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Int J Antimicrob Agents. 2006 Nov;28(5):450-3. Epub 2006 Oct 10.

Multi-azole resistance in Aspergillus fumigatus.

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1
School of Medicine, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. susan.j.howard@manchester.ac.uk

Abstract

Azole resistance in Aspergillus spp. is unusual. We report a patient who received long-term treatment with itraconazole and voriconazole for bilateral chronic cavitary aspergillosis with aspergillomas whose isolates of Aspergillus fumigatus developed simultaneous resistance to itraconazole and voriconazole. A novel mutation (G138C) in the target gene (cyp51A) encoding 14alpha-demethylase was detected. The patient had some response to intravenous caspofungin, which he received six times weekly, without the development of resistance over 9 months.

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