What paths are open for tackling increasing azole resistance in Aspergillus in the clinic?

References

• Auberger J, Lass-Flörl C. Current evidence for the treatment of invasive fungal infections in immunocompromised patients. Clin. Invest. 1(3), 447–457 (2011).
   Google Scholar
• Herbrecht R, Denning DW, Patterson TF et al.; Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N. Engl. J. Med. 347(6), 408–415 (2002).
   PubMed Web of Science ®Google Scholar
• Ullmann AJ, Lipton JH, Vesole DH et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N. Engl. J. Med. 356(4), 335–347 (2007).
   PubMed Web of Science ®Google Scholar
• Cornely OA, Maertens J, Winston DJ et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N. Engl. J. Med. 356(4), 348–359 (2007).
   PubMed Web of Science ®Google Scholar
• Auberger J, Lass-Flörl C, Aigner M, Clausen J, Gastl G, Nachbaur D. Invasive fungal breakthrough infections, fungal colonization and emergence of resistant strains in high-risk patients receiving antifungal prophylaxis with posaconazole: real-life data from a single-centre institutional retrospective observational study. J. Antimicrob. Chemother. 67(9), 2268–2273 (2012).
   PubMed Web of Science ®Google Scholar
• Mayr A, Lass-Flörl C. Epidemiology and antifungal resistance in invasive aspergillosis according to primary disease – review of the literature. Eur. J. Med. Res. 16, 153–157 (2011).
   PubMed Web of Science ®Google Scholar
• Verweij PE, Howard SJ, Melchers WJ, Denning DW. Azole-resistance in Aspergillus: proposed nomenclature and breakpoints. Drug Resist. Updat. 12(6), 141–147 (2009).
   PubMed Web of Science ®Google Scholar
• Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am. J. Med. 125(Suppl. 1), S3–S13 (2012).
   Web of Science ®Google Scholar
• Arendrup MC, Jensen RH, Grif K et al. In vivo emergence of Aspergillus terreus with reduced azole susceptibility and a CYP51a M2171I alteration. J. Infect. Dis. 206(6), 981–985 (2012).
   PubMed Web of Science ®Google Scholar
• Snelders E, Melchers WJ, Verweij PE. Azole resistance in Aspergillus fumigatus: a new challenge in the management of invasive aspergillosis? Future Microbiol. 6(3), 335–347 (2011).
   PubMed Web of Science ®Google Scholar
• Camps SM, van der Linden JW, Li Y et al. Rapid induction of multiple resistance mechanisms in Aspergillus fumigatus during azole therapy: a case study and review of the literature. Antimicrob. Agents Chemother. 56(1), 10–16 (2012).
   PubMed Web of Science ®Google Scholar
• Verweij PE, Snelders E, Kema GH, Mellado E, Melchers WJ. Azole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use? Lancet Infect. Dis. 9(12), 789–795 (2009).
   PubMed Web of Science ®Google Scholar
• Snelders E, Camps SM, Karawajczyk A et al. Triazole fungicides can induce cross-resistance to medical triazoles in Aspergillus fumigatus. PLoS ONE 7(3), e31801 (2012).
   PubMed Web of Science ®Google Scholar
• Lass-Flörl C. Triazole antifungal agents in invasive fungal infections: a comparative review. Drugs 71(18), 2405–2419 (2011).
   PubMed Web of Science ®Google Scholar
• van der Linden JW, Snelders E, Kampinga GA et al. Clinical implications of azole resistance in Aspergillus fumigatus, The Netherlands, 2007–2009. Emerg. Infect. Dis. 17(10), 1846–1854 (2011).
   PubMed Web of Science ®Google Scholar
• Mortensen KL, Mellado E, Lass-Flörl C et al. Environmental study of azole-resistant Aspergillus fumigatus and other aspergilli in Austria, Denmark, and Spain. Antimicrob. Agents Chemother. 54(11), 4545–4549 (2010).
   PubMed Web of Science ®Google Scholar
• Denning DW, Park S, Lass-Florl C et al. High-frequency triazole resistance found In nonculturable Aspergillus fumigatus from lungs of patients with chronic fungal disease. Clin. Infect. Dis. 52(9), 1123–1129 (2011).
   PubMed Web of Science ®Google Scholar
• Lass-Flörl C, Perkhofer S, Mayr A. In vitro susceptibility testing in fungi: a global perspective on a variety of methods. Mycoses 53(1), 1–11 (2010).
   PubMed Web of Science ®Google Scholar
• Perkhofer S, Lass-Flörl C, Hell M et al. The Nationwide Austrian Aspergillus Registry: a prospective data collection on epidemiology, therapy and outcome of invasive mould infections in immunocompromised and/or immunosuppressed pateints. Int. J. Antimicrob. Agents 36(6), 531–536 (2010).
   PubMed Web of Science ®Google Scholar
• Brown GD, Denning DW, Levitz SM. Tackling human fungal infections. Science 336(6082), 647 (2012).
   PubMed Web of Science ®Google Scholar