Invasive Aspergillosis by : Epidemiology, Diagnosis, Antifungal Resistance, and Management.

is the second most common etiological agent of invasive aspergillosis (IA) after . However, most literature describes IA in relation to or together with other species. Certain differences exist in IA caused by and and studies on infections are increasing. Hence, we performed a comprehensive updated review on IA due to . is the cause of a broad spectrum of human diseases predominantly in Asia, the Middle East, and Africa possibly due to its ability to survive better in hot and arid climatic conditions compared to other spp. Worldwide, ~10% of cases of bronchopulmonary aspergillosis are caused by Outbreaks have usually been associated with construction activities as invasive pulmonary aspergillosis in immunocompromised patients and cutaneous, subcutaneous, and mucosal forms in immunocompetent individuals. Multilocus microsatellite typing is well standardized to differentiate isolates into different clades. is intrinsically resistant to polyenes. In contrast to , triazole resistance infrequently occurs in and is associated with mutations in the gene. Overexpression of efflux pumps in non-wildtype strains lacking mutations in the gene can also lead to high voriconazole minimum inhibitory concentrations. Voriconazole remains the drug of choice for treatment, and amphotericin B should be avoided. Primary therapy with echinocandins is not the first choice but the combination with voriconazole or as monotherapy may be used when the azoles and amphotericin B are contraindicated.