{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:00:23Z","timestamp":1793714423067,"version":"4.6.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,7,30]],"date-time":"2022-07-30T00:00:00Z","timestamp":1659139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Emergence of triazole resistance has been observed in Aspergillus fumigatus over the past decade including Africa. This review summarizes the current published data on the epidemiology and reported mechanisms of triazole-resistant Aspergillus fumigatus (TRAF) in both environmental and clinical isolates from Africa. Searches on databases Medline, PubMed, HINARI, Science Direct, Scopus and Google Scholar on triazole resistance published between 2000 and 2021 from Africa were performed. Isolate source, antifungal susceptibility using internationally recognized methods, cyp51A mechanism of resistance and genotype were collected. Eleven published African studies were found that fitted the search criteria; these were subsequently analyzed. In total this constituted of 1686 environmental and 46 clinical samples. A TRAF prevalence of 17.1% (66\/387) and 1.3% (5\/387) was found in respectively environmental and clinical settings in African studies. Resistant to itraconazole, voriconazole, and posaconazole was documented. Most of the triazole-resistant isolates (30\/71, 42.25%) were found to possess the TR34\/L98H mutation in the cyp51A-gene; fewer with TR46\/Y121F\/T289A (n\u00a0=\u00a08), F46Y\/M172V\/E427K (n\u00a0=\u00a01), G54E (n\u00a0=\u00a013), and M172V (n\u00a0=\u00a01) mutations. African isolates with the TR34\/L98H, TR46\/Y121F\/T289A and the G54E mutations were closely related and could be grouped in one of two clusters (cluster-B), whereas the cyp51A-M172V mutation clustered with most cyp51A-WT strains (cluster-A). A single case from Kenya shows that TR34\/L98H from environmental and clinical isolates are closely related. Our findings highlight that triazole resistance in environmental and clinical A. fumigatus is a cause for concern in a number of African countries. There is need for epidemiological surveillance to determine the true burden of the problem in Africa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay Summary<\/jats:title>\n                  <jats:p>Emergence of triazole resistance has been observed in Aspergillus fumigatus. TRAF was found from environmental (17.1%) and clinical (1.3%) settings in Africa. We highlighted that triazole resistance in environmental and clinical A. fumigatus is a cause for concern in a number of African countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mmy\/myac059","type":"journal-article","created":{"date-parts":[[2022,7,30]],"date-time":"2022-07-30T10:49:43Z","timestamp":1659178183000},"source":"Crossref","is-referenced-by-count":17,"title":["Triazole resistance in <i>Aspergillus fumigatus<\/i> isolates in Africa: a systematic review"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3436-4553","authenticated-orcid":false,"given":"Fructueux Modeste","family":"Amona","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Marien Ngouabi University , Brazzaville , Republic of Congo"},{"name":"Research Center and Study of Infectious and Tropical Pathologies , Oyo , Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-3345","authenticated-orcid":false,"given":"Rita Okeoghene","family":"Oladele","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos , Lagos , Nigeria"},{"name":"Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital , Idi-Araba, Lagos , Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-1030","authenticated-orcid":false,"given":"Agustin","family":"Resendiz-Sharpe","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven , Belgium"},{"name":"Department of Imaging and Pathology, Biomedical MRI , KU Leuven, Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Denning","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, the University of Manchester and Manchester Academic Health Science Centre , Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0662-1265","authenticated-orcid":false,"given":"Chris","family":"Kosmidis","sequence":"additional","affiliation":[{"name":"National Aspergillosis Centre, Manchester University Foundation Trust, Manchester , UK"},{"name":"Manchester Academic Health Science Centre, the University of Manchester , Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien","family":"Lagrou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven , Belgium"},{"name":"Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven , Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanying","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Han","sequence":"additional","affiliation":[{"name":"Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,30]]},"reference":[{"key":"2022082217280308800_bib1","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.3201\/eid1507.090043","article-title":"Frequency and evolution of azole resistance in Aspergillus fumigatus associated with treatment failure","volume":"15","author":"Howard","year":"2009","journal-title":"Emerg Infect 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