{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:14:27Z","timestamp":1791342867437,"version":"4.3.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000},"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":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Increasing resistance of Aspergillus fumigatus to triazoles in high-risk populations is a concern. Its impact on mortality is not well understood, but rates from 50% to 100% have been reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine the prevalence of voriconazole-resistant A. fumigatus invasive aspergillosis (IA) and its associated mortality in a large multicentre cohort of haematology patients with culture-positive IA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a multicentre retrospective study, in which outcomes of culture-positive haematology patients with proven\/probable IA were analysed. Patients were stratified based on the voriconazole susceptibility of their isolates (EUCAST broth microdilution test). Mycological and clinical data were compared, along with survival at 6 and 12\u2009weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 129 A. fumigatus culture-positive proven or probable IA cases; 103 were voriconazole susceptible (79.8%) and 26 were voriconazole resistant (20.2%). All but one resistant case harboured environment-associated resistance mutations in the cyp51A gene: TR34\/L98H (13 cases) and TR46\/Y121F\/T289A (12 cases). Triazole monotherapy was started in 75.0% (97\/129) of patients. Mortality at 6 and 12\u2009weeks was higher in voriconazole-resistant cases in all patients (42.3% versus 28.2%, P\u205f=\u205f0.20; and 57.7% versus 36.9%, P\u205f=\u205f0.064) and in non-ICU patients (36.4% versus 21.6%, P\u205f=\u205f0.16; and 54.4% versus 30.7%; P\u205f=\u205f0.035), compared with susceptible ones. ICU patient mortality at 6 and 12\u2009weeks was very high regardless of triazole susceptibility (75.0% versus 66.7%, P\u205f=\u205f0.99; and 75.0% versus 73.3%, P\u205f=\u205f0.99).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A very high prevalence of voriconazole resistance among culture-positive IA haematology patients was observed. The overall mortality at 12\u2009weeks was significantly higher in non-ICU patients with voriconazole-resistant IA compared with voriconazole-susceptible IA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz258","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T07:08:46Z","timestamp":1559027326000},"page":"2759-2766","source":"Crossref","is-referenced-by-count":88,"title":["Prevalence of voriconazole-resistant invasive aspergillosis and its impact on mortality in haematology patients"],"prefix":"10.1093","volume":"74","author":[{"given":"Agustin","family":"Resendiz-Sharpe","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toine","family":"Mercier","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Department of Haematology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter P A","family":"Lestrade","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Viecuri Medical Centre, Venlo, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha T","family":"van der Beek","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Leiden University Medical Centre, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"von dem Borne","sequence":"additional","affiliation":[{"name":"Department of Haematology, Leiden University Medical Centre, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Department of Haematology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"De Kort","sequence":"additional","affiliation":[{"name":"Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J A","family":"Rijnders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander F A D","family":"Schauwvlieghe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-9860","authenticated-orcid":false,"given":"Paul E","family":"Verweij","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Centre of Expertise in Mycology, Radboud UMC\/CWZ, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Maertens","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Department of Haematology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien","family":"Lagrou","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"},{"name":"Department of Laboratory Medicine and National Reference Center for Mycosis, Excellence Centre for Medical Mycology (ECMM), University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"2019091012284242900_dkz258-B1","first-page":"1068","article-title":"The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study","volume":"91","author":"Pagano","year":"2006","journal-title":"Haematologica"},{"key":"2019091012284242900_dkz258-B2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1086\/318483","article-title":"Aspergillosis case-fatality rate: systematic review of the literature","volume":"32","author":"Lin","year":"2001","journal-title":"Clin Infect 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