TY - JOUR
T1 - Clinical implications of azole resistance in Aspergillus fumigatus, The Netherlands, 2007-2009
AU - van der Linden, Jan W.M.
AU - Snelders, Eveline
AU - Kampinga, Greetje A.
AU - Rijnders, Bart J.A.
AU - Mattsson, Eva
AU - Debets-Ossenkopp, Yvette J.
AU - Kuijper, Ed J.
AU - van Tiel, Frank H.
AU - Melchers, Willem J.G.
AU - Verweij, Paul E.
PY - 2011/10
Y1 - 2011/10
N2 - The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azoleresistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate among patients with invasive aspergillosis.
AB - The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azoleresistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate among patients with invasive aspergillosis.
U2 - 10.3201/eid1710.110226
DO - 10.3201/eid1710.110226
M3 - Article
AN - SCOPUS:84930481483
VL - 17
SP - 1846
EP - 1854
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
SN - 1080-6040
IS - 10
ER -
