Clonal Expansion of Environmental Triazole Resistant Aspergillus fumigatus in Iran

Azole-resistance in is a worldwide medical concern complicating the management of aspergillosis (IA). Herein, we report the clonal spread of environmental triazole resistant isolates in Iran. In this study, 63 isolates were collected from 300 compost samples plated on Sabouraud dextrose agar supplemented with itraconazole (ITR) and voriconazole (VOR). Forty-four isolates had the TR /L98H mutation and three isolates a TR /Y121F/T289A resistance mechanism, while two isolates harbored a M172V substitution in 51A. Fourteen azole resistant isolates had no mutations in 51A. We found that 41 out of 44 strains with the TR /L98H mutation, isolated from compost in 13 different Iranian cities, shared the same allele across all nine examined microsatellite loci. Clonal expansion of triazole resistant in this study emphasizes the importance of establishing antifungal resistance surveillance studies to monitor clinical isolates in Iran, as well as screening for azole resistance in environmental isolates.