Multicenter Study of Azole-Resistant Aspergillus fumigatus Clinical Isolates, Taiwan1

Emerg Infect Dis. 2020 Apr;26(4):804-806. doi: 10.3201/eid2604.190840.


In a multicenter study, we determined a prevalence rate of 4% for azole-resistant Aspergillus fumigatus in Taiwan. Resistance emerged mainly from the environment (TR34/L98H, TR34/L98H/S297T/F495I, and TR46/Y121F/T289A mutations) but occasionally during azole treatment. A high mortality rate observed for azole-resistant aspergillosis necessitates diagnostic stewardship in healthcare and antifungal stewardship in the environment.

Keywords: Aspergillus fumigatus; HMG-CoA reductase; TR34/L98H; TR46/Y121F/T289A; Taiwan; antimicrobial resistance; azole resistance; azole use; cdr1B; clinical isolates; cyp51A; environments; fungi; humans.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Aspergillus fumigatus* / genetics
  • Azoles* / pharmacology
  • Drug Resistance, Fungal
  • Fungal Proteins / genetics
  • Microbial Sensitivity Tests
  • Taiwan / epidemiology


  • Antifungal Agents
  • Azoles
  • Fungal Proteins