Cited by 604Antifungal resistance and susceptibilityFungal Plant Pathogen ControlFungal and yeast genetics research

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Azole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use?

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Verweij, Paul E, Snelders, Eveline, Kema, Gert HJ, Mellado, Emilia, Melchers, Willem JG·2009·The Lancet Infectious Diseases

DOI 10.1016/s1473-3099(09)70265-8

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Abstract

Invasive aspergillosis due to multi-azole-resistant Aspergillus fumigatus has emerged in the Netherlands since 1999, with 6.0-12.8% of patients harbouring resistant isolates. The presence of a single resistance mechanism (denoted by TR/L98H), which consists of a substitution at codon 98 of cyp51A and a 34-bp tandem repeat in the gene-promoter region, was found in over 90% of clinical A fumigatus isolates. This is consistent with a route of resistance development through exposure to azole compounds in the environment. Indeed, TR/L98H A fumigatus isolates were cultured from soil and compost, were shown to be cross-resistant to azole fungicides, and genetically related to clinical resistant isolates. Azoles are abundantly used in the environment and the presence of A fumigatus resistant to medical triazoles is a major challenge because of the possibility of worldwide spread of resistant isolates. Reports of TR/L98H in other European countries indicate that resistance might already be spreading.

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Manavathu EK, Baskaran I, K rishnan S, Alangaden G, Chandrasekar PH. Cytochrome P450 14-alpha-sterol demethylase mutation dependent triazole cross-resistance in Aspergillus fumigatus. Proceedings of the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, IL, USA; Sept 14–17, 2003. Abstract M-392.

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Authors: Verweij, P. E., Snelders, E., Kema, G. H., Mellado, E., & Melchers, W. J.
Affiliations: Radboud University Medical Center (NL)
Wageningen University & Research (NL)
Instituto de Salud Carlos III (ES)
Corresponding author: Verweij, Paul E
ORCID: Verweij, Paul E
Snelders, Eveline
Kema, Gert HJ
Mellado, Emilia
Melchers, Willem JG
Venue: The Lancet Infectious Diseases
Publisher: Elsevier BV
Published: 2009-12
Volume: 9
Issue: 12
Pages: 789-795
ISSN: 1473-3099 (ISSN-L)
DOI: 10.1016/s1473-3099(09)70265-8
OpenAlex: W2133000347
Cited by: 604
References: 52
Citations by year: 2026: 23 · 2025: 25 · 2024: 32 · 2023: 23 · 2022: 28 · 2021: 56 · 2020: 46 · 2019: 47 · 2018: 34 · 2017: 50 · 2016: 40 · 2015: 47 · 2014: 33 · 2013: 27 · 2012: 37
FWCI: 21.32
Type: journal article
Language: en
Open access: green
research.wur.nl
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The Lancet Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Socio-Environmental Systems Modeling (acceptedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Pfizer
Basilea Pharmaceutica
Schering-Plough
Gilead Sciences
Cephalon
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Agricultural and Biological Sciences › Plant Science › Fungal Plant Pathogen Control
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Keywords: Aspergillus fumigatus, azole resistance, invasive aspergillosis, cyp51A, triazole fungicides, cross-resistance, clinical isolates, resistance spread
MeSH terms: Antifungal Agents, Aspergillosis, Aspergillus fumigatus, Cytochrome P-450 Enzyme System, Europe, Fungal Proteins, Fungicides, Industrial, Humans, Microbial Sensitivity Tests, Mutation, Soil Microbiology, Triazoles, Drug Resistance, Multiple, Fungal

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Azole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use?

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