Azole antifungal drugs are the primary option for the prophylaxis and treatment of invasive aspergillosis. Resistance to azoles in Aspergillus fumigatus is emerging as a global health problem through both the use of azoles in the environment and the prolonged use in the management of patients with invasive aspergillosis.
Delayed diagnosis, and limited treatment options for azole-resistant invasive aspergillosis results in poor patient outcomes, with mortality reported as high as 88 %¹. Early detection of resistance is crucial to ensure patients receive effective treatment quickly.
Resistance in Aspergillus fumigatus is caused by known mutations of the Cyp51 gene that threaten the role of the azole class of antifungals. The most common of these mutations, and their associated amino acid substitutions, are:
- Tandem Repeat 34 (TR34) and the associated amino acid substitution L98H
- Tandem Repeat 46 (TR46 ) and the associated amino acid substitutions T289A and Y121F
Fungiplex Aspergillus Azole-R assay is a real-time PCR designed to detect the presence of mutations in the Cyp51 gene of Aspergillus fumigatus, namely tandem repeat sequences TR34 and TR46 of the Cyp51A gene in Aspergillus fumigatus.
¹Van der Linden et al. Emerg Infect Dis 2015; 21 (6): 1041-44.