{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:36:52Z","timestamp":1792427812151,"version":"4.5.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences, Inc","doi-asserted-by":"publisher","award":["IN-NL-131-4187"],"award-info":[{"award-number":["IN-NL-131-4187"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive aspergillosis (IA) by a triazole-resistant Aspergillus fumigatus is associated with high mortality. Real-time resistance detection will result in earlier initiation of appropriate therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a prospective study, we evaluated the clinical value of the AsperGenius polymerase chain reaction (PCR) assay in hematology patients from 12 centers. This PCR assay detects the most frequent cyp51A mutations in A. fumigatus conferring azole resistance. Patients were included when a computed tomography scan showed a pulmonary infiltrate and bronchoalveolar fluid (BALf) sampling was performed. The primary end point was antifungal treatment failure in patients with azole-resistant IA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 323 patients enrolled, complete mycological and radiological information was available for 276 (94%), and probable IA was diagnosed in 99\/276 (36%). Sufficient BALf for PCR testing was available for 293\/323 (91%). Aspergillus DNA was detected in 116\/293 (40%) and A. fumigatus DNA in 89\/293 (30%). The resistance PCR was conclusive in 58\/89 (65%) and resistance detected in 8\/58 (14%). Two had a mixed azole-susceptible\/azole-resistant infection. In the 6 remaining patients, treatment failure was observed in 1. Galactomannan positivity was associated with mortality (P = .004) while an isolated positive Aspergillus PCR was not (P = .83).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Real-time PCR-based resistance testing may help to limit the clinical impact of triazole resistance. In contrast, the clinical impact of an isolated positive Aspergillus PCR on BALf seems limited. The interpretation of the EORTC\/MSGERC PCR criterion for BALf may need further specification (eg, minimum cycle threshold value and\/or PCR positive on &amp;gt;1 BALf sample).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad141","type":"journal-article","created":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T07:20:00Z","timestamp":1678519200000},"page":"38-45","source":"Crossref","is-referenced-by-count":62,"title":["Clinical Impact of Polymerase Chain Reaction\u2013Based <i>Aspergillus<\/i> and Azole Resistance Detection in Invasive Aspergillosis: A Prospective Multicenter Study"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-8256","authenticated-orcid":false,"given":"Sammy","family":"Huygens","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochem B","family":"Buil","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corn\u00e9 H W","family":"Klaassen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E","family":"Verweij","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Amsterdam University Medical Centers , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Department of Hematology, Amsterdam University Medical Centers , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J W M","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Amsterdam University Medical Centers , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter J F M","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Hematology, Radboud University Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J","family":"Biemond","sequence":"additional","affiliation":[{"name":"Department of Hematology, Amsterdam University Medical Centers , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldert","family":"Bart","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Amsterdam University Medical Centers , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke H W","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Infectious Diseases, University Medical Center Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter-Jan A","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Center Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid M P","family":"Demandt","sequence":"additional","affiliation":[{"name":"Department of Hematology, Maastricht University Medical Center ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Oudhuis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Maastricht University Medical Center ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"von dem Borne","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Leiden University Medical Center ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha T","family":"van der Beek","sequence":"additional","affiliation":[{"name":"Department of Hematology, Leiden University Medical Center ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia K","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Hematology, Meander Medical Center , Amersfoort ,","place":["The Netherlands"]},{"name":"Department of Hematology, University Medical Center Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Godschalk","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Meander Medical Center , Amersfoort ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambert F R","family":"Span","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Medical Center Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douwe F","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Medical Center Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greetje A","family":"Kampinga","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Groningen, University Medical Center Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Maertens","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospitals Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven , Leuven 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Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette K","family":"Doorduijn","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander F A D","family":"Schauwvlieghe","sequence":"additional","affiliation":[{"name":"Department of Hematology, AZ St-Jan Brugge-Oostende Hospital , Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-9610","authenticated-orcid":false,"given":"Bart J 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