{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:48:31Z","timestamp":1790516911102,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Aspergillomas develop from progressive layers of mycelial growth on the walls of pulmonary cavities over months. Aspergillomas are characteristic of chronic pulmonary aspergillosis and are a risk factor for azole resistance. We investigated genotypic and phenotypic alterations in <jats:italic>Aspergillus fumigatus<\/jats:italic> recovered from aspergillomas. Aspergillomas were removed from three patients (two at surgery, one at autopsy) and dissected. Overall 92 colonies of <jats:italic>A. fumigatus<\/jats:italic> were isolated. Microsatellite typing was conducted to determine genetic type. Itraconazole, voriconazole and posaconazole susceptibilities were performed. The <jats:italic>cyp51A<\/jats:italic> gene was sequenced in 22 isolates. Isolates from Patient 1 (<jats:italic>n\u2003<\/jats:italic>=\u200325) were azole susceptible and resistant, although all <jats:italic>cyp51A<\/jats:italic> sequences were wild type, the isolates split into two distinct clades. In Patient 2, isolates were less variable (<jats:italic>n\u2003<\/jats:italic>=\u200310), all were azole susceptible. In Patient 3 only azole\u2010resistant strains (<jats:italic>n\u2003<\/jats:italic>=\u200357) were isolated, with M220K or M220T Cyp51A alterations, and microevolution was indicated. Marked diversity was observed in isolates from these patients; revealing differences in azole susceptibility, mechanism of resistance and genetic type. Importantly, routine sampling from respiratory specimens proved suboptimal in all cases; azole resistance was missed (Patient 1), cultures were negative (Patient 2) and high\u2010level posaconazole resistance was not detected (Patient 3).<\/jats:p>","DOI":"10.1111\/myc.12047","type":"journal-article","created":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T16:15:17Z","timestamp":1359735317000},"page":"434-441","source":"Crossref","is-referenced-by-count":50,"title":["Major variations in <i>Aspergillus fumigatus<\/i> arising within aspergillomas in chronic pulmonary aspergillosis"],"prefix":"10.1111","volume":"56","author":[{"given":"S. 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