Recreation of in-host acquired single nucleotide polymorphisms by CRISPR-Cas9 reveals an uncharacterised gene playing a role in Aspergillus fumigatus azole resistance via a non-cyp51A mediated resistance mechanism. (Ballard et al., 2019)
This paper describes a clinically relevant novel azole resistance mechanism in A.fumigatus that is not cyp51A mediated. The isolates investigated were obtained from a patient suffering from persistent and recurrent invasive aspergillosis. The specific SNP was identified as 167* in AFUA_7G01960 and was acquired in-host during infection.
Chronic Pulmonary Aspergillosis (CPA) in a Tertiary Care Centre in Spain: A Retrospective, Observational Study. (Aguilar-Company et al., 2019)
This is the first study providing an overview of the features of CPA in patients from Spain. Chronic cavitary pulmonary aspergillosis (CCPA) was the most frequent form of CPA and A. fumigatus the most frequently isolated species. Patients with cancer history and subacute invasive aspergillosis (SAIA) had a worse prognosis.
This paper characterises the assessment of the blood levels of isavuconazole and their association with efficacy and toxicity using therapeutic drug monitoring in patients with invasive aspergillosis. The authors found that isavuconazole was efficacious and well tolerated. Side effects, mainly gastrointestinal, were associated with prolonged administration and high serum levels.
Culture-Documented Invasive Mold Infections at MD Anderson Cancer Center in Houston, Texas, Pre– and Post–Hurricane Harvey (Dimitrios et al., 2019)
Following hurricane Harvey immunocompromised patients raised concerns about mold infections caused by flooded damp homes. This study sought to evaluate the impact of hurricane Harvey on the incidence of culture-positive invasive mold infections in patients treated at MD Anderson Cancer Center in Houston, Texas. No emergence of unusual mold infections was seen.
Invasive Aspergillosis in solidāorgan transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice (Husain and Camargo, 2019)
This paper describes updated AST-ISCOP guidelines which provide information on epidemiology, diagnosis, and management of Aspergillus after solid organ transplantation. Risk factors for invasive aspergillosis in organ transplant recipients are given, as well as clinical manifestations, and strategies for diagnosis, treatment and prevention. Finally, this paper outlines the areas where further work is required for example, the development of ECVs/breakpoints for isavuconazole against Aspergillus to aid in the interpretation of isavuconazole MICs.