Azole-resistant aspergillosis.
Azole-resistance in Aspergillus fumigatus is emerging and is becoming an increasing problem in the management of aspergillosis. Two types of development of resistance have been described; resistance acquired during azole treatment in an individual patient and through environmental exposure to fungicides. The main molecular mechanism of azole resistance in A. fumigatus is explained by mutations in the cyp51A-gene. The environmental route of resistance development is particularly worrying and may affect all patients whether azole exposed or naïve, and whether suffering from acute or chronic aspergillosis. No management guidelines to assist clinicians confronted with azole-resistant aspergillosis are available and pre-clinical and clinical evidence supporting treatment choices is scarce.
Honorary Consultant Paediatric Infectious Diseases & Immunology, Institute of Medical Sciences, Aberdeen Fungal Group, University of Aberdeen, Foresterhill, AB25 2ZD Aberdeen, Scotland, UK. Electronic address: a.warris@abdn.ac.uk.
Adilia
A
Warris
D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D001228:Aspergillosis; D001232:Aspergillus fumigatus / Q000187:drug effects*; D001393:Azoles / Q000494:pharmacology / Q000627:therapeutic use; D025141:Drug Resistance, Fungal; D006801:Humans
D000935:Antifungal Agents; D001393:Azoles
A. fumigatus; Aspergillosis; Azoles; Resistance