Mechanisms of Triazole Resistance in Aspergillus fumigatus.
Environ Microbiol. 2020 Oct 12;:
Authors: Nywening AV, Rybak JM, Rogers PD, Fortwendel JR
The ubiquitous fungal pathogen Aspergillus fumigatus is the primary cause of opportunistic mold infections in humans. Aspergilli disseminate via asexual conidia passively traveling through air currents to germinate within a broad range of environs, wherever suitable nutrients are found. Though the average human inhales hundreds of conidia daily, A. fumigatus invasive infections primarily affect the immunocompromised. At-risk individuals can develop often fatal invasive disease for which therapeutic options are limited. Regrettably, the global insurgence of isolates resistant to the triazoles, the frontline antifungal class used in medicine and agriculture to control A. fumigatus, is complicating the treatment of patients. Triazole antifungal resistance in A. fumigatus has become recognized as a global, yet poorly comprehended, problem. Due to a multitude of factors, the magnitude of resistant infections and their contribution to treatment outcomes are likely underestimated. Current studies suggest that human drug-resistant infections can be either environmentally acquired or de novo host selected during patient therapy. While much concerning development of resistance is yet unknown, recent investigations have revealed assorted underlying mechanisms enabling triazole resistance within individual clinical and environmental isolates. This review will provide an overview of triazole resistance as it is currently understood, as well as highlight some of the prominent biological mechanisms associated with clinical and environmental resistance to triazoles in A. fumigatus. This article is protected by copyright. All rights reserved.
PMID: 33047482 [PubMed – as supplied by publisher]