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Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes
Resistance of the human pathogenic fungus Aspergillus fumigatus to antifungal agents is on the rise. However, links between patient infections, their potential acquisition from local environmental sources, and links to global diversity remain cryptic. Here, we used genotyping analyses using nine mic...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512841/ https://www.ncbi.nlm.nih.gov/pubmed/34660341 http://dx.doi.org/10.3389/fcimb.2021.729476 |
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author | Rocchi, Steffi Sewell, Thomas R. Valot, Benoit Godeau, Chloé Laboissiere, Audrey Millon, Laurence Fisher, Matthew C. |
author_facet | Rocchi, Steffi Sewell, Thomas R. Valot, Benoit Godeau, Chloé Laboissiere, Audrey Millon, Laurence Fisher, Matthew C. |
author_sort | Rocchi, Steffi |
collection | PubMed |
description | Resistance of the human pathogenic fungus Aspergillus fumigatus to antifungal agents is on the rise. However, links between patient infections, their potential acquisition from local environmental sources, and links to global diversity remain cryptic. Here, we used genotyping analyses using nine microsatellites in A. fumigatus, in order to study patterns of diversity in France. In this study, we genotyped 225 local A. fumigatus isolates, 112 azole susceptible and 113 azole resistant, collected from the Bourgogne-Franche-Comté region (Eastern France) and sampled from both clinical (n = 34) and environmental (n = 191) sources. Azole-resistant clinical isolates (n = 29) were recovered mainly from cystic fibrosis patients and environmental isolates (n = 84) from market gardens and sawmills. In common with previous studies, the TR(34)/L98H allele predominated and comprised 80% of resistant isolates. The genotypes obtained for these local TR(34)/L98H isolates were integrated into a broader analysis including all genotypes for which data are available worldwide. We found that dominant local TR(34)/L98H genotypes were isolated in different sample types at different dates (different patients and types of environments) with hospital air and patient’s isolates linked. Therefore, we are not able to rule out the possibility of some nosocomial transmission. We also found genotypes in these same environments to be highly diverse, emphasizing the highly mixed nature of A. fumigatus populations. Identical clonal genotypes were found to occur both in the French Eastern region and in the rest of the world (notably Australia), while others have not yet been observed and could be specific to our region. Our study demonstrates the need to integrate patient, healthcare, and environmental sampling with global databases in order to contextualize the local-scale epidemiology of antifungal resistant aspergillosis. |
format | Online Article Text |
id | pubmed-8512841 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85128412021-10-14 Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes Rocchi, Steffi Sewell, Thomas R. Valot, Benoit Godeau, Chloé Laboissiere, Audrey Millon, Laurence Fisher, Matthew C. Front Cell Infect Microbiol Cellular and Infection Microbiology Resistance of the human pathogenic fungus Aspergillus fumigatus to antifungal agents is on the rise. However, links between patient infections, their potential acquisition from local environmental sources, and links to global diversity remain cryptic. Here, we used genotyping analyses using nine microsatellites in A. fumigatus, in order to study patterns of diversity in France. In this study, we genotyped 225 local A. fumigatus isolates, 112 azole susceptible and 113 azole resistant, collected from the Bourgogne-Franche-Comté region (Eastern France) and sampled from both clinical (n = 34) and environmental (n = 191) sources. Azole-resistant clinical isolates (n = 29) were recovered mainly from cystic fibrosis patients and environmental isolates (n = 84) from market gardens and sawmills. In common with previous studies, the TR(34)/L98H allele predominated and comprised 80% of resistant isolates. The genotypes obtained for these local TR(34)/L98H isolates were integrated into a broader analysis including all genotypes for which data are available worldwide. We found that dominant local TR(34)/L98H genotypes were isolated in different sample types at different dates (different patients and types of environments) with hospital air and patient’s isolates linked. Therefore, we are not able to rule out the possibility of some nosocomial transmission. We also found genotypes in these same environments to be highly diverse, emphasizing the highly mixed nature of A. fumigatus populations. Identical clonal genotypes were found to occur both in the French Eastern region and in the rest of the world (notably Australia), while others have not yet been observed and could be specific to our region. Our study demonstrates the need to integrate patient, healthcare, and environmental sampling with global databases in order to contextualize the local-scale epidemiology of antifungal resistant aspergillosis. Frontiers Media S.A. 2021-09-29 /pmc/articles/PMC8512841/ /pubmed/34660341 http://dx.doi.org/10.3389/fcimb.2021.729476 Text en Copyright © 2021 Rocchi, Sewell, Valot, Godeau, Laboissiere, Millon and Fisher https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cellular and Infection Microbiology Rocchi, Steffi Sewell, Thomas R. Valot, Benoit Godeau, Chloé Laboissiere, Audrey Millon, Laurence Fisher, Matthew C. Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title | Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title_full | Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title_fullStr | Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title_full_unstemmed | Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title_short | Molecular Epidemiology of Azole-Resistant Aspergillus fumigatus in France Shows Patient and Healthcare Links to Environmentally Occurring Genotypes |
title_sort | molecular epidemiology of azole-resistant aspergillus fumigatus in france shows patient and healthcare links to environmentally occurring genotypes |
topic | Cellular and Infection Microbiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512841/ https://www.ncbi.nlm.nih.gov/pubmed/34660341 http://dx.doi.org/10.3389/fcimb.2021.729476 |
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