A prototype of the VIPcheck™ was used for detection of azole resistance in Aspergillus fumigatus in an international surveillance study, which was recently published [Emerg Infect Dis 2015; 21:1041-4].
Other studies also indicate an emerging global problem, with reports of azole resistance from various countries including France [Antimicrob Agents Chemother 2015;59:4331-5], Australia [Mycoses 2015;58:350-5], Turkey [J Infect Chemother 2015;21:581-6] and Taiwan [Mycoses 2015;58:544-9]. The most important route of resistance is the environmental route, where Aspergillus fumigatus is believed to develop resistance through exposure to azole fungicides.
It is important to determine if azole resistance is a problem in your hospital by testing a series of Aspergillus fumigatus isolates. Previous studies indicate that at least 70 isolates need to be screened in order to detect resistance, as the prevalence in most centers is still low.