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(New) Methods for Detection of Aspergillus fumigatus Resistance in Clinical Samples

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A Correction to this article was published on 10 July 2019

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Abstract

Purpose of Review

The incidence of invasive aspergillosis has increased substantially over the past few decades, accompanied by a change in susceptibility patterns of Aspergillus fumigatus with increasing resistance observed against triazole antifungals, including voriconazole and isavuconazole, the most commonly used antifungal agents for the disease. Culture-based methods for determining triazole resistance are still the gold standard but are time consuming and lack sensitivity. We sought to provide an update on non-culture-based methods for detecting resistance patterns to Aspergillus.

Recent Findings

New molecular-based approaches for detecting triazole resistance to Aspergillus, real-time polymerase chain reaction (PCR) to detect mutations to the Cyp51A protein, have been developed which are able to detect most triazole-resistant A. fumigatus strains in patients with invasive aspergillosis.

Summary

Over the last few years, a number of non-culture-based methods for molecular detection of Aspergillus triazole resistance have been developed that may overcome some of the limitations of culture. These molecular methods are therefore of high epidemiological and clinical relevance, mainly in immunocompromised patients with hematological malignancies, where culture has particularly limited sensitivity. These assays are now able to detect most triazole-resistant Aspergillus fumigatus strains. Given that resistance rates vary, clinical utility for these assays still depends on regional resistance patterns.

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Change history

  • 10 July 2019

    Funding information was incomplete. The correct information is given below.

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Funding

This work was supported using funds from the Oesterreichische Nationalbank (Anniversary Fund, project number 15346).

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Authors and Affiliations

  1. Department of Medicine, University of California San Diego, San Diego, CA, 92103, USA

    Jeffrey D. Jenks & Martin Hoenigl

  2. Department of Hematology and Oncology, Scientific Laboratory, University Hospital Mannheim, Heidelberg University, Pettenkoferstraße 22, 68169, Mannheim, Germany

    Birgit Spiess & Dieter Buchheidt

  3. Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria

    Martin Hoenigl

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Dieter Buchheidt reports being a consultant to Basilea, Gilead Sciences, and Merck Sharp & Dohme/Merck; receiving research grants from Gilead Sciences and Pfizer; serving on the speakers’ bureau of Astellas, Basilea, Gilead Sciences, Merck Sharp & Dohme/Merck, Pfizer, and TEVA; and receiving travel grants from Astellas, Gilead Sciences, Merck Sharp & Dohme/Merck, and Pfizer. Martin Hoenigl reports untied research funding from Gilead. Jeffrey Jenks and Birgit Spiess declare no conflict of interest relevant to this manuscript.

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Jenks, J.D., Spiess, B., Buchheidt, D. et al. (New) Methods for Detection of Aspergillus fumigatus Resistance in Clinical Samples. Curr Fungal Infect Rep 13, 129–136 (2019). https://doi.org/10.1007/s12281-019-00342-w

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