Triazole fungicides and the selection of resistance to medical triazoles in the opportunistic mould Aspergillus fumigatus

P.E. Verweij, G.H.J. Kema, B.J. Zwaan, W.J.G. Melchers

Research output: Contribution to journalArticleAcademicpeer-review

36 Citations (Scopus)

Abstract

Azole resistance is an emerging problem in the opportunistic mould Aspergillus fumigatus. The triazoles are the most important agents for the management of Aspergillus diseases in humans. Selection for acquired resistance may occur in the hospital setting through exposure to high doses of azoles during azole therapy, but evidence is accumulating that A. fumigatus may become resistant to medical triazoles through environmental exposure to fungicides. The recovery of A. fumigatus isolates resistant to the medical triazoles from azole-naive patients as well as from the environment strongly indicates an environmental route of resistance selection. Molecule alignment studies have identified five fungicides that share a very similar molecule structure with the medical triazoles, and thus may have selected for mechanisms that confer resistance to both groups of compounds. It is important to explore further the presumed fungicide-driven route of resistance selection in order to implement effective preventive measures as the prevalence of azole resistance in A. fumigatus continues to increase and causes major challenges in the management of azole-resistant Aspergillus diseases
Original languageEnglish
Pages (from-to)165-170
JournalPest Management Science
Volume69
Issue number2
DOIs
Publication statusPublished - 2013

Fingerprint

triazole fungicides
azoles
triazoles
Aspergillus fumigatus
molds (fungi)
fungicides
Aspergillus
resistance mechanisms
human diseases
therapeutics
dosage

Keywords

  • azole resistance
  • invasive aspergillosis
  • fungal disease
  • cyp51a gene
  • itraconazole
  • posaconazole
  • fluconazole
  • patient
  • surveillance
  • voriconazole

Cite this

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title = "Triazole fungicides and the selection of resistance to medical triazoles in the opportunistic mould Aspergillus fumigatus",
abstract = "Azole resistance is an emerging problem in the opportunistic mould Aspergillus fumigatus. The triazoles are the most important agents for the management of Aspergillus diseases in humans. Selection for acquired resistance may occur in the hospital setting through exposure to high doses of azoles during azole therapy, but evidence is accumulating that A. fumigatus may become resistant to medical triazoles through environmental exposure to fungicides. The recovery of A. fumigatus isolates resistant to the medical triazoles from azole-naive patients as well as from the environment strongly indicates an environmental route of resistance selection. Molecule alignment studies have identified five fungicides that share a very similar molecule structure with the medical triazoles, and thus may have selected for mechanisms that confer resistance to both groups of compounds. It is important to explore further the presumed fungicide-driven route of resistance selection in order to implement effective preventive measures as the prevalence of azole resistance in A. fumigatus continues to increase and causes major challenges in the management of azole-resistant Aspergillus diseases",
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Triazole fungicides and the selection of resistance to medical triazoles in the opportunistic mould Aspergillus fumigatus. / Verweij, P.E.; Kema, G.H.J.; Zwaan, B.J.; Melchers, W.J.G.

In: Pest Management Science, Vol. 69, No. 2, 2013, p. 165-170.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Kema, G.H.J.

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AU - Melchers, W.J.G.

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