Résistance microbiologique des Aspergillus aux antifongiques : de l'identification au séquençage des mutations

Microbiological resistance of Aspergillus spp. is increasing. The first step is a correct species identification since the taxonomy of Aspergillus sections has been recently revised. Inside a given section, resistant and susceptible species can coexist. For the azole resistance in Aspergillus fumigatus, mutations in cyp51A gene have been evidenced. For the other molecules and the other species, the responsible mutations are still being described. Knowledge of epidemiology of resistance is insufficient. Environmental pressure due to agriculture use of fungicides seems to be a major cause compared to medical use of antifungal drugs. Surveillance programs are needed for the next years for surveying these phenomena and to adapt our therapeutic guidelines.