Multidrug-Resistant Aspergillus fumigatus Carrying Mutations Linked to Environmental Fungicide Exposure — Three States, 2010–2017

Abstract

What is already known about this topic? The environmental mold Aspergillus fumigatus is the primary cause of invasive aspergillosis. In patients with high-risk conditions, mortality exceeds 50%. A. fumigatus isolates resistant to medical triazoles have recently been identified in the United States in clinical and environmental specimens. The resistance marker TR34/L98H causes resistance to all triazoles and is associated with agricultural and environmental fungicide use. What is added by this report? Seven U.S. clinical TR34/L98H A. fumigatus isolates were identified during 2010-2017 from three states; four were collected from patients with no known previous triazole exposure. What are the implications for public health practice? U.S. clinicians and public health personnel should be aware that infections with triazole-resistant A. fumigatus can occur in patients not previously exposed to these medications.