Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector68507910.17816/medjrf685079OGHCOFReviewsНаучные обзорыReview ArticleEpidemiology and mechanisms of antifungal resistance in Aspergillus : а reviewЭпидемиология и механизмы устойчивости грибов рода Aspergillus к противогрибковым препаратам: литературный обзорhttps://orcid.org/0000-0001-5098-53794409-8108AvtonomovaAnastasia V.АвтономоваАнастасия Витальевна
Russian Federation

Cand. Sci. (Biology)

канд. биол. наук

nomova@yandex.ruhttps://orcid.org/0000-0003-4799-13181153-8414KisilOlga V.КисильОльга Валерьевна
Russian Federation

Cand. Sci. (Chemistry)

кандидат химических наук

olvv@mail.ruResearch Institute for the Search of New Antibiotics named after G.F. GauseНаучно-исследовательский институт по изысканию новых антибиотиков имени Г.Ф. Гаузе07122025311220253165685781806202511082025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://medjrf.com/0869-2106/article/view/685079

Invasive mycoses have become an increasingly serious global public health concern, particularly in immunocompromised patients. Species of the genus Aspergillus—most notably Aspergillus fumigatus—are among the principal causative pathogens. Despite advances in antifungal therapy, especially azole-based agents, the spread of azole-resistant Aspergillus spp. is emerging as a major clinical threat.

This review summarizes current data on the prevalence of drug-resistant Aspergillus spp. and describes the resistance mechanisms identified to date. The primary focus is on publications from the last decade; however, key foundational studies from earlier periods were also considered. The scientific data search was performed in eLIBRARY.RU, PubMed, Google Scholar, and Wally.

The analysis demonstrated a substantial increase in invasive aspergillosis cases caused by resistant Aspergillus strains. The main mechanisms of resistance include mutations in the cyp51 gene and hyperactivation of efflux transport proteins. Resistant isolates have been reported in Europe, Asia, Africa, and the Americas.

These findings may be used to inform guidelines aimed at improving epidemiologic surveillance of antifungal resistance in Aspergillus. Priority areas for future research should include development of antifungal agents, improved diagnostic assays for rapid detection of resistant strains, and optimization of treatment regimens. There is an urgent need for greater clinician awareness regarding the risks associated with azole use and tighter antifungal resistance control measures.

Инвазивные микозы становятся всё более серьёзной проблемой глобального здравоохранения, особенно для иммунокомпрометированных пациентов. Одними из основных возбудителей этих инфекций являются грибы рода Aspergillus, особенную опасность представляет Aspergillus fumigatus. Несмотря на успехи в лечении антимикотиками, в первую очередь азольными препаратами, распространение устойчивых к ним штаммов Aspergillus spp. становится новой угрозой для медицины.

В настоящем обзоре обобщена информация о распространённости лекарственно-устойчивых Aspergillus spp. и о выявленных у них механизмах устойчивости к противогрибковым препаратам. Основной акцент сделан на литературу последнего десятилетия, однако учтены и важные фундаментальные работы предыдущих периодов. Поиск проводили в электронных базах данных eLIBRARY.RU, PubMed, Google Scholar, Wally.

Анализ показал значительный рост случаев инвазивных аспергиллёзов, вызванных резистентными штаммами рода Aspergillus. Основные механизмы устойчивости включают мутации в гене cyp51 и гиперактивацию транспортных белков, выводящих лекарства из клетки. Устойчивые формы патогенов обнаруживаются в странах Европы, Азии, Африки и Америки.

Полученные результаты могут быть использованы для составления рекомендаций по повышению эффективности управления эпидемиологическим надзором за устойчивостью грибов рода Aspergillus к противогрибковым препаратам. Направления приоритетных исследований должны включать разработку антимикотиков, создание новых диагностических тестов для быстрого выявления резистентных штаммов и оптимизацию схем терапии. Необходимо повысить осведомлённость медицинских работников о рисках, связанных с использованием азольных препаратов, и усилить меры контроля за появлением устойчивых видов грибов.

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