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Invasive Aspergillosis and the Impact of Azole-resistance

Davide Bosetti1, Dionysios Neofytos1

  • 1Division of Infectious Diseases, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.

Current Fungal Infection Reports
|June 26, 2023
PubMed
Abstract

Insights

Azole-resistant invasive aspergillosis presents significant challenges, particularly for immunocompromised patients. Early detection and novel therapeutic strategies are crucial for improving outcomes in this growing clinical concern.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Hematology

Background:

  • Invasive aspergillosis (IA) caused by azole-resistant strains is linked to increased morbidity and mortality.
  • Azole resistance in Aspergillus species is rising globally, driven by environmental factors and extensive azole use in prophylaxis and treatment.

Purpose of the Study:

  • To review the current epidemiology, diagnostics, and therapeutics of azole-resistant IA.
  • To focus on the clinical entity in patients with hematologic malignancies.

Main Methods:

  • Literature review of current epidemiological data.
  • Analysis of diagnostic strategies for azole-resistant Aspergillus.
  • Evaluation of therapeutic approaches for invasive aspergillosis.

Main Results:

  • Azole resistance in Aspergillus is increasing worldwide.
  • Therapeutic options are complicated by multidrug resistance, drug interactions, and patient factors.
  • Hematopoietic stem cell transplant recipients are particularly vulnerable.

Conclusions:

  • Rapid identification of resistant strains is critical for timely antifungal treatment, especially in allogeneic hematopoietic cell transplantation.
  • Further research is needed to understand resistance mechanisms and optimize diagnostics.
  • Ongoing surveillance and susceptibility profiling against new antifungal agents are essential for improved clinical outcomes.
Keywords:
Azole-resistanceCryptic Aspergillus speciesInvasive aspergillosis

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