MOLECULAR EPIDEMIOLOGY AND AZOLE RESISTANCE MECHANISM IN ASPERGILLUS SPP.: A STUDY OF ACUTE INVASIVE AND POST-TB CHRONIC PULMONARY ASPERGILOSIS ISOLATES IN TWO REGIONS OF SÃO PAULO STATE.

• Grant number: 22/14747-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Effective date (Start): June 01, 2023
• Effective date (End): May 31, 2026
• Field of knowledge: Health Sciences - Medicine - Pathological Anatomy and Clinical Pathology
• Principal Investigator: Gil Benard
• Grantee: Tiago Alexandre Cocio
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Pulmonary Aspergillosis, caused by some species of the genus Aspergillus, is considered a severe fungal infection with great clinical relevance. Among the clinical forms of Pulmonary Aspergillosis, Chronic Pulmonary Aspergillosis (APC) is considered one of the most frequent affecting mainly immunocompetent patients. In addition to APC, Acute Invasive Aspergillosis (AIA) is a serious treat to immunocompromised patients. In cases of APC and AIA, A. fumigatus and A. flavus are considered the most frequente species, but there are akso reports of species considered uncommon such as A. niger and A. terreus. Aspergillosis, both APC and AIA are considered neglected diseases in some countries, especially in Latin America. In Brazil, Aspergillosis is not included among the notifiable diseases. Therefore there need for better knowledge of the molecular epidemiology of the species causing aspergillosis as well as their susceptibility to antifungal agents used, in our setting. This project aims to carry out the phenotypic and genotypic identification (species and variants) of the genus Aspergillus by next-generation sequencing) and MALDI-TOF, evaluate their susceptibility to antifungal agents (CLSI and EUCAST) and characterize the mutations of azole resistance genes (e.g., cyp51) of the clinical isolates collected from post-tuberculosis (TBP) and post- non-tuberculous mycobacteria (MNT) infected patients and acute invasive aspergillosis (AIA) of immunosuppressed patients. The project may contribute to broadening the knowledge of the mycological aspects of APC associated with TBP or NTM, and of AIA in immunosuppressed patients, improving the management of the patiens by providing information to guide the use of more effective antifungals.