1887

Chapter 49 : Aspergillus as a Human Pathogen: an Evolutionary Perspective

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Aspergillus as a Human Pathogen: an Evolutionary Perspective, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815639/9781555814144_Chap49-1.gif /docserver/preview/fulltext/10.1128/9781555815639/9781555814144_Chap49-2.gif

Abstract:

The opportunistic mould Aspergillus is one of the most ubiquitous filamentous fungi in the world. Aspergillus fumigatus is the most prevalent airborne fungal pathogen in humans and obviously the most common cause of aspergillosis, causing around 90% of infections. This chapter provides a general overview of the pathogenesis, clinical aspects, and epidemiology of aspergillosis. Invasive aspergillosis is uncommon in the healthy host, and hence there are doubts regarding the virulence of Aspergillus spp. The most significant pathogenic factor of A. fumigatus is its ubiquitous nature that increases the chance to interact with hosts presenting factors that predispose them to infection. Aspergillus is an unusual cause of onychomycosis, particularly Aspergillus sydowii and Aspergillus versicolor. The complete recognition of Aspergillus virulence could lead to advances in one's understanding of the disease and in the management of diverse clinical presentations. During the past decade the incidence of invasive infection by molds and resistance to antifungal agents have been increasing. The azole-derived antifungal agents inhibit the ergosterol biosynthesis pathway via the inhibition of 14-αsterol demethylase, the enzyme that removes the methyl group at position C-14 of precursor sterols. The study of molecular mechanisms of antifungal drug resistance is the most valuable strategy for controlling the progress of resistance and in helping develop safer and more active molecules able to avoid them.

Citation: Mellado E, Cuenca-Estrella M, Rodríguez-Tudela J. 2008. Aspergillus as a Human Pathogen: an Evolutionary Perspective, p 591-601. In Baquero F, Nombela C, Cassell G, Gutiérrez-Fuentes J (ed), Evolutionary Biology of Bacterial and Fungal Pathogens. ASM Press, Washington, DC. doi: 10.1128/9781555815639.ch49
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1.
Figure 1.

Summary of Aspergillus fumigatus resistance mechanisms to azole antifungal drugs. Differences in amino acid changes correlate with different patterns of azole resistance. ITC, itraconazole; VRC, voriconazole; RVC, ravuconazole; POS, posaconazole.

Citation: Mellado E, Cuenca-Estrella M, Rodríguez-Tudela J. 2008. Aspergillus as a Human Pathogen: an Evolutionary Perspective, p 591-601. In Baquero F, Nombela C, Cassell G, Gutiérrez-Fuentes J (ed), Evolutionary Biology of Bacterial and Fungal Pathogens. ASM Press, Washington, DC. doi: 10.1128/9781555815639.ch49
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555815639.ch49
1. Ader, F.,, S. Nseir,, R. Le Berre,, S. Leroy,, I. Tillie-Leblond,, C. H. Marquette, and, A. Durocher. 2005. Invasive pulmonary aspergillosis in chronic obstructive pulmonary disease: an emerging fungal pathogen. Clin. Microbiol. Infect. 11:427429.
2. Akbari, J. G.,, P. K. Varma,, P. K. Neema,, M. U. Menon, and, K. S. Neelakandhan. 2005. Clinical profile and surgical outcome for pulmonary aspergilloma: a single center experience. Ann. Thorac. Surg. 80:10671072.
3. Almyroudis, N. G.,, S. M. Holland, and, B. H. Segal. 2005. Invasive aspergillosis in primary immunodeficiencies. Med. Mycol. 43:S247S259.
4. Ascioglu, S.,, J. H. Rex,, B. de Pauw,, J. E. Bennett,, J. Bille,, F. Crokaert,, D. W. Denning,, J. P. Donnelly,, J. E. Edwards,, Z. Erjavec,, D. Fiere,, O. Lortholary,, J. Maertens,, J. F. Meis,, T. F. Patterson,, J. Ritter,, D. Selleslag,, P. M. Shah,, D. A. Stevens, and, T. J. Walsh. 2002. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin. Infect. Dis. 34:714.
