Epidemiology and antifungal resistance in invasive aspergillosis according to primary disease - review of the literature

European Journal of Medical Research

C Lass-Flörl¹  A Mayr¹ 

[1] Division of Hygiene and Medical Microbiology, Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria

关键词: candins;    azoles;    Aspergillus;    antifungal resistance;    Epidemiology;   

Others  :  825435
DOI  :  10.1186/2047-783X-16-4-153

 received in 2011-02-03, accepted in 2011-02-22,  发布年份 2011

【 摘 要 】

Aspergilli, less susceptible to antifungals emerge and resistance to azoles have been found mainly in Aspergillus fumigatus; this has launched a new phase in handling aspergillosis. Resistant strains have currently been reported from Belgium, Canada, China, Denmark, France, Norway, Spain, Sweden, The Netherlands, UK and the USA. Centres in the UK (Manchester) and The Netherlands (Nijmegen) have described particularly high frequencies (15 and 10% respectively), and a significant increase in azole resistance in recent years. The reason of this high incidence may be due to long term azole therapy in patients with chronic aspergillosis in Manchester, and due to high use of agricultural azoles in Nijmegen. The primary underlying mechanism of resistance is as a result of alterations in the cyp51A target gene, with a variety of mutations found in clinical isolates and one genotype identified in the environmental (LH98). Reports on well documented in vitro and in vivo resistance to echinocandins are rare for Aspergillus species and resistance may be under-diagnosed as susceptibility testing is less frequently performed due to technical reasons.

【 授权许可】

   
2011 I. Holzapfel Publishers

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