随着抗真菌药物在临床上的广泛使用,致病性真菌的耐药率越来越高,耐药曲霉对侵袭性曲霉病的诊治产生了重要影响。目前,致病性曲霉耐药性的确定主要依靠抗真菌药敏试验和分子诊断。在有关曲霉耐药机制的研究中,报道最多的是曲霉对唑类药物的耐药,其机制主要包括外排泵表达增加、靶酶Cyp51突变和表达水平增高、形成生物膜,以及热休克蛋白90(Hsp90)介导的信号通路参与而导致的耐药。本文就上述领域近年来的主要进展进行综述。
With the wide use of antifungals in the clinic ,there have been increasing reports of resistant strains of Aspergillus spp .to antifungals .The resistance of Aspergillus spp .has important impact on the diagnosis and treatment of invasive aspergillosis .Currently ,the determination of antifungal resistance of pathogenic Aspergillus spp .relies on antifungal susceptibility testing and molecular detection .Recently ,the resistance of Aspergillus spp .to antifungals is mainly focused on azole antifungals .The research progress on antifungal resistance of pathogenic Aspergillus spp ., including the diagnosis for resistance and the molecular mechanisms ,such as over‐expression of efflux pumps ,mutations in the target enzyme (Cyp51) ,formation of biofilm and heat shock protein 90 (Hsp90)‐mediated signaling pathways are reviewed .