Print page Print page
Switch language
Hvidovre Hospital - a part of Copenhagen University Hospital

Azole Resistance in Aspergillus fumigatus. The first 2-year's Data from the Danish National Surveillance Study, 2018-2020

Research output: Contribution to journalJournal articleResearchpeer-review


  1. Possible misinterpretation of penicillin susceptibility in Staphylococcus aureus blood isolate due to in vitro loss of the blaZ gene

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Behandling af indlæggelseskrævende COVID-19

    Research output: Contribution to journalReviewResearchpeer-review

  3. Udredning og opfølgning af indlæggelseskrævende COVID-19

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Predominance of hospital-acquired bloodstream infection in patients with Covid-19 pneumonia

    Research output: Contribution to journalLetterResearchpeer-review

  • Malene Risum
  • Rasmus Krøger Hare
  • Jan Berg Gertsen
  • Lise Kristensen
  • Flemming Schønning Rosenvinge
  • Sofia Sulim
  • Nissrine Abou-Chakra
  • Jette Bangsborg
  • Bent Løwe Røder
  • Ea Sofie Marmolin
  • Karen Marie Thyssen Astvad
  • Michael Pedersen
  • Esad Dzajic
  • Steen Lomborg Andersen
  • Maiken Cavling Arendrup
View graph of relations

BACKGROUND: Azole resistance complicates treatment of patients with invasive aspergillosis with an increased mortality. Azole resistance in Aspergillus fumigatus is a growing problem and associated with human and environmental azole use. Denmark has a considerable and highly efficient agricultural sector. Following reports on environmental azole resistance in A. fumigatus from Danish patients, the ministry of health requested a prospective national surveillance of azole-resistant A. fumigatus and particularly that of environmental origin.

OBJECTIVES: To present the data from the first 2 years of the surveillance programme.

METHODS: Unique isolates regarded as clinically relevant and any A. fumigatus isolated on a preferred weekday (background samples) were included. EUCAST susceptibility testing was performed and azole-resistant isolates underwent cyp51A gene sequencing.

RESULTS: The azole resistance prevalence was 6.1% (66/1083) at patient level. The TR34 /L98H prevalence was 3.6% (39/1083) and included the variants TR34 /L98H, TR34 3 /L98H and TR34 /L98H/S297T/F495I. Resistance caused by other Cyp51A variants accounted for 1.3% (14/1083) and included G54R, P216S, F219L, G54W, M220I, M220K, M220R, G432S, G448S and Y121F alterations. Non-Cyp51A-mediated resistance accounted for 1.2% (13/1083). Proportionally, TR34 /L98H, other Cyp51A variants and non-Cyp51A-mediated resistance accounted for 59.1% (39/66), 21.2% (14/66) and 19.7% (13/66), respectively, of all resistance. Azole resistance was detected in all five regions in Denmark, and TR34 /L98H specifically, in four of five regions during the surveillance period.

CONCLUSION: The azole resistance prevalence does not lead to a change in the initial treatment of aspergillosis at this point, but causes concern and leads to therapeutic challenges in the affected patients.

Original languageEnglish
Article number13426
Issue number4
Pages (from-to)419-428
Number of pages10
Publication statusPublished - Apr 2022

Bibliographical note

This article is protected by copyright. All rights reserved.

ID: 73462672