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Current Fungal Infection Reports
Published in: Current Fungal Infection Reports 2/2023

Open Access 18-03-2023 | Voriconazole

Invasive Aspergillosis and the Impact of Azole-resistance

Authors: Davide Bosetti, Dionysios Neofytos

Published in: Current Fungal Infection Reports | Issue 2/2023

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Abstract  

Purpose of Review

IA (invasive aspergillosis) caused by azole-resistant strains has been associated with higher clinical burden and mortality rates. We review the current epidemiology, diagnostic, and therapeutic strategies of this clinical entity, with a special focus on patients with hematologic malignancies.

Recent Findings

There is an increase of azole resistance in Aspergillus spp. worldwide, probably due to environmental pressure and the increase of long-term azole prophylaxis and treatment in immunocompromised patients (e.g., in hematopoietic stem cell transplant recipients). The therapeutic approaches are challenging, due to multidrug-resistant strains, drug interactions, side effects, and patient-related conditions.

Summary

Rapid recognition of resistant Aspergillus spp. strains is fundamental to initiate an appropriate antifungal regimen, above all for allogeneic hematopoietic cell transplantation recipients. Clearly, more studies are needed in order to better understand the resistance mechanisms and optimize the diagnostic methods to identify Aspergillus spp. resistance to the existing antifungal agents/classes. More data on the susceptibility profile of Aspergillus spp. against the new classes of antifungal agents may allow for better treatment options and improved clinical outcomes in the coming years. In the meantime, continuous surveillance studies to monitor the prevalence of environmental and patient prevalence of azole resistance among Aspergillus spp. is absolutely crucial.
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Metadata
Title
Invasive Aspergillosis and the Impact of Azole-resistance
Authors
Davide Bosetti
Dionysios Neofytos
Publication date
18-03-2023
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 2/2023
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-023-00459-z

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