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© Research
Publication : The Lancet. Infectious diseases

Azole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use?

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in The Lancet. Infectious diseases - 01 Dec 2009

Verweij PE, Snelders E, Kema GH, Mellado E, Melchers WJ

Link to Pubmed [PMID] – 19926038

Lancet Infect Dis 2009 Dec;9(12):789-95

Invasive aspergillosis due to multi-azole-resistant Aspergillus fumigatus has emerged in the Netherlands since 1999, with 6.0-12.8% of patients harbouring resistant isolates. The presence of a single resistance mechanism (denoted by TR/L98H), which consists of a substitution at codon 98 of cyp51A and a 34-bp tandem repeat in the gene-promoter region, was found in over 90% of clinical A fumigatus isolates. This is consistent with a route of resistance development through exposure to azole compounds in the environment. Indeed, TR/L98H A fumigatus isolates were cultured from soil and compost, were shown to be cross-resistant to azole fungicides, and genetically related to clinical resistant isolates. Azoles are abundantly used in the environment and the presence of A fumigatus resistant to medical triazoles is a major challenge because of the possibility of worldwide spread of resistant isolates. Reports of TR/L98H in other European countries indicate that resistance might already be spreading.