5. Aubry, A.,, R. Porcher,, J. Bottero,, S. Touratier,, T. Leblanc,, B. Brethon,, P. Rousselot,, E. Raffoux,, J. Menotti,, F. Derouin,, P. Ribaud, and, A. Sulahian. 2006. Occurrence and kinetics of false-positive Aspergillus galactomannan test results following treatment with β-lactam antibiotics in patients with hematological disorders. J. Clin. Microbiol. 44:389394.
6. Balajee, S. A.,, J. Gribskov,, M. Brandt,, J. Ito,, A. Fothergill, and, K. A. Marr. 2005a. Mistaken identity: Neosartorya pseudo-fischeri and its anamorph masquerading as Aspergillus fumigatus. J. Clin. Microbiol. 43:59965999.
7. Balajee, S. A.,, J. L. Gribskov,, E. Hanley,, D. Nickle, and, K. A. Marr. 2005b. Aspergillus lentulus sp. nov., a new sibling species of A. fumigatus. Eukaryot. Cell 4:625632.
8. Balajee, S. A.,, M. Weaver,, A. Imhof,, J. Gribskov, and, K. A. Marr. 2004. Aspergillus fumigatus variant with decreased susceptibility to multiple antifungals. Antimicrob. Agents Chemother. 48:11971203.
9. Bandini, G.,, F. Bonifazi, and, M. Stanzani. 2005. Umbilical-cord blood for transplantation in adults. N. Engl. J. Med. 352:935937.
10. Bart-Delabesse, E.,, M. Basile,, A. Al Jijakli,, D. Souville,, F. Gay,, B. Philippe,, P. Bossi,, M. Danis,, J. P. Vernant, and, A. Datry. 2005. Detection of Aspergillus galactomannan antigenemia to determine biological and clinical implications of beta-lactam treatments. J. Clin. Microbiol. 43:52145220.
11. Bertout, S.,, F. Renaud,, R. Barton,, F. Symoens,, J. Burnod,, M. A. Piens,, B. Lebeau,, M. A. Viviani,, F. Chapuis,, J. M. Bastide,, R. Grillot, and, M. Mallie. 2001. Genetic polymorphism of Aspergillus fumigatus in clinical samples from patients with invasive aspergillosis: investigation using multiple typing methods. J. Clin. Microbiol. 39:17311737.
12. Bretagne, S. 2003. Molecular diagnostics in clinical parasitology and mycology: limits of the current polymerase chain reaction (PCR) assays and interest of the real-time PCR assays. Clin. Microbiol. Infect. 9:505511.
13. Chandrasekar, P. H. 2005. Antifungal resistance in Aspergillus. Med. Mycol. 43(Suppl. 1): S295S298.
14. Cuenca-Estrella, M.,, J. L. Rodriguez-Tudela,, E. Mellado,, J. V. Martinez-Suarez, and, A. Monzon. 1998. Comparison of the in-vitro activity of voriconazole (UK-109,496), itraconazole and amphotericin B against clinical isolates of Aspergillus fumigatus. J. Antimicrob. Chemother. 42:531533.
15. de Hoog, G. S.,, J. Guarro,, J. Gene, and, M. J. Figueres. 2000. Atlas of Clinical Fungi. Centraalbureau voor Schimmelcultures/Universitat Rovira i Virgili, Utrecht/Reus, The Netherlands.
16. Debeaupuis, J. P.,, J. Sarfati,, V. Chazalet, and, J. P. Latge. 1997. Genetic diversity among clinical and environmental isolates of Aspergillus fumigatus. Infect. Immun. 65:30803085.
17. Denning, D. W. 1998. Invasive aspergillosis. Clin. Infect. Dis. 26:781803.
18. Denning, D. W. 2001. Chronic forms of pulmonary aspergillosis. Clin. Microbiol. Infect. 7(Suppl. 2): 2531.
19. Denning, D. W.,, B. R. O’Driscoll,, C. M. Hogaboam,, P. Bowyer, and, R. M. Niven. 2006. The link between fungi and severe asthma: a summary of the evidence. Eur. Respir. J. 27:615626.
