ArticleEmerging infectious diseases2009
Frequency and evolution of Azole resistance in Aspergillus fumigatus associated with treatment failure.
Article in Emerging infectious diseases, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 372 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
372 citing papers in PubMed, 2 syntheses or guidelines pooled it, 742 citations in OpenAlex.
- Antifungal Stewardship in Invasive Fungal Infections, a Systematic Review.Advances in experimental medicine and biology · 2025Pooled it
- Guideline
- Article
- Aneuploidy promotes transient stress adaptation and metabolic flexibility in the human fungal pathogen Aspergillus fumigatus.Current biology : CB · 2026Article
- Article
- Pseudomonas aeruginosa adaptation and persistence in the aspergilloma microbiome revealed by integrated multi-omics.G3 (Bethesda, Md.) · 2026Article
- Molecular and Phenotypic Characterization of Multidrug-ResistantJournal of fungi (Basel, Switzerland) · 2026Article
- The dual role of azoles: lifesaving antifungals and drivers of resistance - a One Health perspective.Nature communications · 2026Review
- Genotype-Phenotype Relationships in Azole-ResistantJournal of fungi (Basel, Switzerland) · 2026Review
- Evidence that increased azole persistence and stress resistance precede theMicrobiology spectrum · 2026Article
- Positivity rate of Aspergillus spp. in patients with tuberculosis-like symptoms in Yaoundé, Cameroon and antifungal resistance profile.BMC infectious diseases · 2026Article
- Neutrophil progenitor cell therapy rescues host defense against Staphylococcus aureus in murine chronic granulomatous disease.Journal of leukocyte biology · 2026Article
- Design, synthesis and biological profiling of bis-thiazole linked Schiff bases as effective enzyme inhibitors for targeting urease and thymidine phosphorylase proteins.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Global epidemiology of azole resistance inJAC-antimicrobial resistance · 2026Review
- A One Health Perspective onJournal of fungi (Basel, Switzerland) · 2026Article
- Genomic variant-driven prediction of azole resistance inFrontiers in microbiology · 2026Article
- Identification and Distribution of Potentially Azole-Resistant Airborne Fungi in Outdoor Environments of the Basque Country.Environmental microbiology reports · 2025Article
- In Vitro Activity of Nitroxoline (5-Nitro-8-Hydroxyquinoline) Against Aspergillus Species.Mycoses · 2025Article
- Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- Whole-chromosome duplications drive antimicrobial resistance inbioRxiv : the preprint server for biology · 2025Article
312 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Azoles are the mainstay of oral therapy for aspergillosis. Azole resistance in Aspergillus has been reported infrequently. The first resistant isolate was detected in 1999 in Manchester, UK. In a clinical collection of 519 A. fumigatus isolates, the frequency of itraconazole resistance was 5%, a significant increase since 2004 (p<0.001). Of the 34 itraconazole-resistant isolates we studied, 65% (22) were cross-resistant to voriconazole and 74% (25) were cross-resistant to posaconazole. Thirteen of 14 evaluable patients in our study had prior azole exposure; 8 infections failed therapy (progressed), and 5 failed to improve (remained stable). Eighteen amino acid alterations were found in the target enzyme, Cyp51A, 4 of which were novel. A population genetic analysis of microsatellites showed the existence of resistant mutants that evolved from originally susceptible strains, different cyp51A mutations in the same strain, and microalterations in microsatellite repeat number. Azole resistance in A. fumigatus is an emerging problem and may develop during azole therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.