Appearance of Environment‐Linked Azole Resistance in the <i>Aspergillus fumigatus</i> Complex in New Zealand
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Bibliographic record
Abstract
ABSTRACT Background Until 2020, azole resistance in Aspergillus fumigatus complex isolates in New Zealand was due to cyp51A hot spot mutations. This report details the appearance of environment‐linked tandem repeat (TR)‐related azole resistance genotypes since 2021. Methods Isolates were tested by broth micro‐dilution. Clinical Laboratory Standards Institute criteria were used to define wild type (WT) and non‐wild type (non‐WT) isolates, which were identified by ß‐tubulin gene sequencing and had their cyp51A genotype for azole resistance determined. Whole genome sequencing (WGS) was applied to two patient pairs of sequential WT and non‐WT isolates. Results From January 2021 to June 2024, 15 of 147 (10.2%) A. fumigatus complex isolates were resistant or non‐WT for one or more azole agents. Genotyping detected hot spot mutations in four and TR‐associated resistance in nine. No mutations were detected in two isolates. Four of the five TR 46 mutations were TR 46 /Y121F/T289A. Three of the four TR 34 mutations were different. WGS of the paired isolates showed that the non‐WT isolates were distinct. Azole‐containing fungicides are available for home use from garden centres. Patients with TR‐associated resistance did not have any obvious exposure to azole‐containing fungicides. There was no evidence for healthcare‐acquired transmission. Conclusions A. fumigatus sensu stricto isolates with TR‐mutations linked to environmental resistance are now present in New Zealand. Those at risk of invasive A. fumigatus infection should receive advice to avoid high‐risk exposures. Reintroducing monitoring of azole‐containing fungicides is recommended.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it