Rivero-Menendez Olga, Alastruey-Izquierdo Ana, Mellado Emilia, Cuenca-Estrella Manuel
Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III., Carretera de Majadahonda a Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
Spanish Network for Research in Infectious Diseases (REIPI RD12/0015)-co-financed by European Development Regional Fund "A way to achieve Europe" ERDF, Madrid, Spain.
J Fungi (Basel). 2016 Jul 4;2(3):21. doi: 10.3390/jof2030021.
Since the first description of an azole-resistant strain in 1997, there has been an increasing number of papers describing the emergence of azole resistance. Firstly reported in the USA and soon after in Europe, it has now been described worldwide, challenging the management of human aspergillosis. The main mechanism of resistance is the modification of the azole target enzyme: 14-α sterol demethylase, encoded by the 51A gene; although recently, other resistance mechanisms have also been implicated. In addition, a shift in the epidemiology has been noted with other species (mostly azole resistant) increasingly being reported as causative agents of human disease. This paper reviews the current situation of azole resistance and its implications in the clinical setting.
自1997年首次描述唑类耐药菌株以来，描述唑类耐药性出现的论文数量不断增加。该耐药性首先在美国被报道，不久后在欧洲也有报道，现在全球范围内都有相关描述，这对人类曲霉病的管理构成了挑战。主要耐药机制是唑类靶酶14-α甾醇去甲基酶的修饰，该酶由51A基因编码；不过最近也发现了其他耐药机制。此外，流行病学也发生了变化，越来越多其他物种（大多对唑类耐药）被报道为人类疾病的病原体。本文综述了唑类耐药的现状及其在临床环境中的影响。
