Azole resistance in Aspergillus: global status in Europe and Asia

Area of Science:

• Medical Mycology
• Antimicrobial Resistance

Background:

• Azole-resistant Aspergillus strains are increasingly reported globally.
• The prevalence of triazole resistance and multi-azole resistance in Aspergillus remains unclear due to limited clinical data and surveillance.
• Data primarily focuses on Aspergillus fumigatus, leaving the resistance landscape of non-fumigatus species less understood.

Purpose of the Study:

• To highlight the current understanding of azole resistance in Aspergillus species.
• To emphasize the need for comprehensive surveillance studies to determine the true prevalence of azole resistance.
• To explore the potential impact of medical and agricultural azole use on resistance development.

Main Methods:

• Review of existing reports on azole-resistant Aspergillus strains.
• Analysis of factors influencing the acquisition of triazole resistance.
• Discussion of the significance of environmental sampling in surveillance.

Main Results:

• Azole resistance in Aspergillus has been documented in Europe and Asia.
• Limited clinical isolation rates and screening studies hinder accurate prevalence assessment.
• Agricultural use of azoles is a potential driver for resistance development.

Conclusions:

• Continued surveillance studies are crucial for elucidating azole resistance in Aspergillus.
• Environmental sampling is important, given the potential link between agricultural azole use and resistance.
• Further research is needed to clarify the resistance patterns in non-fumigatus Aspergillus species.