Azole Preexposure Affects the Aspergillus fumigatus Population in Patients

Abstract

ABSTRACTThe relationship between the azole preexposure of 86 patients and the genotype, azole susceptibility, andcyp51Apolymorphisms of 110 correspondingAspergillus fumigatusisolates was explored. Isolates carrying serial polymorphisms (F46Y and M172V with or without N248T with or without D255E with or without E427K) had higher itraconazole MICs (P= 0.04), although <2 μg/ml using the EUCAST methodology, were associated with two genetic clusters (P< 0.001) and with voriconazole preexposure of patients (P= 0.016). Voriconazole preexposure influences the distribution ofA. fumigatusisolates with selection of isolates carryingcyp51Apolymorphisms and higher itraconazole MICs.