20. Denning, D. W.,, K. Riniotis,, R. Dobrashian, and, H. Sambatakou. 2003. Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review. Clin. Infect. Dis. 37(Suppl. 3): S265S280.
21. Denning, D. W.,, K. Venkateswarlu,, K. L. Oakley,, M. J. Anderson,, N. J. Manning,, D. A. Stevens,, D. W. Warnock, and, S. L. Kelly. 1997. Itraconazole resistance in Aspergillus fumigatus. Antimicrob. Agents Chemother. 41:13641368.
22. Diaz-Guerra, T. M.,, E. Mellado,, M. Cuenca-Estrella, and, J. L. Rodriguez-Tudela. 2003. A point mutation in the 14-alpha-sterol demethylase gene cyp51A contributes to itraconazole resistance in Aspergillus fumigatus. Antimicrob. Agents Chemother. 47:11201124.
23. Donnelly, J. P. 2006. Polymerase chain reaction for diagnosing invasive aspergillosis: getting closer but still a ways to go. Clin. Infect. Dis. 42:487489.
24. Dufour, X.,, C. Kauffmann-Lacroix,, F. Roblot,, J. M. Goujon,, J. P. Breux,, J. C. Ferrie, and, J. M. Klossek. 2004. Chronic invasive fungal rhinosinusitis: two new cases and review of the literature. Am. J. Rhinol. 18:221226.
25. Favre, B.,, M. Didmon, and, N. S. Ryder. 1999. Multiple amino acid substitutions in lanosterol 14alpha-demethylase contribute to azole resistance in Candida albicans. Microbiology 145(Pt 10): 27152725.
26. Fortun, J.,, P. Martin-Davila,, M. E. Alvarez,, A. Sanchez-Sousa,, C. Quereda,, E. Navas,, R. Barcena,, E. Vicente,, A. Candelas,, A. Honrubia,, J. Nuno,, V. Pintado, and, S. Moreno. 2001. Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic method for invasive aspergillosis in liver transplant recipients. Transplantation 71:145149.
27. Garnacho-Montero, J.,, R. Amaya-Villar,, C. Ortiz-Leyba,, C. Leon,, F. Alvarez-Lerma,, J. Nolla-Salas,, J. Iruretagoyena, and, F. Barcenilla. 2005. Isolation of Aspergillus spp. from the respiratory tract in critically ill patients: risk factors, clinical presentation and outcome. Crit. Care 9:R191R199.
28. Gavalda, J.,, O. Len,, R. San Juan,, J. M. Aguado,, J. Fortun,, C. Lumbreras,, A. Moreno,, P. Munoz,, M. Blanes,, A. Ramos,, G. Rufi,, M. Gurgui,, J. Torre-Cisneros,, M. Montejo,, M. Cuenca-Estrella,, J. L. Rodriguez-Tudela, and, A. Pahissa. 2005. Risk factors for invasive aspergillosis in solid-organ transplant recipients: a case-control study. Clin. Infect. Dis. 41:5259.
29. Ghannoum, M. A., and, L. B. Rice. 1999. Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin. Microbiol. Rev. 12:501517.
30. Gianni, C., and, C. Romano. 2004. Clinical and histological aspects of toenail onychomycosis caused by Aspergillus spp.: 34 cases treated with weekly intermittent terbinafine. Dermatology 209:104110.
31. Gomez-Lopez, A.,, G. Garcia-Effron,, E. Mellado,, A. Monzon,, J. L. Rodriguez-Tudela, and, M. Cuenca-Estrella. 2003. In vitro activities of three licensed antifungal agents against spanish clinical isolates of Aspergillus spp. Antimicrob. Agents Chemother. 47:30853088.
