scholarly journals First Detection of TR34 L98H and TR46 Y121F T289A Cyp51 Mutations in Aspergillus fumigatus Isolates in the United States

2015 ◽  
Vol 54 (1) ◽  
pp. 168-171 ◽  
Author(s):  
Nathan P. Wiederhold ◽  
Veronica Garcia Gil ◽  
Felipe Gutierrez ◽  
Jonathan R. Lindner ◽  
Mohammad T. Albataineh ◽  
...  
Keyword(s):  
United States ◽  
Middle East ◽  
Aspergillus Fumigatus ◽  
East Africa ◽  
The United States ◽  
Azole Resistance ◽  
Content Type

Azole resistance inAspergillus fumigatusis an increasing problem. The TR34 L98H and TR46 Y121F T289A mutations that can occur in patients without previous azole exposure have been reported in Europe, Asia, the Middle East, Africa, and Australia. Here, we report the detection of both the TR34 L98H and TR46 Y121F T289A mutations in confirmedA. fumigatusisolates collected in institutions in the United States. These mutations, other mutations known to cause azole resistance, and azole MICs are reported here.

scholarly journals Molecular Characterization of a Voriconazole-Resistant, Posaconazole-Susceptible Aspergillus fumigatus Isolate in a Lung Transplant Recipient in the United States

2015 ◽  
Vol 60 (2) ◽  
pp. 1129-1133 ◽  
Author(s):  
Jose A. Vazquez ◽  
Elias K. Manavathu
Keyword(s):  
United States ◽  
Aspergillus Fumigatus ◽  
Molecular Characterization ◽  
Lung Transplant ◽  
Transplant Patient ◽  
The United States ◽  
Azole Resistance ◽  
Content Type ◽  
High Level

ABSTRACTMolecular characterization ofcyp51Afrom the azole-resistantAspergillus fumigatusisolate 50593 from a lung transplant patient showed Y121F/T289A changes coupled with a 46-bp tandem repeat (TR46) on the promoter, whereascyp51Afrom the pretherapy isolate,A. fumigatus47381, showed no changes. This is the first reported case ofA. fumigatusazole resistance due to Y121F/T289A/TR46 in the United States, suggesting that multiple mutational alterations ofcyp51Aresulting in high-level azole resistance could occur during prolonged antifungal therapy.

Misusing historical analogies limits US policy options

2021 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
The United States ◽  
Policy Options ◽  
Negative Consequences ◽  
Content Type ◽  
White House ◽  
Decision To Leave ◽  
Us Military ◽  
The Future

Significance The Vietnam analogy implies that President Joe Biden’s decision to leave Afghanistan will have deeply negative consequences for the United States. However, Afghanistan is not Vietnam and the Biden withdrawal needs to be considered within the wider context of his administration’s review of US commitments abroad. Impacts The White House will be pressured to clarify the future of other US military commitments, particularly in Iraq. Biden will seek to reassure allies, particularly those in NATO, that his commitment to multilateralism will not diminish. Biden may seek an opportunity for a military show of force, possibly in the Middle East, to refute accusations of weakness.

Israel will strengthen its ties with the Gulf

2018 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
The United States ◽  
Gulf Cooperation Council ◽  
Public Knowledge ◽  
Content Type ◽  
Economic Opportunities ◽  
The Past ◽  
Gulf States ◽  
Middle East Policy

Significance In October, Netanyahu travelled to Oman -- the first visit there by an Israeli premier in decades. In the past few years, relations between Israel and most of the six Gulf Cooperation Council (GCC) member states have warmed, but this has not been publicised. More recently, GCC states have become less concerned whether their relations with Israel become public knowledge. Meanwhile, the United States is encouraging rapprochement as one of the anchors of its Middle East policy. Impacts Netanyahu may soon visit Bahrain, the first public visit by an Israeli leader to the country. Relations with Qatar will follow a separate track to other Gulf states. A political opening would create economic opportunities.

Russian build-up raises geopolitical stakes in Syria

2015 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
Peace Process ◽  
The United States ◽  
Content Type ◽  
Military Presence ◽  
Gulf States ◽  
Russian Military

Significance US officials estimate that Russia has dispatched tanks and artillery to Syria in recent weeks in a reported military build-up, raising concerns that Moscow is embarking upon an extensive mission to bolster President Bashar al-Assad's embattled regime and establish a substantial Russian military presence in the Middle East. The build-up comes amid an intensive Russian diplomatic drive in Syria. Impacts Recent attempts to revive the UN-backed Geneva peace process will stumble due to the lack of US-Russian and Saudi-Iranian unanimity. Russia will use its influence over Assad as a bargaining chip in its stand-off with the United States and Europe. Hezbollah and Tehran will be emboldened by Moscow's solid backing of the Assad regime. However, this may also complicate Russia's ties with the Gulf states, Turkey and Israel.

