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dc.contributor.authorLestrade, Pieter P A
dc.contributor.authorBuil, Jochem B
dc.contributor.authorvan der Beek, Martha T
dc.contributor.authorKuijper, Ed J
dc.contributor.authorvan Dijk, Karin
dc.contributor.authorKampinga, Greetje A
dc.contributor.authorRijnders, Bart J A
dc.contributor.authorVonk, Alieke G
dc.contributor.authorde Greeff, Sabine C
dc.contributor.authorSchoffelen, Annelot F
dc.contributor.authorvan Dissel, Jaap
dc.contributor.authorMeis, Jacques F
dc.contributor.authorMelchers, Willem J G
dc.contributor.authorVerweij, Paul E
dc.date.accessioned2021-05-02T19:25:43Z
dc.date.available2021-05-02T19:25:43Z
dc.identifier.pmid32568033
dc.identifier.doi10.3201/eid2607.200088
dc.identifier.urihttp://hdl.handle.net/10029/624918
dc.description.abstractWe investigated the prevalence of azole resistance of Aspergillus fumigatus isolates in the Netherlands by screening clinical A. fumigatus isolates for azole resistance during 2013-2018. We analyzed azole-resistant isolates phenotypically by in vitro susceptibility testing and for the presence of resistance mutations in the Cyp51A gene. Over the 6-year period, 508 (11%) of 4,496 culture-positive patients harbored an azole-resistant isolate. Resistance frequency increased from 7.6% (95% CI 5.9%-9.8%) in 2013 (58/760 patients) to 14.7% (95% CI 12.3%-17.4%) in 2018 (112/764 patients) (p = 0.0001). TR34/L98H (69%) and TR46/Y121F/T289A (17%) accounted for 86% of Cyp51A mutations. However, the mean voriconazole MIC of TR34/L98H isolates decreased from 8 mg/L (2013) to 2 mg/L (2018), and the voriconazole-resistance frequency was 34% lower in 2018 than in 2013 (p = 0.0001). Our survey showed changing azole phenotypes in TR34/L98H isolates, which hampers the use of current PCR-based resistance tests.en_US
dc.language.isoenen_US
dc.subjectAspergillus fumigatusen_US
dc.subjectantimicrobial resistanceen_US
dc.subjectazole-resistanten_US
dc.subjectfungal infectionsen_US
dc.subjectfungien_US
dc.subjectsurveillanceen_US
dc.subjectthe Netherlandsen_US
dc.titleParadoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013-2018.en_US
dc.typeArticleen_US
dc.identifier.eissn1080-6059
dc.identifier.journalEmerg Infect Dis 2020; 26(7):1447-55en_US
dc.source.journaltitleEmerging infectious diseases
dc.source.volume26
dc.source.issue7
dc.source.beginpage1447
dc.source.endpage1455
dc.source.countryUnited States


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