32. Greene, R. 2005. The radiological spectrum of pulmonary aspergillosis. Med. Mycol. 43:S147S154.
33. Guarro, J.,, E. G. Kallas,, P. Godoy,, A. Karenina,, J. Gene,, A. Stchigel, and, A. L. Colombo. 2002. Cerebral aspergillosis caused by Neosartorya hiratsukae, Brazil. Emerg. Infect. Dis. 8:989991.
34. Gupta, A. K.,, J. E. Ryder,, R. Baran, and, R. C. Summerbell. 2003. Nondermatophyte onychomycosis. Dermatol. Clin. 21:257268.
35. Herbrecht, R.,, V. Letscher-Bru,, C. Oprea,, B. Lioure,, J. Waller,, F. Campos,, O. Villard,, K. L. Liu,, S. Natarajan-Ame,, P. Lutz,, P. Dufour,, J. P. Bergerat, and, E. Candolfi. 2002. Aspergillus galactomannan detection in the diagnosis of invasive aspergillosis in cancer patients. J. Clin. Oncol. 20:18981906.
36. Hope, W. W.,, T. J. Walsh, and, D. W. Denning. 2005. The invasive and saprophytic syndromes due to Aspergillus spp. Med. Mycol. 43(Suppl. 1): S207S238.
37. Horger, M.,, H. Hebart,, H. Einsele,, C. Lengerke,, C. D. Claussen,, R. Vonthein, and, C. Pfannenberg. 2005. Initial CT manifestations of invasive pulmonary aspergillosis in 45 non-HIV immunocompromised patients: association with patient outcome? Eur. J. Radiol. 55:437444.
38. Husain, S.,, E. J. Kwak,, A. Obman,, M. M. Wagener,, S. Kusne,, J. E. Stout,, R. McCurry, and, N. Singh. 2004. Prospective assessment of plateliatm Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am. J. Transplant. 4:796802.
39. Jarv, H.,, J. Lehtmaa,, R. C. Summerbell,, E. S. Hoekstra,, R. A. Samson, and, P. Naaber. 2004. Isolation of Neosartorya pseudo-fischeri from blood: first hint of pulmonary aspergillosis. J. Clin. Microbiol. 42:925928.
40. Johnson, E. M.,, K. L. Oakley,, S. A. Radford,, C. B. Moore,, P. Warn,, D. W. Warnock, and, D. W. Denning. 2000. Lack of correlation of in vitro amphotericin B susceptibility testing with outcome in a murine model of Aspergillus infection. J. Antimicrob. Chemother. 45:8593.
41. Kaur, R.,, N. Mittal,, M. Kakkar,, A. K. Aggarwal, and, M. D. Mathur. 2000. Otomycosis: a clinicomycologic study. Ear Nose Throat J. 79:606609.
42. Kontoyiannis, D. P., and, G. P. Bodey. 2002. Invasive aspergillosis in 2002: an update. Eur. J. Clin. Microbiol. Infect. Dis. 21:161172.
43. Kwak, E. J.,, S. Husain,, A. Obman,, L. Meinke,, J. Stout,, S. Kusne,, M. M. Wagener, and, N. Singh. 2004. Efficacy of galactomannan antigen in the platelia Aspergillus enzyme immunoassay for diagnosis of invasive aspergillosis in liver transplant recipients. J. Clin. Microbiol. 42:435438.
44. Lair-Fulleringer, S.,, J. Guillot,, C. Desterke,, D. Seguin,, S. Warin,, A. Bezille,, R. Chermette, and, S. Bretagne. 2003. Differentiation between isolates of Aspergillus fumigatus from breeding turkeys and their environment by genotyping with microsatellite markers. J. Clin. Microbiol. 41:17981800.
45. Lass-Florl, C.,, K. Griff,, A. Mayr,, A. Petzer,, G. Gastl,, H. Bonatti,, M. Freund,, G. Kropshofer,, M. P. Dierich, and, D. Nachbaur. 2005. Epidemiology and outcome of infections due to Aspergillus terreus: 10-year single centre experience. Br. J. Haematol. 131:201207.
