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The genotype-phenotype correlation study resolved the status of 5 uncharacterized UL54 deoxyribonucleic acid polymerase (G441S, A543V, F460S, R512C, A928T) and 2 UL56 terminase (F345L, P800L) mutations found in clinical isolates. A928T conferred high, triple resistance to ganciclovir, foscarnet, and cidofovir, and A543V had 10-fold reduced susceptibility to cidofovir. Viral growth assays showed G441S, A543V, F345L, and P800L impaired viral growth capacities compared with wild-type AD169 HCMV. Three-dimensional modeling predicted A543V and A928T phenotypes but not R512C, reinforcing the need for individual characterization of mutations by recombinant phenotyping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extending mutation databases is crucial to optimize treatments and to improve the assessment of patients with resistant\/refractory HCMV infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiac349","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T04:17:56Z","timestamp":1661141876000},"page":"1528-1536","source":"Crossref","is-referenced-by-count":13,"title":["Genotypic and Phenotypic Study of Antiviral Resistance Mutations in Refractory Cytomegalovirus Infection"],"prefix":"10.1093","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5270-4454","authenticated-orcid":false,"given":"Marta","family":"Santos Bravo","sequence":"first","affiliation":[{"name":"Microbiology Department, Hospital Clinic of Barcelona, University of Barcelona. 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