Purpose: Aspergillus section Fumigati includes species that commonly cause life-threatening infections in humans and animals. This section currently comprises more than 50 species of Aspergillus. Morphological characteristics and microscopic features are not sufficient for distinguishing between species of the Aspergillus section Fumigati; therefore molecular techniques are routinely used. This study sought to evaluate antifungal susceptibility patterns of Aspergillus spp. within the section Fumigati.
Methods: A literature search was conducted on published studies that employed antifungal susceptibility testing on Aspergillus species within the section Fumigati using PubMed and Google Scholar between years 1997 and 2017. Key search words included “Aspergillus fumigatus”, “Aspergillus section Fumigati, “antifungals”, “Aspergillus lentulus”, “triazoles resistance”, “Neosartorya fischeri”, “Neorsartorya pseudofischeri”, and “Neorsartorya hiratsukae”
Results: Eighty-nine studies reporting susceptibility patterns of Aspergillus spp. Included in the section Fumigati to amphotericin B, triazoles and the echinocandin classes of antifungals were reviewed. A. fumigatus strains showing resistance to azole drugs has been reported, however, these isolates have low minimum inhibitory concentrations (MICs) to amphotericin B. Resistance to the triazole antifungal agents is remarkable in Aspergillus lentulus, Aspergillus udagawae and Aspergillus pseudofischeri species. Aspergillus lentulus has been shown to exhibit more resistance to the currently available antifungal agents; it has decreased in vitro susceptibilities to multiple antifungals, including amphotericin B and the echinocandins. Aspergillus udagawae and Aspergillus pseudofischeri have shown variable sensitivity to triazoles with high itraconazole, voriconazole and ravuconazole MICs.
Conclusion: Antifungal susceptibility patterns vary significantly in Aspergillus species of different sections, particularly within the section Fumigati. Molecular methods are needed for the correct identification of members of Aspergillus section Fumigati to the species level. This information enables clinicians to optimize treatment of aspergillosis with improved treatment outcomes.
Full conference title:
- AAA 8th (2018)