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Volume 15, Number 7—July 2009
Research

Frequency and Evolution of Azole Resistance in Aspergillus fumigatus Associated with Treatment Failure1

Susan J. Howard, Dasa Cerar, Michael J. Anderson, Ahmed Albarrag, Matthew C. Fisher, Alessandro C. Pasqualotto, Michel Laverdiere, Maiken C. Arendrup, David S. Perlin, and David W. DenningComments to Author 
Author affiliations: Regional Mycology Laboratory, Manchester, UK (S.J. Howard, D.W. Denning); University of Manchester, Manchester Academic Health Science Centre, Manchester (S.J. Howard, M.J. Anderson, A. Albarrag, D.W. Denning); University Medical Centre, Ljubljana, Slovenia (D. Cerar); Imperial College, London, UK (M.C. Fisher); Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (A.C. Pasqualotto); Hôpital Maisonneuve-Rosemont, Montreal, Québec, Canada (M. Laverdiere); Statens Serum Institut, Copenhagen, Denmark (M.C. Ardendrup); Public Health Research Institute, Newark, NJ, USA (D.S. Perlin)

Main Article

Table 1

MICs for 519 Aspergillus fumigatus isolates from RMLM culture collection, 1992–2007*

Isolate group (no. isolates) Susceptibility results, mg/L
Itraconazole
 Voriconazole
 Posaconazole
 Amphotericin B
GM 
(range) MIC50/ MIC90 GM 
(range) MIC50/ MIC90 GM 
(range) MIC50/ MIC90 GM 
(range) MIC50/ MIC90
RMLM collection (519), 1992–2007
 0.46
(<0.015–>8)
 0.25/2
0.92
(0.125–>8)
 1/2
0.22
(0.03–>8)
 0.125/2
0.34
(0.06–2)
 0.25/1
Azole resistant (34)
 16.0
(>8)
 >8/>8
3.69
(0.125–>8)
 4/>8
1.70
(0.125–>8)
 1/>8
0.22†
(0.06–0.5)
 0.25/0.5
Percentage resistant
 100%
65%
74%
0%
Aspergilloma (18) 16.0
(>8) >8/>8 2.16
(0.5–4.0) 4/4 1.92
(0.125–>8) 1/>8 0.10‡
(0.06–0.125) 0.125/ 0.125

*RMLM, Regional Mycology Laboratory Manchester; GM, geometric mean. Values >8 mg/L were classed as 16 mg/L for GM analysis. See also the Appendix Table.
†n = 28.
‡n = 6.

Main Article

1These data were presented in part at the 2nd Advances Against Aspergillosis meeting, February 22–26, 2006, Athens, Greece; and 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, September 27–30, 2006, San Francisco, CA, USA.

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