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Mechanisms of triazole resistance in Aspergillus fumigatus

Ashley V Nywening1,2, Jeffrey M Rybak1, Phillip David Rogers1

  • 1Department of Clinical Pharmacy and Translational Sciences, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN, USA.

Environmental Microbiology
|October 13, 2020
PubMed

Insights

Triazole antifungal resistance in Aspergillus fumigatus is a growing global concern, complicating treatment for invasive fungal infections. Understanding resistance mechanisms is crucial for managing this opportunistic pathogen, especially in immunocompromised patients.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Aspergillus fumigatus is a common airborne fungus causing opportunistic infections, primarily in immunocompromised individuals.
  • Invasive aspergillosis is a severe, often fatal, disease with limited therapeutic options.
  • The emergence of triazole-resistant A. fumigatus strains poses a significant global health threat, complicating treatment in both clinical and agricultural settings.

Purpose of the Study:

  • To review the current understanding of triazole antifungal resistance in Aspergillus fumigatus.
  • To highlight the biological mechanisms underlying clinical and environmental triazole resistance.
  • To underscore the underestimated impact of resistant infections on patient outcomes.

Main Methods:

  • Literature review of recent investigations into triazole resistance mechanisms in A. fumigatus.
  • Analysis of factors contributing to the underestimation of resistant infections.
  • Synthesis of current knowledge on environmental and host-selected resistance.

Main Results:

  • Triazole resistance in A. fumigatus is a poorly comprehended global problem.
  • Resistant infections can be acquired from the environment or selected within a patient during therapy.
  • Various biological mechanisms confer triazole resistance in different A. fumigatus isolates.

Conclusions:

  • The increasing prevalence of triazole-resistant A. fumigatus necessitates a deeper understanding of resistance mechanisms.
  • Effective management strategies are needed to combat this emerging threat to public health.
  • Further research is essential to accurately assess the impact of resistant strains and improve treatment outcomes.

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