title: The Current Status of Drug-resistant Aspergillus.
abstract: Aspergillus spp. are important fungi because of the high mortality associated with aspergillosis. However, we have only three classes of anti-aspergillus drugs available; and only two drugs, itraconazole (ITCZ) and voriconazole (VRCZ), are available as oral agents in Japan. If azole-resistant Aspergillus causes chronic aspergillosis, we cannot treat such patients with oral azoles on an outpatient basis. As is the case with foreign countries, we found the existence of azole-resistant Aspergillus fumigatus in clinical settings in Japan. Resistance was attributed to mutations of the target protein (CYP51A). Additionally, we also found that long-term itraconazole treatment induced G54 substitution in CYP51A, causing itraconazole-resistance. Although there are few resistant Aspergillus strains existing in Japan now, we have to continue to find such resistant isolates, which are spreading worldwide.
authors: Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences.
authors: Masato
authors: M
authors: Tashiro
authors: Koichi
authors: K
authors: Izumikawa
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000302:isolation & purification; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000235:genetics*; D005656:Fungal Proteins / Q000235:genetics; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D007564:Japan; D009154:Mutation; D055732:Pulmonary Aspergillosis / Q000382:microbiology*; D065819:Voriconazole / Q000494:pharmacology*
chemical_list: D000935:Antifungal Agents; D005656:Fungal Proteins; D017964:Itraconazole; D003577:Cytochrome P-450 Enzyme System; C465526:cytochrome P-450 CYP51A, Aspergillus; D065819:Voriconazole