Vol.61 No.2 March 2013
Current status of drug-resistant Aspergillus: evolution of resistance and future
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan
Abstract
Aspergillus causes severe and sometimes incurable infections in both immune-compromised and immune-competent patients, with a high associated mortality. Only three classes of antifungals (azoles, polyenes, and echinocandins) are currently available. Recent studies have found that azole resistance is appearing in Aspergillus fumigatus strains around the world, and such resistance is becoming a clinical concern. Although long-term azole treatment in cases with chronic aspergillosis and the heavy environmental use of fungicides have both been considered as possible causes of azole resistance, the mechanism of resistance has not yet been determined. Although the mainstay of the azole resistance mechanism is a mutation in the target protein 14 alpha-demethylase encoded by cyp51A, other mechanisms may be involved. In this review, we showed the current status of azole-resistance in Nagasaki, Japan, and indicated that the prolonged use of itraconazole might be linked to resistance acquisition.
Key word
Aspergillus fumigatus, azole-resistance, itraconazole, voriconazole, cyp51
Received
January 25, 2013
Accepted
January 31, 2013
Jpn. J. Chemother. 61 (2): 149-156, 2013
