For a better user experience please update your browser or use Chrome or Firefox browser.
Utilities
Publication detail
HomeRisk assessment on the impact of environmental usage of traizoles on the development and spread of resistance to medical triazoles in Aspergillus species
Publication metadata
In recent years, triazole resistance in human Aspergillus diseases appears to have been increasing in several European countries. However, current data on the prevalence of resistance are based on a small number of studies which are only available from a few European countries. If present, triazole resistance can severely limit treatment options since alternatives, which are only available in intravenous form, have been shown to be associated with more side effects and poorer outcomes. Triazole resistance in Aspergillus spp. can evolve during therapy. Several point mutations, particularly in the cyp51A gene, have been associated with the development of resistance. Increasingly however, resistant isolates are also being detected in azole-naive patients. These isolates tend to have a particular genetic alteration consisting of a 34-base pair tandem repeat in the promoter coupled with a point mutation in the cyp51A target gene. This leads to an amino-acid substitution at codon 98 (TR34/L98H) causing multi-azole resistance. In patients whose Aspergillus isolates have developed resistance during azole therapy wildtype isolates, closely related genetically to the resistant isolates, have regularly been recovered from samples taken before the start of therapy or during an earlier phase. To date however, no isogenic isolate with a wild-type phenotype has been recovered from patients infected with an Aspergillus strain carrying the TR34/L98H genetic alteration. This suggests a possible environmental origin of the resistant fungus. This particular resistance mechanism has been observed most frequently in clinical isolates in the Netherlands where it has also been found in the environment. Moreover, the resistance mechanism has been demonstrated in clinical isolates in eight other European countries.
- Published:
- Corporate author(s): European Centre for Disease Prevention and Control (EU body or agency)
- Themes: Health policy , Medical and biological research
- Subject: allergy , disease prevention , environmental impact , infectious disease , pesticide , public health
|
Paper
|
|||
| ISSN | ISBN 978-92-9193-444-7 | DOI 10.2900/76274 | Catalogue number TQ-32-13-107-EN-C |
- Released on EU publications website:
This publication is available for download in web format (PDF) and in print-quality format (PDF/X). For more information on how to print your own copy of EU publications, please refer to our FAQ section.
Document viewer
Note:
The publication cannot be displayed in the document viewer. Open web version
You may access it from: Download and languages