Azole Resistance in Aspergillus fumigatus Isolates

Invasive Aspergillosis (IA) is an important cause of mortality and morbidity in the immunocompromised host such as، neutropenic individuals، chronic granulomatous disorder، leukemia، those undergoing solid organ transplantation، patients using broad spectrum antibiotics and steroids، patients with severe underlying diseases and patients with chronic pulmonary obstructive disease are among the main risk groups. Successful management in the treatment of IA depends on early diagnosis and treatment، the adequate choice of therapy، and antifungal resistance. The diagnosis of IA remains difficult and significant proportions of cases of IA remain undetected، thus in case of IA treatment should be considered as early as possible and carried out until the improvements. The treatment is usually based on surgery، antifungal therapy and reduction of immunosuppression. Azole-resistant Aspergillus fumigatus was first observed in Netherlands in 1999. Full mechanism of evolution of azole resistance is not completely known، however، increasing evidence indicates a role for azole fungicide used in agriculture. Due to the presence of A. fumigatus as an agent of IA in our environment and risk for patients، understanding the evolution of the increasing azole resistance in A. fumigatus is crucially recommended. Therefore، induction of azole resistance or its spread can be possibly prevented to allow future treatment of IA due to A. fumigatus.