{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:05:40Z","timestamp":1789995940616,"version":"4.0.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Alternaria spp. are dematiaceous ascomycetes that can cause opportunistic infections in immunocompromised hosts. They are challenging to identify and treat. However, optimal antifungal therapy remains undefined.<\/jats:p>\n                  <jats:p>We retrospectively reviewed antifungal susceptibilities (AST) of all Alternaria spp. isolates from adults at a tertiary care center between 2011 and 2025. We evaluated culture sources, minimum inhibitory concentration (MIC) and minimal effective concentration (MEC) distributions, and MIC\u2085\u2080\/MIC\u2089\u2080 and MEC50\/MEC90 values. Clinical characteristics, treatment measures, and outcomes of patients with clinically significant Alternaria spp. infections were described.<\/jats:p>\n                  <jats:p>Forty-one patients had Alternaria spp. isolated, most commonly from skin (n = 13), bone\/joint (n = 5), nail (n = 3), or cornea (n = 3). Posaconazole and itraconazole demonstrated low MICs (MIC\u2085\u2080\/MIC\u2089\u2080: 0.06\/0.5 and 0.25\/0.5\u00b5g\/ml, respectively). Voriconazole and isavuconazole showed higher MIC\u2085\u2080\/MIC\u2089\u2080 (1\/2 and 2\/4\u00b5g\/ml). Caspofungin (0.125\/0.5\u00b5g\/ml) and amphotericin B (0.25\/1\u00b5g\/ml) had low MICs and MECs. Alternaria spp. represented clinically significant infection in 27 cases (66%); 26% were solid organ transplant recipients and 15% had hematologic malignancies. Other risk factors included preceding trauma (22%) and autoimmune disease (15%). Posaconazole was the most frequently used empiric agent (6, 32%). Following AST results, 14 patients (52%) received oral antifungal therapy; posaconazole was used in all 14. In addition, seven patients (26%) received combination therapy with IV amphotericin B. Adjunctive surgery occurred in 14 cases (52%). Five patients (19%) died before completing therapy;<\/jats:p>\n                  <jats:p>Alternaria infections occurred predominantly in immunocompromised hosts and were frequently managed with posaconazole and surgery. Interpretive criteria for Alternaria spp. are needed to guide empiric and definitive therapy.<\/jats:p>","DOI":"10.1093\/mmy\/myag093","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T11:22:17Z","timestamp":1788693737000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics, susceptibility profiles, and outcomes of infection with\n                    <i>Alternaria<\/i>\n                    species: A 14-year retrospective study"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-8488","authenticated-orcid":false,"given":"Joya-Rita","family":"Hindy","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Department of Medicine , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin B","family":"Auyeung","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Department of Medicine , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-6689","authenticated-orcid":false,"given":"Ryan W","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Mayo Clinic , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-6214","authenticated-orcid":false,"given":"Nischal","family":"Ranganath","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Department of Medicine , Rochester, MN, 55905 ,","place":["USA"]},{"name":"Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M","family":"Deml","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine, Mayo Clinic , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy L","family":"Wengenack","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine, Mayo Clinic , Rochester, MN, 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya S","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Department of Medicine , Rochester, MN, 55905 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