Prospective Multicenter International Surveillance of Azole Resistance in Aspergillus fumigatus

摘要

A zole resistance is increasingly recognized as a prob- lem in aspergillus diseases (1). Within the Aspergillus fumigatus species complex, new sibling species have been reported to cause invasive aspergillosis; these species are generally intrinsically less susceptible than A. fumigatus sensu strictu to azole compounds (2). Acquired resistance to azoles in A. fumigatus has become a public health concern because of the presumed fungicide-driven route of resistance selection and the associated risk for geographic migration. Surveillance studies show that, in areas to which Aspergillus is endemic, the environmental route of resistance selection contributes to >90% of resistance mechanisms in azole-re- sistant aspergillus diseases (1,3). Azole resistance has been observed in patients with no recent history of azole therapy, and the mortality rate for patients with azole-resistant inva- sive aspergillosis was 88% (3).