Multi-azole resistance in Aspergillus fumigatus.


Howard SJ, Webster I, Moore CB, Gardiner RE, Park S, Perlin DS, Denning DW.

Date: 14 February 2007


Azole resistance in Aspergillus spp. is unusual. We report a patient who received long-term treatment with itraconazole and voriconazole for bilateral chronic cavitary aspergillosis with aspergillomas whose isolates of Aspergillus fumigatus developed simultaneous resistance to itraconazole and voriconazole. A novel mutation (G138C) in the target gene (cyp51A) encoding 14alpha-demethylase was detected. The patient had some response to intravenous caspofungin, which he received six times weekly, without the development of resistance over 9 months.

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