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Journal of Clinical Microbiology, October 2009, p. 3271-3275, Vol. 47, No. 10
0095-1137/09/$08.00+0 doi:10.1128/JCM.00854-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Patterns of Susceptibility of Aspergillus Isolates Recovered from Patients Enrolled in the Transplant-Associated Infection Surveillance Network
John W. Baddley,1,2*
Kieren A. Marr,3
David R. Andes,4
Thomas J. Walsh,5
Carol A. Kauffman,6
Dimitrios P. Kontoyiannis,7
James I. Ito,8
S. Arunmozhi Balajee,9
Peter G. Pappas,1 and
Stephen A. Moser10
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama,1 Department of Medicine, Infectious Diseases Section, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama,2 Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland,3 Department of Medicine, Division of Infectious Diseases, University of Wisconsin, Madison, Wisconsin,4 Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland,5 Department of Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan,6 Department of Medicine, MD Anderson Cancer Research Center, Houston, Texas,7 Division of Infectious Diseases, Department of Medicine, City of Hope National Medical Center, Duarte, California,8 Division of Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia,9 Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama,10
Received 28 April 2009/ Returned for modification 1 July 2009/ Accepted 11 August 2009
We analyzed antifungal susceptibilities of 274 clinical Aspergillus isolates from transplant recipients with proven or probable invasive aspergillosis collected as part of the Transplant-Associated Infection Surveillance Network (TRANSNET) and examined the relationship between MIC and mortality at 6 or 12 weeks. Antifungal susceptibility testing was performed by the Clinical and Laboratory Standards Institute (CLSI) M38-A2 broth dilution method for amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and ravuconazole (RAV). The isolate collection included 181 Aspergillus fumigatus, 28 Aspergillus niger, 27 Aspergillus flavus, 22 Aspergillus terreus, seven Aspergillus versicolor, five Aspergillus calidoustus, and two Aspergillus nidulans isolates and two isolates identified as Aspergillus spp. Triazole susceptibilities were 
4 µg/ml for most isolates (POS, 97.6%; ITR, 96.3%; VOR, 95.9%; RAV, 93.5%). The triazoles were not active against the five A. calidoustus isolates, for which MICs were 
4 µg/ml. AMB inhibited 93.3% of isolates at an MIC of 1 µg/ml. The exception was A. terreus, for which 15 (68%) of 22 isolates had MICs of >1 µg/ml. One of 181 isolates of A. fumigatus showed resistance (MIC 4 µg/ml) to two of three azoles tested. Although there appeared to be a correlation of higher VOR MICs with increased mortality at 6 weeks, the relationship was not statistically significant (R2 = 0.61; P = 0.065). Significant relationships of in vitro MIC to all-cause mortality at 6 and 12 weeks for VOR or AMB were not found.
* Corresponding author. Mailing address: University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, 1900 University Boulevard, 229 Tinsley Harrison Tower, Birmingham, AL 35294-0006. Phone: (205) 934-5191. Fax: (205) 934-5155. E-mail: jbaddley{at}uab.edu
Published ahead of print on 19 August 2009.
Journal of Clinical Microbiology, October 2009, p. 3271-3275, Vol. 47, No. 10
0095-1137/09/$08.00+0 doi:10.1128/JCM.00854-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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