Current status of azole-resistant aspergillus fumigatus isolates in east asia: China, Japan, Korea, and Taiwan

Abstract

Aspergillus fumigatus is a saprophytic fungus that is a major causative pathogen for aspergillosis. Only a few classes of antifungals are used for treating this life-threatening fungal infection. Azoles are the first-line drugs and are widely used for the management and prophylaxis of aspergillosis. An emerging issue is the increasing incidence of resistant isolates worldwide. In particular,environmentally derived tandem-repeat-type azole-resistant mutations,such as Cyp51A TR34/L98H,and Cyp51A TR46/Y121F/T289A,have emerged over the last decade. In particular,azole-resistant isolates were prevalent in clinical settings in European countries; many of the reports are from the Netherlands,UK,and Germany. In contrast,reports on azole-resistant A. fumigatus isolates from East Asian countries are still few and have only recently begun to increase. Herein,all literature on East Asian azole-resistant A. fumigatus isolates were reviewed,and a complete list of resistant isolates from China,Japan,Taiwan, and Korea is provided. As of this report,the total numbers of tandem-repeat-type azole-resistant isolates are 26,3,32,and 1 in China,Japan,Taiwan,and Korea,respectively.