Howard et al evaluated azole resistance in Aspergillus fumigatus, which can result in treatment failure. The authors are from the University of Manchester, University Medical Centre Ljubljana, Imperial College London, Universidade Federal do Rio Grande do Sul (Brazil), Hopital Maisonneuve-Rosement (Montreal), Statens Serum Institut (Copenhagen) and the Public Health Research Institute (Newark, NJ).
Factors that may predict a patient with a strain of Aspergillus fumigatus that is resistant to an azole agent:
(1) previous therapy with the azole
(2) progression of the infection or failure to improve during therapy with the azole
(3) history of resistance to another azole (due to cross-resistance)
Spread of a resistant strain is a serious hazard to other patients. Prompt identification of resistance, aggressive management and contact isolation may be able to control spread.
An additional risk factor would be the presence of resistant strains at the healthcare facility.
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