TABLE 1

Patient characteristics, azole in vitro activities, and cyp51A resistance mechanisms in four high-level azole-resistant A. fumigatus isolates

CaseSexa/age (yr)Underlying conditionAspergillus diseasePrior azole exposureOrigin of isolateMIC (mg/liter) ofb:cyp51A mutation(s)
AmBAFGITCVRCPOSISA
1M/22Cystic fibrosisABPAcITCSputum10.063>1616>16>16TR34/L98H
2M/71BronchiectasisNoneNoneSputum10.063>16>16>16>16None detected
3F/47SarcoidosisEmpyemaITC, VRC, POSSputum0.50.016>16>16>16>16TR46/Y121F/T298A, M172I, G448S
4M/39Chronic granulomatous diseaseChronic invasive aspergillosisITC, VRC, POSBALd specimen0.50.063>168>1616M220R
  • a M, male; F, female.

  • b All MICs were determined using EUCAST methodology (2, 4). AmB, amphotericin B; AFG, anidulafungin; ITC, itraconazole; VRC, voriconazole; POS, posaconazole; ISA, isavuconazole.

  • c ABPA, allergic bronchopulmonary aspergillosis.

  • d BAL, bronchoalveolar lavage.