Use of cell surface protein typing for genotyping of azole-- 6 7 1 resistant and --susceptible Aspergillus fumigatus isolates in Iran

Aspergillus fumigatus is the leading cause of mortality in severely immunocompromised
17
Parasitology/Invasive Fungi Research Center individuals. Understanding pathogen dispersion and relatedness is essential for deter-
18 (IFRC), School of Medicine, Mazandaran
19 University of Medical Sciences, Sari, Iran mining the epidemiology of nosocomial infections. Therefore, the aim of this study
3
20 Department of Medical Mycology and was to investigate the diversity and putative origins of clinical and environmental
21 Parasitology/Cellular and Molecular Research azole-susceptible and -resistant A. fumigatus isolates from Iran. In all, 79 isolates, inCenter, Faculty of Medicine, Urmia University
22 of Medical Sciences, Urmia, Iran cluding 64 azole--susceptible and 15 azole--resistant isolates, were genotyped using the
23 4Department of Parasitology and Mycology, cell surface protein (CSP) gene. Seven distinct repeat types (r01, r02, r03, r04, r05, r06
24 School of Medicine, Shahid Beheshti
and r07) and 11 different CSP variants (t01, t02, t03, t04A, t06A, t06B, t08, t10, t18A,
25 University of Medical Sciences, Tehran, Iran
5
26 Department of Medical Microbiology and t18B and t22) were observed. Interestingly, t06B, t18A and t18B were exclusively
Infectious Diseases, Canisius-Wilhelmina present in azole-­resistant isolates. The Simpson’s index of diversity (D) was calculated
27
Hospital (CWZ), Nijmegen, The Netherlands
28 4 6Centre of Expertise in Mycology at 0.78. Resistant isolates were genetically less diverse than azole--susceptible isolates.
29 Radboudumc/CWZ, Nijmegen, The However, azole-resistant A. fumigatus without TR34/L98H were more diverse than
30 Netherlands with TR34/L98H. The limited CSP type diversity of the TR34/L98H isolates versus
31
Correspondence azole--susceptible isolates suggests that repeated independent emergence of the TR34/
32 Hamid Badali, PhD, Department of Medical
L98H mechanism is unlikely. It has been suggested that CSP types might have a
33 Mycology and Parasitology/Invasive Fungi
34 Research Center (IFRC), School of Medicine, common- ancestor that developed locally and subsequently migrated worldwide.