Aspergillus, Aspergillosis, Antifungal Resistance and Dispersal

Aspergillus species may be found in soil, decaying matter, and on or within plants. Some species are pathogens of humans, other animals, or plants, or cause food spoilage. Invasive aspergillosis affects three million people, mostly immunocompromised individuals, and mortality is around 50% where treatment is provided and almost 100% without treatment. Allergic bronchopulmonary aspergillosis affects five million people, particularly asthmatics and cystic fibrosis patients. Resistance to azole antifungals is rising, possibly because of agricultural use of azoles. This review discusses Aspergillus species, aspergillosis, and Aspergillus plant infections; immune reactions and how Aspergilli counteract immune responses; risk factors and virulence factors, including the rise of antifungal resistance and the spread of resistant strains from the environment to humans. This review also discusses the dispersal of Aspergillus spores and mycelial fragments (propagules) and suggests prospects for future work, including the effects of climate change, possible research directions, and methods of detection and treatment.