46. Latge, J. P. 1999. Aspergillus fumigatus and aspergillosis. Clin. Microbiol. Rev. 12:310350.
47. Leenders, A. C.,, A. van Belkum,, M. Behrendt,, A. Luijendijk, and, H. A. Verbrugh. 1999. Density and molecular epidemiology of Aspergillus in air and relationship to outbreaks of Aspergillus infection. J. Clin. Microbiol. 37:17521757.
48. Lewis, R. E.,, N. P. Wiederhold,, J. Chi,, X. Y. Han,, K. V. Komanduri,, D. P. Kontoyiannis, and, R. A. Prince. 2005. Detection of gliotoxin in experimental and human aspergillosis. Infect. Immun. 73:635637.
49. Lin, S. J.,, J. Schranz, and, S. M. Teutsch. 2001. Aspergillosis case-fatality rate: systematic review of the literature. Clin. Infect. Dis. 32:358366.
50. Lonial, S.,, L. Williams,, G. Carrum,, M. Ostrowski, and, P. McCarthy. 1997. Neosartorya fischeri: an invasive fungal pathogen in an allogeneic bone marrow transplant patient. Bone Marrow Transplant. 19:753755.
51. Maertens, J.,, J. Verhaegen,, H. Demuynck,, P. Brock,, G. Verhoef,, P. Vandenberghe,, J. Van Eldere,, L. Verbist, and, M. Boogaerts. 1999. Autopsy-controlled prospective evaluation of serial screening for circulating galactomannan by a sandwich enzyme-linked immunosorbent assay for hematological patients at risk for invasive Aspergillosis. J. Clin. Microbiol. 37:32233228.
52. Maertens, J.,, J. Verhaegen,, K. Lagrou,, J. Van Eldere, and, M. Boogaerts. 2001. Screening for circulating galactomannan as a noninvasive diagnostic tool for invasive aspergillosis in prolonged neutropenic patients and stem cell transplantation recipients: a prospective validation. Blood 97:16041610.
53. Mann, P. A.,, R. M. Parmegiani,, S. Q. Wei,, C. A. Mendrick,, X. Li,, D. Loebenberg,, B. DiDomenico,, R. S. Hare,, S. S. Walker, and, P. M. McNicholas. 2003. Mutations in Aspergillus fumigatus resulting in reduced susceptibility to posaconazole appear to be restricted to a single amino acid in the cytochrome P450 14alpha-demethylase. Antimicrob. Agents Chemother. 47:577581.
54. Marr, K. A.,, S. A. Balajee,, L. McLaughlin,, M. Tabouret,, C. Bentsen, and, T. J. Walsh. 2004. Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J. Infect. Dis. 190:641649.
55. Meersseman, W.,, S. J. Vandecasteele,, A. Wilmer,, E. Verbeken,, W. E. Peetermans, and, E. Van Wijngaerden. 2004. Invasive aspergillosis in critically ill patients without malignancy. Am. J. Respir. Crit. Care Med. 170:621625.
56. Mellado, E.,, T. M. Diaz-Guerra,, M. Cuenca-Estrella, and, J. L. Rodriguez-Tudela. 2001. Identification of two different 14-alpha sterol demethylase-related genes (cyp51A and cyp51B) in Aspergillus fumigatus and other Aspergillus species. J. Clin. Microbiol. 39:24312438.
57. Mellado, E.,, G. Garcia-Effron,, L. Alcazar-Fuoli,, M. Cuenca-Estrella, and, J. L. Rodriguez-Tudela. 2004. Substitutions at methionine 220 in the 14alpha-sterol demethylase (Cyp51A) of Aspergillus fumigatus are responsible for resistance in vitro to azole antifungal drugs. Antimicrob. Agents Chemother. 48:27472750.
58. Mellado, E.,, G. Garcia-Effron,, M. J. Buitrago,, L. Alcazar-Fuoli,, M. Cuenca-Estrella, and, J. L. Rodriguez-Tudela. 2005. Targeted gene disruption of the 14-alpha sterol demethylase (cyp51A) in Aspergillus fumigatus and its role in azole drug susceptibility. Antimicrob. Agents Chemother. 49:25362538.
