Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain.
Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain.
Int J Antimicrob Agents. 2020 Jan;55(1):105807. doi: 10.1016/j.ijantimicag.2019.09.011. Epub 2019 Sep 19.
Aspergillus fumigatus is the main causal agent of invasive aspergillosis (IA), however other species of the genus can also cause IA, such as Aspergillus flavus, Aspergillus terreus, Aspergillus niger and related cryptic species. This infectious disease mainly affects immunosuppressed patients and is linked to elevated mortality rates. As voriconazole is the treatment of choice for this condition, the relevant increase in the number of azole-resistant isolates in recent years has gathered alarming attention, as it also translates into an increase in clinical failures. In this review, we summarise and discuss the azole resistance molecular data described to date in the most clinically prevalent sections of Aspergillus, including mechanisms involving the target proteins Cyp51 and ATP-binding cassette (ABC) or major facilitator superfamily (MFS) efflux pumps. Other resistance mechanisms proposed but not yet fully characterised are also discussed.
烟曲霉是侵袭性曲霉病（IA）的主要病原体，但属中的其他物种也可引起 IA，如黄曲霉、土曲霉、黑曲霉和相关的隐种。这种传染病主要影响免疫抑制患者，并与高死亡率有关。由于伏立康唑是治疗这种疾病的首选药物，近年来唑类耐药分离株数量的相关增加引起了人们的警惕，因为这也意味着临床失败的增加。在这篇综述中，我们总结并讨论了迄今为止在最具临床意义的曲霉部分描述的唑类耐药的分子数据，包括涉及靶蛋白 Cyp51 和三磷酸腺苷（ATP）结合盒（ABC）或主要易化超家族（MFS）外排泵的机制。还讨论了其他提出但尚未完全表征的耐药机制。
