Abstract
To investigate azole resistance in clinical Aspergillus isolates, we conducted prospective multicenter international surveillance. A total of 3,788 Aspergillus isolates were screened in 22 centers from 19 countries. Azole-resistant A. fumigatus was more frequently found (3.2% prevalence) than previously acknowledged, causing resistant invasive and noninvasive aspergillosis and severely compromising clinical use of azoles.
Highlights
To investigate azole resistance in clinical Aspergillus isolates, we conducted prospective multicenter international surveillance
A susceptible control isolate was assigned; this control isolate was the first susceptible isolate screened on the 4-well plate format in the same center after the resistant isolate, and they received molecular species identification and susceptibility testing according to the EUCAST broth microdilution reference method (6)
Overall prevalence of azole resistance was 3.2%; TR34/L98H was the predominant mechanism of resistance (48.9%) in A. fumigatus sensu strictu isolates
Summary
To investigate azole resistance in clinical Aspergillus isolates, we conducted prospective multicenter international surveillance. The Study Our objective was to investigate the prevalence of azole resistance in clinical Aspergillus isolates. Patient characteristics were registered through an online questionnaire, and patients with invasive aspergillosis were classified according to the European Organization for the Research and Treatment of Cancer/Mycoses Study Group consensus definitions (5). A susceptible control isolate was assigned; this control isolate was the first susceptible isolate screened on the 4-well plate format in the same center after the resistant isolate, and they received molecular species identification and susceptibility testing according to the EUCAST broth microdilution reference method (6)
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