59. Meyer, R. D.,, C. R. Gaultier,, J. T. Yamashita,, R. Babapour,, H. E. Pitchon, and, P. R. Wolfe. 1994. Fungal sinusitis in patients with AIDS: report of 4 cases and review of the literature. Medicine (Baltimore)73:6978.
60. Morgan, J.,, K. A. Wannemuehler,, K. A. Marr,, S. Hadley,, D. P. Kontoyiannis,, T. J. Walsh,, S. K. Fridkin,, P. G. Pappas, and, D. W. Warnock. 2005. Incidence of invasive aspergillosis following hematopoietic stem cell and solid organ transplantation: interim results of a prospective multicenter surveillance program. Med. Mycol. 43:S49S58.
61. Mosquera, J., and, D. W. Denning. 2002. Azole cross-resistance in Aspergillus fumigatus. Antimicrob. Agents Chemother. 46:556557.
62. Moss, R. B. 2005. Pathophysiology and immunology of allergic bronchopulmonary aspergillosis. Med. Mycol. 43(Suppl. 1): S203S206.
63. Nascimento, A. M.,, G. H. Goldman,, S. Park,, S. A. Marras,, G. Delmas,, U. Oza,, K. Lolans,, M. N. Dudley,, P. A. Mann, and, D. S. Perlin. 2003. Multiple resistance mechanisms among Aspergillus fumigatus mutants with high-level resistance to itraconazole. Antimicrob. Agents Chemother. 47:17191726.
64. National Committee for Clinical Laboratory Standards. 2002. Reference method for broth diution antifungal susceptibility testing of filamentous fungi. Approved standard. M38-A. National Committee for Clinical Laboratory Standards, Wayne, PA.
65. Obayashi, T.,, M. Yoshida,, T. Mori,, H. Goto,, A. Yasuoka,, H. Iwasaki,, H. Teshima,, S. Kohno,, A. Horiuchi, and, A. Ito. 1995. Plasma (1→3)-beta-D-glucan measurement in diagnosis of invasive deep mycosis and fungal febrile episodes. Lancet 345:1720.
66. Odabasi, Z.,, G. Mattiuzzi,, E. Estey,, H. Kantarjian,, F. Saeki,, R. J. Ridge,, P. A. Ketchum,, M. A. Finkelman,, J. H. Rex, and, L. Ostrosky-Zeichner. 2004. beta-D-glucan as a diagnostic adjunct for invasive fungal infections: Validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome. Clin. Infect. Dis. 39:199205.
67. Odds, F. C.,, F. Van Gerven,, A. Espinel-Ingroff,, M. S. Bartlett,, M. A. Ghannoum,, M. V. Lancaster,, M. A. Pfaller,, J. H. Rex,, M. G. Rinaldi, and, T. J. Walsh. 1998. Evaluation of possible correlations between antifungal susceptibilities of filamentous fungi in vitro and antifungal treatment outcomes in animal infection models. Antimicrob. Agents Chemother. 42:282288.
68. Ostrosky-Zeichner, L.,, B. D. Alexander,, D. H. Kett,, J. Vazquez,, P. G. Pappas,, F. Saeki,, P. A. Ketchum,, J. Wingard,, R. Schiff,, H. Tamura,, M. A. Finkelman, and, J. H. Rex. 2005. Multicenter clinical evaluation of the (1→3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin. Infect. Dis. 41:654659.
69. Paoletti, M.,, C. Rydholm,, E. U. Schwier,, M. J. Anderson,, G. Szakacs,, F. Lutzoni,, J. P. Debeaupuis,, J. P. Latge,, D. W. Denning, and, P. S. Dyer. 2005. Evidence for sexuality in the opportunistic fungal pathogen Aspergillus fumigatus. Curr. Biol. 15:12421248.
70. Patterson, T. F. 2003. Aspergillosis, p. 221240. In W. E. Dismukes,, P. G. Pappas, and, J. D. Sobel (ed.), Clinical Mycology. Oxford University Press, New York, NY.
