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Epidemiology and Prevalence of Azole-Resistant Aspergillus fumigatus: What Is Our Understanding of the Situation?

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Abstract

Purpose of the Review

Azole-resistant Aspergillus fumigatus is an emerging clinical problem. Resistance can develop both with clinical exposure and with environmental exposure to azole and azole-like fungicides used against phytopathogens. Here, our current understanding of the epidemiology and prevalence of this emerging problem is reviewed.

Recent Findings

Azole-resistant A. fumigatus is now a worldwide problem, as it has been documented in clinical and environmental samples on all but one continent. Although Europe has been the center of this issue, hotspots are now emerging in Asia. However, there are several limitations to our current understanding of the extent of this problem, including issues with surveillance strategies and our reliance on phenotypic methods for detecting resistance.

Summary

Azole-resistant A. fumigatus is an emerging issue both clinically and in the environment that requires greater attention in order to preserve this very useful class of antifungal agents for the treatment of aspergillosis.

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  1. Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Nathan P. Wiederhold

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NPW has received grants and non-financial support from Astellas, grants from bioMerieux, grants, personal fees and non-financial support from F2G, grants from Maxwell Biosciences, grants and non-financial support from Mycovia, grants from Sfunga, non-financial support from Cidara, non-financial support from Pfizer, outside the submitted work. All grants to UT Health San Antonio.

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Wiederhold, N.P. Epidemiology and Prevalence of Azole-Resistant Aspergillus fumigatus: What Is Our Understanding of the Situation?. Curr Fungal Infect Rep 17, 177–187 (2023). https://doi.org/10.1007/s12281-023-00469-x

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