A2 method. The collection contained 20 Aspergillus niger, 59 Aspergillus welwitschiae, and 39 Aspergillus tubingensis strains. Drug susceptibility testing revealed 30 to 55% of A. niger, 6.8 to 18.6% of A. welwitschiae, and 79.5 to 89.7% of A. tubingensis isolates to be less susceptible (so-called resistant) to itraconazole (ITC) and/or voriconazole (VRC) according to the epidemiologic cutoff values (ECVs) proposed for A. niger previously. MIC distributions of ITC or VRC showed no remarkable differences between clinical and environmental isolates. When the cyp51A sequences were compared between susceptible and resistant strains, 18 amino acid mutations were specific for resistant isolates of A. niger and A. tubingensis; however, none of them were confirmed to be associated with azole resistance. Three nonrelated A. welwitschiae isolates possessed a partial deletion in cyp51A, likely attributable to being more susceptible to azoles than other isolates. One of five ITC-resistant A. tubingensis isolates showed higher expression of cyp51A than did susceptible strains. Our results show that cyp51A point mutations may have no association with azole resistance but that in some cases the overexpression of cyp51A may lead to the azole resistance in these species.
Insights
Aspergillus section Nigri species, including Aspergillus niger, show varying azole resistance. While cyp51A mutations were not linked to resistance, overexpression of cyp51A may cause azole resistance in these fungi.
Area of Science:
- Medical Mycology
- Antifungal Drug Resistance
- Molecular Biology
Background:
- Aspergillus section Nigri species are common clinical isolates globally and in Japan.
- Understanding azole drug susceptibility in these fungi is crucial for effective treatment.
Purpose of the Study:
- To identify Aspergillus section Nigri species isolated in Japan.
- To investigate the drug susceptibility of these isolates to azole antifungals.
- To explore the role of the cyp51A gene in azole resistance.
Main Methods:
- Species identification using DNA sequencing of partial beta-tubulin genes.
- Antifungal drug susceptibility testing following CLSI M38-A2 guidelines.
- Analysis of cyp51A gene sequences and expression levels.
Main Results:
- A collection of 20 Aspergillus niger, 59 Aspergillus welwitschiae, and 39 Aspergillus tubingensis strains were analyzed.
- High rates of itraconazole and/or voriconazole resistance were observed in A. tubingensis (79.5-89.7%) and A. niger (30-55%).
- No association was found between cyp51A point mutations and azole resistance, but cyp51A overexpression was linked to resistance in some A. tubingensis isolates.
Conclusions:
- Aspergillus tubingensis and Aspergillus niger exhibit significant azole resistance.
- cyp51A gene overexpression, rather than point mutations, may be a mechanism for azole resistance in Aspergillus section Nigri.
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