Emergence of azole resistance in Aspergillus fumigatus and spread of a single resistance mechanism
2008

Emergence of Azole Resistance in Aspergillus fumigatus

Sample size: 1219 publication Evidence: high

Author Information

Author(s): Eveline Snelders, Henrich A. L. van der Lee, Judith Kuijpers, Anthonius J. M. M. Rijs, János Varga, Robert A. Samson, Emilia Mellado, A. Rogier T. Donders, Willem J. G. Melchers, Paul E. Verweij

Primary Institution: Radboud University Nijmegen Medical Centre

Hypothesis

What is the prevalence and spread of azole resistance in Aspergillus fumigatus?

Conclusion

Azole resistance has emerged in Aspergillus fumigatus and might be more prevalent than currently acknowledged.

Supporting Evidence

  • The study found ITZ-resistant isolates in 32 of 1,219 patients.
  • Resistance was first observed in 2000, with an annual prevalence of 1.7% to 6%.
  • The dominant resistance mechanism was identified as TR/L98H in the cyp51A gene.

Takeaway

Some types of mold can become resistant to medicine, making it harder to treat infections. This study found that a specific resistance is spreading in a common mold that can make people sick.

Methodology

The study analyzed 1,912 clinical A. fumigatus isolates collected over 14 years, using phenotypic and molecular methods to assess resistance.

Limitations

The study did not collect isolates from other countries with the intention to study epidemiology, limiting accurate estimates of resistance spread.

Participant Demographics

Patients with a variety of underlying conditions, including chronic lung diseases and cancer.

Statistical Information

P-Value

p<0.0001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pmed.0050219

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