Nonrandom Distribution of Azole Resistance across the Global Population of Aspergillus fumigatus
Open accessAbstract
Azole drug resistance in the human-pathogenic fungus Aspergillus fumigatus continues to emerge, potentially leading to untreatable aspergillosis in immunosuppressed hosts. Two dominant, environmentally associated resistance mechanisms, which are thought to have evolved through selection by the agricultural application of azole fungicides, are now distributed globally. Understanding the effect that azole resistance is having on the genetic diversity and global population of A. fumigatus will help mitigate drug-resistant aspergillosis and maintain the azole class of fungicides for future use in both medicine and crop protection.
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Duplications in the cyp51A gene promoter coupled with TR34/L98H and TR46/Y121F/T289A substitutions are becoming widespread in the environment associated with azole use in agriculture and are also isolated from hospital patients without previous antifungal exposure.
“Alarmingly, duplications in the cyp51A gene promoter coupled with specific amino acid substitutions, TR34/L98H and TR46/Y121F/T289A, are becoming widespread in the environment associated with azole use in agriculture, while also isolated from hospital patients without previous exposure to antifungal drugs19–22.”
From Molecular mechanisms governing antifungal drug resistance (2023) · cites this paper as [19]
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References 72 · Cited by 109
- Authors
- Sewell, T. R., Zhu, J., Rhodes, J., Hagen, F., Meis, J. F., Fisher, M. C., & Jombart, T.
- Affiliations
- Imperial College London (GB)
- Westerdijk Fungal Biodiversity Institute (NL)
- Radboud University Medical Center (NL)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Sewell, Thomas R.
- ORCID
- Venue
- mBio
- Publisher
- American Society for Microbiology
- Published
- 2019-06-25
- Volume
- 10
- Issue
- 3
- ISSN
- 2150-7511 (ISSN-L)
- 2161-2129
- PMC
- PMC6529631
- OpenAlex
- W2946571129
- Cited by
- 109
- References
- 72
- Citations by year
- 2026: 11 · 2025: 10 · 2024: 18 · 2023: 16 · 2022: 7 · 2021: 25 · 2020: 20 · 2019: 2
- FWCI
- 10.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- mBio (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (submittedVersion, other-oa)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- RCUK | Medical Research Council (MRC/MR/R015600/1)
- NERC Environmental Bioinformatics Centre (NE/P001165/1)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Keywords
- Aspergillus fumigatus, azole resistance, drug resistance, aspergillosis, genetic diversity, fungal population structure, environmental selection, azole fungicides, antifungal resistance, immunocompromised patients
- MeSH terms
- Antifungal Agents, Aspergillosis, Aspergillus fumigatus, Azoles, Environmental Microbiology, Genotype, Humans, Phylogeny, Genetic Variation, Cluster Analysis, Mycological Typing Techniques, Microsatellite Repeats, Tandem Repeat Sequences, Drug Resistance, Fungal, Molecular Typing
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