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Aspergillus terreus Species Complex

Cornelia Lass-Flörl1, Anna-Maria Dietl1, Dimitrios P Kontoyiannis2

  • 1Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.

Clinical Microbiology Reviews
|June 30, 2021
PubMed

Insights

Invasive infections caused by Aspergillus terreus species complex are increasing, posing a significant threat due to amphotericin B resistance and unique immune interactions. This review details Aspergillus terreus epidemiology, pathogenesis, and resistance mechanisms, contrasting it with Aspergillus fumigatus.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pathogen Biology

Background:

  • Invasive fungal infections (IFIs) pose a significant threat, with Aspergillus species being major contributors.
  • While Aspergillus fumigatus is the most common, Aspergillus terreus complex infections are rising, particularly in at-risk populations.
  • Aspergillus terreus exhibits intrinsic amphotericin B resistance and distinct immune interactions compared to A. fumigatus.

Purpose of the Study:

  • To provide a comprehensive review of the microbiology, epidemiology, and pathogenesis of the Aspergillus terreus species complex.
  • To detail clinical characteristics and highlight mechanisms of amphotericin B resistance in Aspergillus terreus.
  • To contrast key features of Aspergillus terreus with Aspergillus fumigatus for improved clinical and research understanding.

Main Methods:

  • Literature review and synthesis of existing epidemiological data.
  • Analysis of microbiological and pathogenetic studies on Aspergillus terreus.
  • Comparative analysis of Aspergillus terreus and Aspergillus fumigatus in terms of clinical presentation and treatment resistance.

Main Results:

  • Aspergillus terreus infections show increasing incidence and an expanding clinical spectrum, including chronic forms.
  • The Aspergillus terreus species complex is characterized by high potential for tissue invasion, dissemination, and mycotoxin production.
  • Intrinsic resistance to amphotericin B is a key feature of Aspergillus terreus, complicating treatment strategies.

Conclusions:

  • Aspergillus terreus represents a growing clinical challenge due to its increasing incidence, unique pathogenetic features, and antifungal resistance.
  • Understanding the specific characteristics of Aspergillus terreus is crucial for developing effective diagnostic and therapeutic strategies.
  • This review serves as a resource for clinicians and researchers to address the challenges posed by this opportunistic pathogen.
Keywords:
Aspergillus terreusaccessory conidiaaleurioconidiaamphotericin Bantifungal agentsdiagnosisepidemiologyfungal infectionsin vitro resistancein vivo resistance

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