Detecting Azole-Antifungal Resistance in by Pyrosequencing.

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ID: 82541
2020
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Abstract
Guidelines on the diagnosis and management of disease recommend a multi-test approach including CT scans, culture, fungal biomarker tests, microscopy and fungal PCR. The first-line treatment of confirmed invasive aspergillosis (IA) consists of drugs in the azole family; however, the emergence of azole-resistant isolates has negatively impacted the management of IA. Failure to detect azole-resistance dramatically increases the mortality rates of azole-treated patients. Despite drug susceptibility tests not being routinely performed currently, we suggest including resistance testing whilst diagnosing disease. Multiple tools, including DNA sequencing, are available to screen for drug-resistant in clinical samples. This is particularly beneficial as a large proportion of IA samples are culture negative, consequently impeding susceptibility testing through conventional methods. Pyrosequencing is a promising in-house DNA sequencing method that can rapidly screen for genetic hotspots associated with antifungal resistance. Pyrosequencing outperforms other susceptibility testing methods due to its fast turnaround time, accurate detection of polymorphisms within critical genes, including simultaneous detection of wild type and mutated sequences, and-most importantly-it is not limited to specific genes nor fungal species. Here we review current diagnostic methods and highlight the potential of pyrosequencing to aid in a diagnosis complete with a resistance profile to improve clinical outcomes.
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van-der-torre2020detectingjournal Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors van der Torre, Mireille H;Novak-Frazer, Lilyann;Rautemaa-Richardson, Riina;
Journal Journal of fungi (Basel, Switzerland)
Year 2020
DOI
E12
URL
Keywords
azole resistance diagnostics aspergillus fumigatus pyrosequencing antifungal drug resistance cyp51a

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