{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:48:52Z","timestamp":1790516932775,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T00:00:00Z","timestamp":1554768000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fungicide exposure in the environment has driven the emergence of azole-resistant Aspergillus fumigatus worldwide. A screening test allows identification of resistant isolates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We screened clinical samples for azole-resistant Aspergillus through azole-containing agar plates and identified mutations in the cyp51A gene of A. fumigatus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Aspergillus isolates from clinical samples collected in a tertiary care centre from 2014 to 2017 were screened for azole resistance. Samples were subcultured in azole-containing agar plates. Isolates with a positive screening test were subject to DNA extraction, DNA amplification and sequencing of the cyp51A gene (coding and promoter regions). Clinical data were obtained from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We screened 43 Aspergillus isolates from 39 patients for azole resistance. Three isolates from three patients grew on azole-containing agar plates: two A. fumigatus and one Aspergillus flavus. PCR analysis and cyp51A sequencing identified the TR34\/L98H mutation in both A. fumigatus isolates. The prevalence of cyp51A mutations among A. fumigatus was 8.3% (2\/24). Both patients with TR34\/L98H mutants were azole naive and presented with invasive aspergillosis; one had multiple myeloma and the other was a liver retransplant recipient. They suffered progressive disease and failed voriconazole therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To the best of our knowledge, this is the first report of azole-resistant A. fumigatus with the TR34\/L98H mutation in two azole-naive patients with refractory invasive aspergillosis in Mexico.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkz121","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T20:10:18Z","timestamp":1551730218000},"page":"2047-2050","source":"Crossref","is-referenced-by-count":22,"title":["Azole resistance and cyp51A mutation screening in Aspergillus fumigatus in Mexico"],"prefix":"10.1093","volume":"74","author":[{"given":"Maria F","family":"Gonzalez-Lara","sequence":"first","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M","family":"Roman-Montes","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulette","family":"Diaz-Lomeli","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rangel-Cordero","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria O","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Ponce-de-Leon","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Sifuentes-Osornio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Ostrosky-Zeichner","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Texas Health Medical School, Houston, TX, USA"},{"name":"Department of Epidemiology, Memorial Hermann Texas Medical Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areli","family":"Martinez-Gamboa","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Instituto Nacional de Ciencias M\u00e9dicasy Nutrici\u00f3n Salvador Zubir\u00e1n, 15 Vasco de Quiroga Ave, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, M\u00e9xico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,8]]},"reference":[{"key":"2019091011514866500_dkz121-B1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1136\/thoraxjnl-2014-206291","article-title":"The clinical spectrum of pulmonary aspergillosis","volume":"70","author":"Kosmidis","year":"2015","journal-title":"Thorax"},{"key":"2019091011514866500_dkz121-B2","doi-asserted-by":"crossref","first-page":"S436","DOI":"10.1093\/infdis\/jix210","article-title":"Azole-resistant aspergillosis: epidemiology, molecular mechanisms, and treatment","volume":"216","author":"Chowdhary","year":"2017","journal-title":"J Infect Dis"},{"key":"2019091011514866500_dkz121-B3","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1128\/AAC.41.6.1364","article-title":"Itraconazole resistance in Aspergillus 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