2022
DOI: 10.3201/eid2809.220517
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Fatal Fungicide-Associated Triazole-Resistant Aspergillus fumigatus Infection, Pennsylvania, USA

Abstract: We report a fatal infection in a 65-year-old immunocompromised male patient caused by pan-triazole–resistant Aspergillus fumigatus containing a TR 34 /L98H genetic mutation linked to agricultural fungicide use. Clinical and environmental surveillance of triazole-resistant A. fumigatus is needed in the United States to prevent spread and guide healthcare and agricultural practices.

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Cited by 11 publications
(5 citation statements)
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“…It is well known that triazoles are widely used in the development of agrochemicals and medicines based on their highly efficient and broad‐spectrum biological activities [8] . But the drug resistance in the triazole structures has been significantly increased because of the frequent use of triazole drugs [9] . As a result, triazolium salts that bear similar chemical structures to triazoles have attracted considerable attention in recent years.…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“…It is well known that triazoles are widely used in the development of agrochemicals and medicines based on their highly efficient and broad‐spectrum biological activities [8] . But the drug resistance in the triazole structures has been significantly increased because of the frequent use of triazole drugs [9] . As a result, triazolium salts that bear similar chemical structures to triazoles have attracted considerable attention in recent years.…”
Section: Introductionmentioning
confidence: 99%
“…[8] But the drug resistance in the triazole structures has been significantly increased because of the frequent use of triazole drugs. [9] As a result, triazolium salts that bear similar chemical structures to triazoles have attracted considerable attention in recent years. Some of the triazolium compounds, such as Biapenem [4] and Cresemba, [10] have been approved by U. S. the Food and Drug Administration (FDA) as marketed human drugs (Figure 1).…”
Section: Introductionmentioning
confidence: 99%
“…Antifungal-resistant Aspergillus fumigatus infections may be resulting from the overuse of agricultural fungicides [ 79 , 80 , 81 ]. Evaluating the impacts of agricultural, medicinal, and other environmental uses of antifungal compounds can provide insight into factors influencing this emergence and inform public health action.…”
Section: Disease-specific Priorities ( Table 2 )mentioning
confidence: 99%
“…In the USA, triazole-resistant A. fumigatus has been infrequently reported. However, low case numbers likely reflect a lack of adequate antifungal susceptibility testing capacity and disease surveillance rather than a true absence of disease [ 30 , 31 ]. Although data are limited, triazole-resistant A. fumigatus has been isolated from animals, including birds and a bottlenose dolphin [ 32 , 33 , 34 , 35 ].…”
Section: Environmental Origins: the Case Of Triazole-resistant ...mentioning
confidence: 99%