Azole persistence in the human fungal pathogen Aspergillus fumigatus

A. fumigatus azole resistance is on the rise and it is not understood how azole persistence can influence azole resistance. We demonstrate there are non-growth and slow-growth voriconazole-persisters. We characterized nine clinical isolates of the persisters collection, two of them voriconazole resistant, derived from the same patient who had been treated with voriconazole for two years. Notably, we discovered that these clinical isolates had developed increased voriconazole persistence, resistance to various stresses, and elevated mutation rates upon acquiring voriconazole resistance.