Abstract book 2011 - ISHAM

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Results and discussion: 300 patients were enrolled in this study. At inclusion time, most ofthem were adults colonized with A. fumigatus (about 35% of the patients). Scedosporium wasisolated in 5%, and Exophiala in about 2%. Regarding antifungal susceptibility, isolates ofScedosporium and Exophiala exhibited antifungal resistance comparable with published data.Regarding A. fumigatus, a majority of isolates (88.1%) were found sensitive to itraconazole(MIC≤ 2µg/ml), and 2 new mutations were identified and localized within 3-dimensionalCyp51A protein model. To obtain insight into azole resistance of A. fumigatus, the results areanalyzed taking into account clinical data, itraconazole exposition, and the potentialcorrelation between the identified CYP5IA mutations and azole resistance is discussed basedon the Cyp51A protein homology model.Supported by: French government (PHRC N8 2006/1902 "MucoFong") - Vaincre lamucoviscidose (N8 2006/351) - Pfizer ® (N8 2006/158).Conflict of interest: None to declareKeywords: Aspergillus fumigatus, Scedosporium apiospermum, Scedosporium prolificans,Exophiala spp., antifungal resistance, cystic fibrosis
EPIDEMIOLOGY OF FILAMENTOUS FUNGI IN CYSTIC FIBROSISPATIENTS IN THE NETHERLANDSPaul D. Terpstra 1,2 , Mireille V. Westreenen 3 , Peter Croughs 4 , Paul Verweij 1 ,Ronald Brimicombe 5 , Jan-Bart Yntema 6 , Corné Klaassen 2 , Peter Merkus 6 andJacques F. Meis 21 Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, theNetherlands2 Department of Medical Microbiology and Infectious Diseases, Canisius WilhelminaHospital, Nijmegen, the Netherlands3 Department of Medical Microbiology, Erasmus MC, University Medical Center Rotterdam,the Netherlands4 Department of Medical Microbiology, Academic Hospital Maastricht, the Netherlands5 Department of Medical Microbiology, HagaZiekenhuis, The Hague, the Netherlands6 Department of Paediatrics, Radboud University Medical Center, Nijmegen, the NetherlandsObjectives: The clinical significance of fungal infections in Cystic Fibrosis (CF) are poorlyunderstood. Infections with viruses and bacteria are the main cause of deterioration of lungfunction in these patients. However there is also evidence of an increasing prevalence of fungiin sputum but the reported results vary widely between countries and centers (9-56%). Verylittle is known about the epidemiology, genotypes and resistance patterns of filamentous fungiin Dutch patients with CF. Here we describe the first results of a recently initiated largeprospective study of fungal colonization in CF patients in the Netherlands.Methods: Standardized routine sputum samples were collected in four CF centers. Allsamples were cultured on mould- selective plates and incubated at two temperatures. All non-Candida fungi were collected and stored centrally. After initial morphologic identification,molecular confirmation was sought using AFLP and ITS + D1/D2 sequencing. AllAspergillus fumigatus isolates were additionally analyzed for presence of the most commonmutations in the CYP51 gene.Results: A total of 756 filamentous fungi were isolated from 337 patients in the period May2010 - January <strong>2011</strong>. The main species found was A. fumigatus (n = 456). In addition, avariety of other Aspergillus species were found: A. flavus, A. terreus, A. sydowii, A.protuberus and A. versicolor. Next to these Aspergillus spp., Penicillium spp. (n = 117) andScedosporium spp. (n = 15) were the most common fungi. Exophiala dermatitidis, an alreadyknown potential pathogen in CF, was isolated 17 times. Interestingly we also report the firstisolations of Geosmithia argillacea in Dutch CF patients. At least 10% of the samples showeda discrepancy between morphologic and molecular identification. A total of 4.2% of the testedA. fumigatus appeared to contain the TR/L98H mutation while no other mutations (G54,G138, M220) responsible for azole resistance where found.Conclusion: These results suggest that the Dutch epidemiology of filamentous fungi in CFpatients is comparable to our neighboring countries. The main fungus was A. fumigatus, butalso other fungal species such as Scedosporium spp. and Exophiala spp. were identifiedincluding the newly described species Geosmithia argillacea. In addition 4.2% of A.fumigatus isolates appeared to contain mutations reported to confer azole resistance. These arethe first epidemiological data of azole resistance in A. fumigatus from CF patients in theNetherlands.
Page 1 and 2: Second Meetingof the ECMM/ISHAM Wor
Page 3 and 4: Program___________Thursday Septembe
Page 5 and 6: 9 h 40 Role of real-time PCR and ga
Page 8 and 9: FUNGAL INFECTION/CONTAMINATION IN T
Page 10 and 11: ISOLATION OF FILAMENTOUS FUNGI IN T
Page 12 and 13: FILAMENTOUS FUNGI IN CF - PREVALENC
Page 16 and 17: PNEUMOCYSTIS JIROVECII AND CYSTIC F
Page 18 and 19: TRICHOSPORON MYCOTOXINIVORANS: AN E
Page 20 and 21: species Exophiala phaerumiformis (i
Page 22 and 23: SHORT AND LONG-TERM OUTCOMES WITH P
Page 24 and 25: ROUTINE MOULDS’ IDENTIFICATION IN
Page 26 and 27: SCEDOSPORIUM SPP.: DETECTION, IDENT
Page 28 and 29: ROLE OF REAL TIME PCR AND GALACTOMA
Page 30 and 31: MONOCLONAL ANTIBODIES SPECIFIC TO S
Page 32 and 33: REAL TIME TYPING OF ASPERGILLUS FUM
Page 34 and 35: THE SPECTRUM OF SCEDOSPORIUM ISOLAT
Page 36 and 37: originating from the same state. St
Page 38 and 39: ASPERGILLUS-INDUCED INFLAMMATION IN
Page 40 and 41: ECOLOGY OF THE AIRWAY MICROBIOME IN
Page 42 and 43: Discussion and conclusion: For the
Page 44 and 45: At concentrations >2 mg/L, AMB achi
Page 46 and 47: CLINICAL AND MICROBIOLOGICAL EFFICA
Page 48 and 49: Conclusions: Scedosporium spp. colo
Page 50 and 51: Conclusion: Defining the optimal me
Page 52 and 53: ATCF (AZOLE THERAPY IN CYSTIC FIBRO
Page 54 and 55: * For those using agar plates, spec
Page 56 and 57: ATTENDANTS
Page 58 and 59: * Pr. Josep F. Cano (Unitat de Micr
Page 60 and 61: * Dr. Virginie Jubin (Service de Pn
Page 62: * Pr. Raymond Robert (Groupe d'Etud

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