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Aspergillus species intrinsically resistant to antifungal agents

Jan W M Van Der Linden1, Adilia Warris, Paul E Verweij

  • 1Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.

Medical Mycology
|July 29, 2010
PubMed

Insights

New Aspergillus species show different antifungal resistance than Aspergillus fumigatus. Understanding their role in invasive aspergillosis requires better identification and susceptibility testing methods.

Area of Science:

  • Medical Mycology
  • Antimicrobial Resistance
  • Infectious Diseases

Background:

  • Polyphasic taxonomy has redefined the Aspergillus genus, revealing sibling species.
  • Non-Aspergillus fumigatus species may possess intrinsic resistance to antifungals.
  • Acquired resistance is a growing concern in Aspergillus fumigatus infections.

Purpose of the Study:

  • To highlight the distinct in vitro antifungal susceptibility profiles of non-A. fumigatus species.
  • To emphasize the potential clinical differences in invasive infections caused by these species.
  • To advocate for improved surveillance and diagnostic methods for invasive aspergillosis.

Main Methods:

  • Review of existing literature on Aspergillus taxonomy and antifungal susceptibility.
  • Comparison of minimum inhibitory concentrations (MICs) for key antifungal agents.
  • Discussion of clinical presentations and outcomes of invasive aspergillosis.

Main Results:

  • Non-A. fumigatus Aspergillus species exhibit varied in vitro susceptibility profiles.
  • Elevated MICs for amphotericin B and azoles are observed in some non-A. fumigatus species.
  • Clinical presentation and disease evolution may differ from A. fumigatus infections.

Conclusions:

  • Accurate species identification is crucial for effective antifungal treatment.
  • Enhanced surveillance networks using sequence-based identification are needed.
  • Further research into susceptibility testing and the clinical impact of elevated MICs is essential.

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