Aspergillosis and Triazoles

The environmental mold Aspergillus fumigatus is the primary cause of invasive aspergillosis, a fungal infection that accounts for over 15,000 hospitalizations each year at a cost of $1.3 billion in the United States. A. fumigatus can cause severe infection and is a major cause of mortality in seriously ill patients, including stem cell and organ transplant recipients. Treatment with triazoles, a class of antifungal medicine, has greatly improved survival, but resistant infections are increasingly reported worldwide. People with a triazole-resistant infection have over a 30% higher likelihood of dying than patients with an infection that can be treated with these medicines. Of particular concern are resistant infections that appear to be related to environmental use of triazole fungicides in agriculture rather than to previous patient use of antifungal medicine. Use of triazole fungicides in the environment increased more than fourfold from 2006 to 2016 in the United States, amplifying concerns about resistant A. fumigatus infections.

CDC has developed a plan to address the growing threat of triazole-resistant A. fumigatus and has begun the first phase of implementation. This plan includes efforts to address knowledge gaps in areas such as the occurrence of resistant cases and community practice, engaging with stakeholder partners, and sharing information about the threat and ways that stakeholders can help prevent further resistance.

Learn about other foodborne, waterborne, and fungal disease prevention priorities.

Aspergillosis and Triazoles
Illustration of the condiophores of the fungus Aspergillus fumigatus.