2018, Cilt 48, Sayı 3, Sayfa(lar) 153-166 |
[ Türkçe Özet ]
[ PDF ]
[ Benzer Makaleler ]
|
Aspergillus fumigatus Complex: A New Problem in a Challenging Pathogen, Azole Resistance |
Dolunay GÜLMEZ |
Hacettepe Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalı, Ankara |
Keywords: Aspergillus fumigatus, aspergillosis, azole resistance |
Aspergillus is widespread in nature and this mold may cause
different clinical forms of disease that affect a large group of
patients, mostly immunosupressed patients. Diagnosis of
aspergillosis is still challenging due to complex characteristics
of the disease and the host. Sensitivity of conventional
diagnostic methods is low, use of serological tests is limited to
certain patient subpopulations and molecular methods are yet
to be validated and standardized. Treatment mostly depends
on the use of antifungals and, recommended first line therapy
is azoles. Therefore, emerging azole resistance has a direct
impact on outcome of aspergillosis cases. Furthermore, azoles
are the only oral therapeutic options for aspergillosis and the
cost of alternative treatment options are higher. Mortality
rates in invasive aspergillosis and the need for surgery in
chronic pulmonary aspergillosis increase, if caused by azole
resistant Aspergillus. A less predicted consequence of azole
resistance was the effect on diagnosis. Because culture
methods are still needed to confirm the exact causative agent,
possibility of decreased sensitivity of culture in case of atypical
resistant phenotypes are of concern.
This review aims to summarize current information on
Aspergillus and aspergillosis and, to draw attention to azole
resistance that causes new challenges in an already complex
pathogen. As it is the most widespread human pathogen,
most of the data available are related to Aspergillus
fumigatus complex.
|
[ Türkçe Özet ]
[ PDF ]
[ Benzer Makaleler ]
|