ArticlePloS one2010
Development of azole resistance in Aspergillus fumigatus during azole therapy associated with change in virulence.
Article in PloS one, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers.
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Who cites it
80 citing papers in PubMed, 173 citations in OpenAlex.
- Climate change and antimicrobial resistance.Nature reviews. Microbiology · 2026Review
- Amino acid substitutions at the G118 hotspot in dihydroorotate dehydrogenase confer olorofim resistance inMicrobiology spectrum · 2026Article
- Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- Review
- The Influence ofJournal of fungi (Basel, Switzerland) · 2024Article
- Insights intoJournal of fungi (Basel, Switzerland) · 2024Article
- A one health roadmap towards understanding and mitigating emerging Fungal Antimicrobial Resistance: fAMR.npj antimicrobials and resistance · 2024Review
- Resistance profiling ofEmerging microbes & infections · 2022Article
- Article
- Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment.Nature microbiology · 2022Article
- Experimental and in-host evolution of triazole resistance in human pathogenic fungi.Frontiers in fungal biology · 2022Review
- Use of Bulk Segregant Analysis for Determining the Genetic Basis of Azole Resistance in the Opportunistic PathogenFrontiers in cellular and infection microbiology · 2022Article
- Fungicide effects on human fungal pathogens: Cross-resistance to medical drugs and beyond.PLoS pathogens · 2021Review
- Review
- Clinical and experimental phenotype of azole-resistant Aspergillus fumigatus with a HapE splice site mutation: a case report.BMC infectious diseases · 2021Article
- Molecular typing of clinical and environmental Aspergillus fumigatus isolates from Iran using microsatellites.Current medical mycology · 2021Article
- Mechanisms of triazole resistance in Aspergillus fumigatus.Environmental microbiology · 2020Review
- Five-Year Survey (2014 to 2018) of Azole Resistance in EnvironmentalAntimicrobial agents and chemotherapy · 2020Article
- Structural basis of HapELife science alliance · 2020Article
- Lysine acetylation as drug target in fungi: an underexplored potential in Aspergillus spp.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2020Review
20 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Four sequential Aspergillus fumigatus isolates from a patient with chronic granulomatous disease (CGD) eventually failing azole-echinocandin combination therapy were investigated. The first two isolates (1 and 2) were susceptible to antifungal azoles, but increased itraconazole, voriconazole and posaconazole MICs were found for the last two isolates (3 and 4). Microsatellite typing showed that the 4 isolates were isogenic, suggesting that resistance had been acquired during azole treatment of the patient. An immunocompromised mouse model confirmed that the in vitro resistance corresponded with treatment failure. Mice challenged with the resistant isolate 4 failed to respond to posaconazole therapy, while those infected by susceptible isolate 2 responded. Posaconazole-anidulafungin combination therapy was effective in mice challenged with isolate 4. No mutations were found in the Cyp51A gene of the four isolates. However, expression experiments of the Cyp51A showed that the expression was increased in the resistant isolates, compared to the azole-susceptible isolates. The microscopic morphology of the four isolates was similar, but a clear alteration in radial growth and a significantly reduced growth rate of the resistant isolates on solid and in broth medium was observed compared to isolates 1 and 2 and to unrelated wild-type controls. In the mouse model the virulence of isolates 3 and 4 was reduced compared to the susceptible ones and to wild-type controls. For the first time, the acquisition of azole resistance despite azole-echinocandin combination therapy is described in a CGD patient and the resistance demonstrated to be directly associated with significant change of virulence.
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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.