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Clinical Implications of Azole Resistance in Aspergillus fumigatus , the Netherlands, 2007–2009
Jan W.M. van der Linden, Eveline Snelders, Greetje A. Kampinga and 7 more
Emerging Infectious Diseases · 2011
Abstract
The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azole-resistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate for patients with invasive aspergillosis.
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From PubMed Central, U.S. National Library of Medicine, as current on Oct 17, 2026. Paragraph numbers are ours, so an answer can point at one.
Medscape CME
Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/eid; (4) view/print certificate.
Release date: September 22, 2011; Expiration date: September 22, 2012
Learning Objectives
Upon completion of this activity, participants will be able to:
Describe the prevalence of itraconazole resistance in clinical A. fumigatus isolates on the basis of a prospective, nationwide, multicenter surveillance study in the Netherlands
Describe risk factors for development of itraconazole resistance in A. fumigatus isolates on the basis of that study
Describe outcomes associated with development of itraconazole resistance in A. fumigatus isolates on the basis of that study
MEDSCAPE CME EDITOR
Nancy Mannikko, PhD, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Nancy Mannikko, PhD, has disclosed no relevant financial relationships.
MEDSCAPE CME AUTHOR
Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.
AUTHORS
Disclosures: Jan W.M. van der Linden, MD; Eveline Snelders, MSc; Greetje A. Kampinga, MD, PhD; Bart J.A. Rijnders, MD, PhD; Eva Mattsson, MD, PhD; Yvette J. Debets-Ossenkopp, MD, PhD; Ed J. Kuijper, MD, PhD; Frank H. Van Tiel, MD, PhD; and Willem J.G. Melchers, PhD, have disclosed no relevant financial relationships. Paul E. Verweij, MD, PhD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Merck & Co., Inc.; Astellas Pharma, Inc.; Gilead Sciences, Inc.; served as a speaker or a member of a speakers bureau for Merck & Co., Inc.; Gilead Sciences, Inc.; Pfizer Inc.; Cephalon, Inc.; received grants for clinical research from Merck & Co., Inc.; Gilead Sciences, Inc.; Pfizer Inc.
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