71. Perfect, J. R.,, G. M. Cox,, J. Y. Lee,, C. A. Kauffman,, L. de Repentigny,, S. W. Chapman,, V. A. Morrison,, P. Pappas,, J. W. Hiemenz, and, D. A. Stevens. 2001. The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis. Clin. Infect. Dis. 33:18241833.
72. Phadke, A. P., and, B. Mehrad. 2005. Cytokines in host defense against Aspergillus: recent advances. Med. Mycol. 43(Suppl 1): S173S176.
73. Pickering, J. W.,, H. W. Sant,, C. A. P. Bowles,, W. L. Roberts, and, G. L. Woods. 2005. Evaluation of a (1→3)-{beta}-D-glucan assay for diagnosis of invasive fungal infections. J. Clin. Microbiol. 43:59575962.
74. Pinjon, E.,, G. P. Moran,, C. J. Jackson,, S. L. Kelly,, D. Sanglard,, D. C. Coleman, and, D. J. Sullivan. 2003. Molecular mechanisms of itraconazole resistance in Candida dubliniensis. Anti-microb. Agents Chemother. 47:24242437.
75. Rinyu, E.,, J. Varga, and, L. Ferenczy. 1995. Phenotypic and genotypic analysis of variability in Aspergillus fumigatus. J. Clin. Microbiol. 33:25672575.
76. Rosenberg, M.,, R. Patterson,, R. Mintzer,, B. J. Cooper,, M. Roberts, and, K. E. Harris. 1977. Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillosis. Ann. Intern. Med. 86:405414.
77. Sanglard, D., and, F. C. Odds. 2002. Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences. Lancet Infect. Dis. 2:7385.
78. Schwesinger, G.,, D. Junghans,, G. Schroder,, H. Bernhardt, and, M. Knoke. 2005. Candidosis and aspergillosis as autopsy findings from 1994 to 2003. Mycoses 48:176180.
79. Sigler, L., and, P. E. Verweij. 2003. Aspergillus, Fusarium, and other opportunistic moniliaceous fungi, p. 17261760. In P. R. Murray (ed.), Manual of Clinical Microbiology, 8th ed. ASM Press, Washington, DC.
80. Silva Ferreira, M. E.,, J. L. Capellaro,, M. E. dos Reis,, I. Malavazi,, D. Perlin,, S. Park,, J. B. Anderson,, A. L. Colombo,, B. A. Arthington-Skaggs,, M. H. Goldman, and, G. H. Goldman. 2004. In vitro evolution of itraconazole resistance in Aspergillus fumigatus involves multiple mechanisms of resistance. Antimicrob. Agents Chemother. 48:44054413.
81. Simoneau, E.,, M. Kelly,, A. C. Labbe,, J. Roy, and, M. Laverdiere. 2004. What is the clinical significance of positive blood cultures with Aspergillus sp. in hematopoietic stem cell transplant recipients? A 23 year experience. Bone Marrow Transplant. 35:303306.
82. Singh, N. 2001. Trends in the epidemiology of opportunistic fungal infections: predisposing factors and the impact of antimicrobial use practices. Clin. Infect. Dis. 33:16921696.
83. Singh, N. 2005. Invasive aspergillosis in organ transplant recipients: new issues in epidemiologic characteristics, diagnosis, and management. Med. Mycol. 43:S267S270.
84. Singh, N. and, D. L. Paterson. 2005. Aspergillus infections in transplant recipients. Clin. Microbiol. Rev. 18:4469.
85. Slaven, J. W.,, M. J. Anderson,, D. Sanglard,, G. K. Dixon,, J. Bille,, I. S. Roberts, and, D. W. Denning. 2002. Increased expression of a novel Aspergillus fumigatus ABC transporter gene, atrF, in the presence of itraconazole in an itraconazole resistant clinical isolate. Fungal. Genet. Biol. 36:199206.
