Primary objectives: 1. To investigate the prevalence of azole resistance in Aspergillus clinical isolates collected in participating hospitals in Taiwan 2. To investigate the prevalence of azole resistance in Aspergillus environmental isolates in Taiwan 3. To characterize the molecular mechanisms of azole resistance in Aspergillus isolates in Taiwan 4. To investigate the clonality of Aspergillus clinical and environmental isolates in Taiwan 5. To describe the genetic relationships between local resistant strains with global strains Secondary objective: 1. To describe the clinical characteristics and treatment outcome of patients with proven or probable invasive aspergillosis 2. To evaluate the clinical impact of azole resistance in patients with proven or probable invasive aspergillosis in a case-control study

NCT03024281

Conditions

1. Infection; Aspergillus

MeSH:Aspergillosis

Multiple amino acid substitutions in the cyp51A gene have been described to be associated with azole resistance that emerges during azole treatment, while a resistance mechanism, TR34/L98H mutation in cyp51A, has been linked to the agricultural use of azole fungicides in Europe, which have also been widely used in Taiwan for years. --- L98H ---

A standard treatment protocol for invasive aspergillosis (IA) will be implemented in several academic hematology centers in the Netherlands in which a diagnostic test demonstrating azole resistance by multiplex real-time polymerase chain reaction will guide the choice of appropriate antifungal treatment. Objectives: 1. Improve the outcome of patients infected with azole resistant A. fumigatus by the early detection of Resistance Associated Mutations (RAMs) and with this the earlier initiation of the most appropriate therapy. 2. Monitor the prevalence of invasive aspergillosis due to strains carrying the TR34/L98H or the TR46/T289A/Y121F resistance associated mutations in the Netherlands.

NCT03121235

Conditions

1. Aspergillosis, Invasive Pulmonary

Interventions

1. Diagnostic Test: PCR based detection of azole resistance in A. fumigatus

MeSH:Aspergillosis Invasive Pulmonary Aspergillosis

2. Monitor the prevalence of invasive aspergillosis due to strains carrying the TR34/L98H or the TR46/T289A/Y121F resistance associated mutations in the Netherlands. --- L98H ---

The purpose of this study is to evaluate the performances of the real-time PCR ADEMTECH kit of DNA extraction and detection of Aspergillus fumigatus in serum samples in patients at high-risk for invasive aspergillosis (IA). DNA detection will be associated with detection of TR34/L98H mutations in cyp51A gene, which confer azole resistance.

NCT03349931

Conditions

1. Invasive Aspergillosis in Patients With Onco-haematological Diseases

Interventions

1. Diagnostic Test: DNA extraction and detection of Aspergillus fumigatus in serum samples

MeSH:Aspergillosis

DNA detection will be associated with detection of TR34/L98H mutations in cyp51A gene, which confer azole resistance. --- L98H ---

Detection of TR34 and L98H mutations in the A. fumigatus single-copy number gene cyp51A.. Inclusion Criteria: 1. Adult Patients (≥ 18 years) hospitalized in onco hematologic unit or in hematopoietic stem cell transplantation (HSCT) unit 2. Patients with acute leukemia undergoing induction for AML, ALL, chimotherapy with neutopenia >10 days or Patients undergoing allogeneic stem cell chemotherapy transplantation 3. Patients with biweekly screening for GM detection in serum Exclusion Criteria: 1. Patient < 18 years-old (minor) 2. Informed consent not available 3. Patient without affiliation to French social insurance 4. Patient without biweekly screening for GM detection in serum Inclusion Criteria: 1. Adult Patients (≥ 18 years) hospitalized in onco hematologic unit or in hematopoietic stem cell transplantation (HSCT) unit 2. Patients with acute leukemia undergoing induction for AML, ALL, chimotherapy with neutopenia >10 days or Patients undergoing allogeneic stem cell chemotherapy transplantation 3. Patients with biweekly screening for GM detection in serum Exclusion Criteria: 1. Patient < 18 years-old (minor) 2. Informed consent not available 3. Patient without affiliation to French social insurance 4. Patient without biweekly screening for GM detection in serum Invasive Aspergillosis in Patients With Onco-haematological Diseases Aspergillosis Accurate diagnosis of invasive pulmonary aspergillosis (IPA) in patients at high risk of invasive fungal infection remains challenging due to difficulties in differentiating IPA from pulmonary infections caused by other molds or bacteria on clinical and radiological grounds. --- L98H ---

Azole resistance in A. fumigatus is associated mainly with mutations in the cyp51A gene, and among several mutations described, the most frequent is the mutation comprising a 34-bp tandem repeat (TR34) and the L98H alteration. --- L98H ---

This multiplex assay detects DNA from the A. fumigatus species complex by targeting the multicopy 28S rRNA gene and specific TR34 and L98H mutations in the single-copy number cyp51A gene of A. fumigatus. --- L98H ---

Prospective multi-center surveillance study on the prevalence of azole-resistant Aspergillus spp. in clinical isolates of patients with pulmonary colonization or invasive infections in Switzerland

NCT03443336

Conditions

1. Pulmonary Aspergillosis

MeSH:Aspergillosis Pulmonary Aspergillosis

These mutations, including TR34/L98H and TR46/Y121F/T289A have been identified in the environment and have been demonstrated to cause resistance to azole fungicides used in agriculture. --- L98H ---