Infections due to triazole-resistant Aspergillus fumigatus are increasingly reported worldwide and are associated with treatment failure and mortality. The principal class of azole-resistant isolates is characterized by tandem repeats of 34 bp or 46 bp within the promoter region of the cyp51A gene. Loop-mediated isothermal amplification (LAMP) is a widely used nucleic acid amplification system that is fast and specific. Here we describe a LAMP assay method to detect the 46 bp tandem repeat insertion in the cyp51A gene promoter region based on novel LAMP primer sets. It also differentiated strains with TR
CASE REPORTSa middle-aged man with acute intestinal obstruction due to an ileo-ileal intussusception of inverted Meckel's diverticulum with a lipoma that was managed by laparoscopy.Worthy of note is the very scarce number of case reports on this exceeding uncommon association.
Acid carboxypeptidase [EC 3.4.12.1] isolated from the culture filtrate of Aspergillus saitoi has been investigated for its use in the carboxy-terminal sequence determination of native or reduced S-carboxymethyl-lysozyme and reduced S-carboxymethyl-ribonuclease at pH 2.5. The sequence of the first four carboxy-terminal residues of denatured lysozyme, leucine, arginine, S-carboxymethyl-cysteine, and glycine, could be deduced unequivocally from a time release plot of an incubation mixture with the enzyme. The enzyme catalyzed the release of a small amount of leucine from native lysozyme in citrate buffer, pH 2.2, containing a small amount of the surface active agent Brij-35. The first five residues, valine, serine, alanine, aspartic acid, and phenylalanine, were liberated rapidly from the carboxy terminus of reduced S-carboxymethyl-ribo-nuclease. A small amount of proline, which occupies position eight from the carboxy terminus, can be detected only after prolonged incubation for 20.5 hr.
Mutations in cyp51A gene are known as main mechanisms of azole resistance in Aspergillus fumigatus, whereas azole-susceptible strains also carry cyp51A mutations (polymorphisms). The polymorphisms found in Europe mainly consist of two combinations of mutations, that is combinations of five single-nucleotide polymorphisms (SNPs) of cyp51A, referred to as cyp51A-5SNPs, and combinations of three SNPs of cyp51A, referred to as cyp51A-3SNPs. Few studies have compared the distributions of cyp51A polymorphisms between different regions.The aim of this study was to investigate the regional differences of cyp51A polymorphisms.We compared the proportions of cyp51A polymorphisms in clinical and environmental strains isolated in various countries, and analysed the strains phylogenetically using short tandem repeats (STRs) and whole-genome sequence (WGS).Among the Japanese strains, 15 out of 98 (15.3%) clinical strains and 8 out of 95 (8.4%) environmental strains had cyp51A polymorphisms. A mutation of cyp51AN248K was the most prevalent polymorphism in both clinical (n = 14, 14.3%) and environmental strains (n = 3, 3.2%). Only one environmental strain harboured cyp51A-5SNPs, which was reported to be the most prevalent in Europe. For phylogenetic analyses using STRs and WGS, 183 and 134 strains, respectively, were employed. They showed that most of the strains with cyp51AN248K clustered in the clades different from those of the strains with cyp51A-5SNPs and cyp51A-3SNPs as well as from those with TR34 /L98H mutations.This study suggests that there are genetic differences between cyp51A polymorphisms of A. fumigatus in Japan and Europe.
Azole antifungal resistance in Aspergillus fumigatus is a worldwide concern. As in most public hospitals in Brazil, antifungal susceptibility tests are not routinely performed for filamentous fungi at our institution. A 4-year retrospective azole antifungal resistance screening revealed two azole-resistant A. fumigatus clinical isolates carrying the CYP51A TR34 (34-bp tandem repeat)/L98H (change of L to H at position 98)/S297T/F495I resistance mechanism mutations, obtained from two unrelated patients.
Abstract Aspergillus fumigatus is a pathogenic fungus with a global distribution. The emergence of azole-resistant A. fumigatus (AR Af ) other than the TR-mutants is a problem in Japan. Additionally, the genetic diversity of A. fumigatus strains in Japan remains relatively unknown. Here we show the diversity in the A. fumigatus strains isolated in Japan as well as the complexity in the global distribution of the pathogenic strains. First, we analyzed the genome sequences of 171 strains from Japan as well as the antifungal susceptibility of these strains. Next, we conducted a population analysis of 876 strains by combining the available genomic data for strains isolated worldwide, which were grouped in six clusters. Finally, a genome-wide association study identified the genomic loci associated with AR Af strains, but not the TR-mutants. These results highlight the complexity of the genomic mechanism underlying the emergence of AR Af strains other than the TR-mutants.
"A pendulum stroke" is used by many golfers. The purpose of this study was to understand human motor control by comparing human putting movements and the physical pendulum of firmly fixed putter. Three experienced professional golfers participated in this study. They executed ten putts as accurately as possible, in order to reach a target distance of 2, 4, 6, 8, 10m. Movement pattern characteristics were assessed by kinematic analysis. In addition, putts of the same distance were tried using the physics pendulum. It was found that the putter head speed, at the time of impact in the physics pendulum putt, exceeded that for humans. On the other hand, for ball speed after impact, the human's putting was faster than that of the physics pendulum's. The difference between human putting and the physics pendulum was shown. However, it was understood that successful putts are achieved by having skillful motor control.
We present a case of a 55-year-old man with a heart transplant who acquired Invasive Aspergillosis by Aspergillus fumigatus with the focus in the kidney. During about two years of antifungal treatment, most of the time with voriconazole, it was possible to obtain nine isolates of A. fumigatus, with the same genotypic characteristics, but with an increase in MIC for several azoles. The two last isolates presented high MICs for Voriconazole (>8 μg/mL>). Sequencing of the CYP51A gene showed G448S amino acid substitution in the same two isolates. In long-term treatments with antifungals, it would be important to regularly evaluate the susceptibility of isolated strains, as resistance to azoles has been increasingly described around the world.