86. Stanzani, M.,, E. Orciuolo,, R. Lewis,, D. P. Kontoyiannis,, S. L. Martins,, L. S. St John, and, K. V. Komanduri. 2005. Aspergillus fumigatus suppresses the human cellular immune response via gliotoxin-mediated apoptosis of monocytes. Blood 105:22582265.
87. Stevens, D. A.,, R. B. Moss,, V. P. Kurup,, A. P. Knutsen,, P. Greenberger,, M. A. Judson,, D. W. Denning,, R. Crameri,, A. S. Brody,, M. Light,, M. Skov,, W. Maish, and, G. Mastella. 2003. Allergic bronchopulmonary aspergillosis in cystic fibrosis—state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin. Infect. Dis. 37(Suppl 3): S225S264.
88. Sulahian, A.,, F. Boutboul,, P. Ribaud,, T. Leblanc,, C. Lacroix, and, F. Derouin. 2001. Value of antigen detection using an enzyme immunoassay in the diagnosis and prediction of invasive aspergillosis in two adult and pediatric hematology units during a 4-year prospective study. Cancer 91:311318.
89. Upton, A.,, A. Gugel,, W. Leisenring,, A. Limaye,, B. Alexander,, R. Hayden, and, K. A. Marr. 2005. Reproducibility of low galactomannan enzyme immunoassay index values tested in multiple laboratories. J. Clin. Microbiol. 43:47964800.
90. Vandewoude, K.,, S. Blot,, P. Depuydt,, D. Benoit,, W. Temmerman,, F. Colardyn, and, D. Vogelaers. 2006. Clinical relevance of Aspergillus isolation from respiratory tract samples in critically ill patients. Crit. Care 10:R31.
91. Varga, J. 2003. Mating type gene homologues in Aspergillus fumigatus. Microbiology 149:816819.
92. Verweij, P. E.,, D. T. Te Dorsthorst,, A. J. Rijs,, H. G. Vries-Hospers, and, J. F. Meis. 2002. Nationwide survey of in vitro activities of itraconazole and voriconazole against clinical Aspergillus fumigatus isolates cultured between 1945 and 1998. J. Clin. Microbiol. 40:26482650.
93. Viscoli, C.,, M. Machetti,, P. Gazzola,, A. De Maria,, D. Paola,, M. T. Van Lint,, F. Gualandi,, M. Truini, and, A. Bacigalupo. 2002. Aspergillus galactomannan antigen in the cerebrospinal fluid of bone marrow transplant recipients with probable cerebral aspergillosis J. Clin. Microbiol. 40:14961499.
94. Walsh, T. J.,, S. Shoham,, R. Petraitiene,, T. Sein,, R. Schaufele,, A. Kelaher,, H. Murray,, C. Mya-San,, J. Bacher, and, V. Petraitis. 2004. Detection of galactomannan antigenemia in patients receiving piperacillin-tazobactam and correlations between in vitro, in vivo, and clinical properties of the drug-antigen interaction. J. Clin. Microbiol. 42:47444748.

Tables

Generic image for table
Table 1.

Classification of clinical syndromes caused by Aspergillus spp.

Citation: Mellado E, Cuenca-Estrella M, Rodríguez-Tudela J. 2008. Aspergillus as a Human Pathogen: an Evolutionary Perspective, p 591-601. In Baquero F, Nombela C, Cassell G, Gutiérrez-Fuentes J (ed), Evolutionary Biology of Bacterial and Fungal Pathogens. ASM Press, Washington, DC. doi: 10.1128/9781555815639.ch49
Generic image for table
Table 2.

Summary susceptibility results of most frequent species of Aspergillus isolated from clinical samples a

Citation: Mellado E, Cuenca-Estrella M, Rodríguez-Tudela J. 2008. Aspergillus as a Human Pathogen: an Evolutionary Perspective, p 591-601. In Baquero F, Nombela C, Cassell G, Gutiérrez-Fuentes J (ed), Evolutionary Biology of Bacterial and Fungal Pathogens. ASM Press, Washington, DC. doi: 10.1128/9781555815639.ch49

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error