scholarly journals First Clinical Isolation of an Azole-Resistant Aspergillus fumigatus Isolate Harboring a TR46 Y121F T289A Mutation in South America

2018 ◽  
Vol 62 (10) ◽  
Author(s):  
Guillermina Isla ◽  
Florencia Leonardelli ◽  
Iris N. Tiraboschi ◽  
Nicolás Refojo ◽  
Alejandra Hevia ◽  
...  
Keyword(s):  
United States ◽  
South America ◽  
Aspergillus Fumigatus ◽  
Resistance Mechanism ◽  
Resistance Mechanisms ◽  
Azole Resistance ◽  
Content Type

ABSTRACT One of the most recently described Aspergillus fumigatus CYP51A-mediated azole resistance mechanisms is TR46 Y121F T289A. Clinical A. fumigatus strains harboring these substitutions have been reported worldwide, with the exception of South America. We describe the first clinical A. fumigatus strain with this resistance mechanism isolated from an Argentinian patient. The strain was isolated in 2009 (1 year after the first-described mutant in United States), demonstrating that these alleles were scattered worldwide earlier than previously thought.

scholarly journals Detection of TR 34 /L98H CYP51A Mutation through Passive Surveillance for Azole-Resistant Aspergillus fumigatus in the United States from 2015 to 2017

2018 ◽  
Vol 62 (5) ◽  
Author(s):  
Elizabeth L. Berkow ◽  
Natalie S. Nunnally ◽  
Alex Bandea ◽  
Randall Kuykendall ◽  
Karlyn Beer ◽  
...  
Keyword(s):  
United States ◽  
Amino Acid ◽  
Aspergillus Fumigatus ◽  
Clinical Problem ◽  
The United States ◽  
Passive Surveillance ◽  
Broth Microdilution ◽  
Content Type ◽  
The World ◽  
Amino Acid Mutations

ABSTRACT The emergence of azole-resistant Aspergillus fumigatus has become a clinical problem in many parts of the world. Several amino acid mutations in the azole target protein Cyp51Ap contribute to this resistance, with the most concerning being the environmentally derived TR 34 /L98H and TR 46 /Y121F/T289A mutations. Here, we performed passive surveillance to assess a sample of the A. fumigatus population in the United States for the presence of these mutations. We found 1.4% of those isolates to exhibit elevated MIC via broth microdilution, and five of those isolates harbored the TR 34 /L98H mutation.

US partisanship will damage its Middle East standing

2018 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
House Of Representatives ◽  
The United States ◽  
Content Type ◽  
Regional Role ◽  
The Us ◽  
Us Senate ◽  
Middle East Policy ◽  
The Eu

Significance Trump’s controversial Middle East policy decisions have met bipartisan criticism in the US Senate, but in the House of Representatives -- where the influence of the party grassroots is more keenly felt -- Republican congressmen have staunchly backed the president. There are growing partisan differences towards other countries, a notable shift from previous decades when party was not a clear indicator for preference. This may have a major impact on Washington’s future relationship with the Middle East. Impacts Foreign lobbying efforts in Washington will increasingly be targeted on a partisan basis. Russian foreign policy, not beholden to the vagaries of democracy, may become more influential in the Middle East. The EU could seek to play a stronger, independent regional role to replace the United States.

Berlin will reorient its policy vis-a-vis Washington

2018 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
Crisis Management ◽  
New World ◽  
Foreign Minister ◽  
The United States ◽  
Content Type

Significance This comes after German Foreign Minister Sigmar Gabriel said in December that the “retreat” of the United States under Trump marked a fundamental break in Euro-Atlantic relations. He excluded the possibility that relations might return to pre-Trump normal after his departure and concluded that Germany had to adjust to a new world. Impacts Divergence in strategic outlook between the United States and Germany will complicate crisis management, for example in the Middle East. EU states will have to choose strategically between Washington and Brussels at a time when preferences about the EU’s future diverge. Different intra-EU priorities could complicate EU reform and tempt Trump to play allies off against each other.

Prospects for the Middle East in the fourth quarter

2015 ◽  
Keyword(s):  
United States ◽  
Middle East ◽  
Turning Points ◽  
Oil Prices ◽  
The United States ◽  
Fourth Quarter ◽  
Content Type ◽  
Civil Conflicts ◽  
The Way

Subject Prospects for the Middle East in the fourth quarter. Significance The ratification of the nuclear deal in Iran and the United States will pave the way to Iran's diplomatic and economic re-emergence, but will also raise tensions on proxy fronts across the region. Further low oil prices will trouble the region's energy exporters, while civil conflicts in Libya and Syria face turning-points.

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