title: [Azole resistance with environmental origin: What alternatives for the future?].
abstract: Azole resistant Aspergillus fumigatus strains are increasingly reported in many countries. One resistance mechanism is attributed to the use of azole fungicides in environment. Two mutations, TR34/L98H and TR46/Y121F/T289A, on the cyp51A gene, have been described. Results of 40 publications about azole resistant strain detections, with TR34/L98H and TR46/Y121F/T289A mutations, in clinical and/or environmental samples, are presented in this review. These cases, observed in many countries, suggest spreading phenomenon. Measures to moderate fungicides treatments and/or alternative treatments in environment should be established to preserve the effectiveness of azole antifungal therapy for at-risk patients.
authors.affiliation: Laboratoire de parasitologie-mycologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France; UMR 6249 CNRS chrono-environnement, université de Bourgogne Franche-Comté, 25000 Besançon, France. Electronic address: steffi.rocchi@univ-fcomte.fr.
authors.forename: S
authors.initials: S
authors.lastname: Rocchi
authors.affiliation: Laboratoire de parasitologie-mycologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France; UMR 6249 CNRS chrono-environnement, université de Bourgogne Franche-Comté, 25000 Besançon, France.
authors.forename: G
authors.initials: G
authors.lastname: Reboux
authors.affiliation: Laboratoire de parasitologie-mycologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France; UMR 6249 CNRS chrono-environnement, université de Bourgogne Franche-Comté, 25000 Besançon, France.
authors.forename: L
authors.initials: L
authors.lastname: Millon
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000382:microbiology / Q000401:mortality; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000235:genetics; D001393:Azoles / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal / Q000187:drug effects* / Q000235:genetics; D004777:Environment; D004785:Environmental Pollutants / Q000494:pharmacology*; D005656:Fungal Proteins / Q000235:genetics; D006801:Humans; D017354:Point Mutation
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D004785:Environmental Pollutants; D005656:Fungal Proteins
keywords: Aspergillus fumigatus; Fongicides; Fungicide; Resistance; Résistance; TR34/L98H; TR46/Y121F/T289A; Triazole; Triazolé