Azole resistance of Aspergillus fumigatus isolates from the environment and the clinic in Switzerland [PublishAheadOfPrint]

Aspergillus fumigatus is an ubiquitous opportunistic pathogen. This fungus can acquire resistance to azole antifungals due to mutations in the azole target (cyp51A). Recently, cyp51A mutations typical for environmental azole resistance acquisition (for example TR34/L98H) have been described. These mutations can also be found in isolates recovered from patients. Environmental azole resistance acquisition has been reported in several continents. Here we describe for the first time the occurrence of azole-resistant A. fumigatus isolates from environmental origin in Switzerland with cyp51A mutations and show that they can be also recovered from a few patients. While the TR34/L98H mutation was dominant, a single azole-resistant isolate exhibited a cyp51A mutation (G54R) that was only described from clinical isolates. In conclusion, our study demonstrates that azole resistance with environmental signature is present in environments and patients from Swiss origins and that mutations believed as unique to clinical settings are now also observed in the environment.

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