Azole-resistant Aspergillus fumigatus in the environment: Identifying key reservoirs and hotspots of antifungal resistance.
Azole-resistant Aspergillus fumigatus in the environment: Identifying key reservoirs and hotspots of antifungal resistance.
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DOI：
10.1371/journal.ppat.1009711
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发表时间：
2021-07
期刊：
影响因子：
6.7
通讯作者：
Brewer MT
中科院分区：
文献类型：
--
作者：
Burks C;Darby A;Gómez Londoño L;Momany M;Brewer MT
烟曲霉是一种机会主义的人类病原体，会导致曲霉病，这是一种环境获得性呼吸道疾病的频谱。它分布在世界各地，以腐烂植物物质的腐殖体形式存在于环境中。唑类化合物以麦角固醇合成途径中的Cyp51a为靶点，是用于治疗曲霉病的主要药物类别。氮唑也被用来对抗植物病原真菌。最近，越来越多的未服用氮唑的患者出现了对泛唑耐药的烟曲霉菌株。Cyp51a基因的TR34/L98H和TR46/Y121F/T289A等位基因是引起泛唑耐药的最常见等位基因。有证据表明，这些突变发生在农业环境中；因此，人们进行了大量研究，以确定环境中烟曲霉对唑的抗药性，并确定环境中哪些地方产生了抗药性。在这里，我们根据现有的文献总结了全球环境中出现的耐唑烟曲霉菌。此外，我们还创建了一张交互式世界地图，显示在哪里检测到耐药菌株，并包括有关已识别的特定等位基因、环境设置和唑类杀菌剂使用的信息。除南极洲外，每个大陆都发现了抗氮唑的烟曲霉菌，其中来自欧洲的报告数量最多。发达的环境，特别是医院和花园，是最常见的检测到耐唑烟曲霉菌的环境，其次是从农业环境中采样的土壤。除南美洲TR46/Y121F/T289A等位基因外，其余地区均以TR34/L98H抗性等位基因最常见。解释这项文献调查的一个主要考虑因素是抽样偏差；被广泛抽样的地区和环境更有可能表现出更大的唑类耐药性，尽管耐药性可能在抽样不足或根本没有抽样的地区更为普遍。为了保护作物保护和人类健康，需要加强对水库的监测以及抗真菌管理。
Aspergillus fumigatus is an opportunistic human pathogen that causes aspergillosis, a spectrum of environmentally acquired respiratory illnesses. It has a cosmopolitan distribution and exists in the environment as a saprotroph on decaying plant matter. Azoles, which target Cyp51A in the ergosterol synthesis pathway, are the primary class of drugs used to treat aspergillosis. Azoles are also used to combat plant pathogenic fungi. Recently, an increasing number of azole-naive patients have presented with pan-azole–resistant strains of A. fumigatus. The TR34/L98H and TR46/Y121F/T289A alleles in the cyp51A gene are the most common ones conferring pan-azole resistance. There is evidence that these mutations arose in agricultural settings; therefore, numerous studies have been conducted to identify azole resistance in environmental A. fumigatus and to determine where resistance is developing in the environment. Here, we summarize the global occurrence of azole-resistant A. fumigatus in the environment based on available literature. Additionally, we have created an interactive world map showing where resistant isolates have been detected and include information on the specific alleles identified, environmental settings, and azole fungicide use. Azole-resistant A. fumigatus has been found on every continent, except for Antarctica, with the highest number of reports from Europe. Developed environments, specifically hospitals and gardens, were the most common settings where azole-resistant A. fumigatus was detected, followed by soils sampled from agricultural settings. The TR34/L98H resistance allele was the most common in all regions except South America where the TR46/Y121F/T289A allele was the most common. A major consideration in interpreting this survey of the literature is sampling bias; regions and environments that have been extensively sampled are more likely to show greater azole resistance even though resistance could be more prevalent in areas that are under-sampled or not sampled at all. Increased surveillance to pinpoint reservoirs, as well as antifungal stewardship, is needed to preserve this class of antifungals for crop protection and human health.
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影响因子：
5.8
作者：
Dauchy, C.;Bautin, N.;Frealle, E.
通讯作者：
Frealle, E.
影响因子：
11.8
作者：
Dasbach, EJ;Davies, GM;Teutsch, SM
通讯作者：
Teutsch, SM
影响因子：
4.9
作者：
Denning, DW;Venkateswarlu, K;Kelly, SL
通讯作者：
Kelly, SL
影响因子：
6.1
作者：
Chen, Zhi-Feng;Ying, Guang-Guo;Pan, Chang-Gui
通讯作者：
Pan, Chang-Gui
DOI：
10.3390/jof3040057
发表时间：
2017-10-18
期刊：
Journal of fungi (Basel, Switzerland)
影响因子：
--
作者：
Bongomin F;Gago S;Oladele RO;Denning DW
通讯作者：
Denning DW