Frontiers in Microbiology (Jul 2021)
A 20-Year Antifungal Susceptibility Surveillance (From 1999 to 2019) for Aspergillus spp. and Proposed Epidemiological Cutoff Values for Aspergillus fumigatus and Aspergillus flavus: A Study in a Tertiary Hospital in China
- Xinyu Yang,
- Xinyu Yang,
- Xinyu Yang,
- Xinyu Yang,
- Wei Chen,
- Wei Chen,
- Wei Chen,
- Wei Chen,
- Tianyu Liang,
- Tianyu Liang,
- Tianyu Liang,
- Tianyu Liang,
- JingWen Tan,
- JingWen Tan,
- JingWen Tan,
- JingWen Tan,
- Weixia Liu,
- Weixia Liu,
- Weixia Liu,
- Weixia Liu,
- Yi Sun,
- Yi Sun,
- Yi Sun,
- Yi Sun,
- Qian Wang,
- Qian Wang,
- Qian Wang,
- Qian Wang,
- Hui Xu,
- Hui Xu,
- Hui Xu,
- Hui Xu,
- Lijuan Li,
- Lijuan Li,
- Lijuan Li,
- Lijuan Li,
- Yabin Zhou,
- Yabin Zhou,
- Yabin Zhou,
- Yabin Zhou,
- Qiqi Wang,
- Qiqi Wang,
- Qiqi Wang,
- Qiqi Wang,
- Zhe Wan,
- Zhe Wan,
- Zhe Wan,
- Zhe Wan,
- Yinggai Song,
- Yinggai Song,
- Yinggai Song,
- Yinggai Song,
- Ruoyu Li,
- Ruoyu Li,
- Ruoyu Li,
- Ruoyu Li,
- Wei Liu,
- Wei Liu,
- Wei Liu,
- Wei Liu
Affiliations
- Xinyu Yang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Xinyu Yang
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Xinyu Yang
- Research Center for Medical Mycology, Peking University, Beijing, China
- Xinyu Yang
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Wei Chen
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Wei Chen
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Wei Chen
- Research Center for Medical Mycology, Peking University, Beijing, China
- Wei Chen
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Tianyu Liang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Tianyu Liang
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Tianyu Liang
- Research Center for Medical Mycology, Peking University, Beijing, China
- Tianyu Liang
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- JingWen Tan
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- JingWen Tan
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- JingWen Tan
- Research Center for Medical Mycology, Peking University, Beijing, China
- JingWen Tan
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Weixia Liu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Weixia Liu
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Weixia Liu
- Research Center for Medical Mycology, Peking University, Beijing, China
- Weixia Liu
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Yi Sun
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Yi Sun
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Yi Sun
- Research Center for Medical Mycology, Peking University, Beijing, China
- Yi Sun
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Qian Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Qian Wang
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Qian Wang
- Research Center for Medical Mycology, Peking University, Beijing, China
- Qian Wang
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Hui Xu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Hui Xu
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Hui Xu
- Research Center for Medical Mycology, Peking University, Beijing, China
- Hui Xu
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Lijuan Li
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Lijuan Li
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Lijuan Li
- Research Center for Medical Mycology, Peking University, Beijing, China
- Lijuan Li
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Yabin Zhou
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Yabin Zhou
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Yabin Zhou
- Research Center for Medical Mycology, Peking University, Beijing, China
- Yabin Zhou
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Qiqi Wang
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Qiqi Wang
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Qiqi Wang
- Research Center for Medical Mycology, Peking University, Beijing, China
- Qiqi Wang
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Zhe Wan
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Zhe Wan
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Zhe Wan
- Research Center for Medical Mycology, Peking University, Beijing, China
- Zhe Wan
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Yinggai Song
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Yinggai Song
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Yinggai Song
- Research Center for Medical Mycology, Peking University, Beijing, China
- Yinggai Song
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Ruoyu Li
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Ruoyu Li
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Ruoyu Li
- Research Center for Medical Mycology, Peking University, Beijing, China
- Ruoyu Li
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Wei Liu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
- Wei Liu
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Wei Liu
- Research Center for Medical Mycology, Peking University, Beijing, China
- Wei Liu
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- DOI
- https://doi.org/10.3389/fmicb.2021.680884
- Journal volume & issue
-
Vol. 12
Abstract
The emergence of resistant Aspergillus spp. is increasing worldwide. Long-term susceptibility surveillance for clinically isolated Aspergillus spp. strains is warranted for understanding the dynamic change in susceptibility and monitoring the emergence of resistance. Additionally, neither clinical breakpoints (CBPs) nor epidemiological cutoff values (ECVs) for Aspergillus spp. in China have been established. In this study, we performed a 20-year antifungal susceptibility surveillance for 706 isolates of Aspergillus spp. in a clinical laboratory at Peking University First Hospital from 1999 to 2019; and in vitro antifungal susceptibility to triazoles, caspofungin, and amphotericin B was determined by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. It was observed that Aspergillus fumigatus was the most common species, followed by Aspergillus flavus and Aspergillus terreus. Forty isolates (5.7%), including A. fumigatus, A. flavus, A. terreus, Aspergillus niger, and Aspergillus nidulans, were classified as non-wild type (non-WT). Importantly, multidrug resistance was observed among A. flavus, A. terreus, and A. niger isolates. Cyp51A mutations were characterized for 19 non-WT A. fumigatus isolates, and TR34/L98H/S297T/F495I was the most prevalent mutation during the 20-year surveillance period. The overall resistance trend of A. fumigatus increased over 20 years in China. Furthermore, based on ECV establishment principles, proposed ECVs for A. fumigatus and A. flavus were established using gathered minimum inhibitory concentration (MIC)/minimum effective concentration (MEC) data. Consequently, all the proposed ECVs were identical to the CLSI ECVs, with the exception of itraconazole against A. flavus, resulting in a decrease in the non-WT rate from 6.0 to 0.6%.
Keywords
- Aspergillus spp.
- susceptibility surveillance
- epidemiological cutoff values
- non-wild-type
- a single-center study
