{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:06:57Z","timestamp":1777378017579,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T00:00:00Z","timestamp":1580860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic pulmonary aspergillosis (CPA) is a progressive respiratory disease, caused most commonly by <jats:italic>A fumigatus,<\/jats:italic> with significant morbidity and mortality. Azole resistance in <jats:italic>A fumigatus<\/jats:italic> is a growing concern worldwide, with resistance to itraconazole reported in up to 50% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to determine whether a positive <jats:italic>Aspergillus<\/jats:italic> PCR (polymerase chain reaction) is a marker of resistance in CPA patients on azole therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were selected via a consecutive database search for the first 50 CPA patients with a positive <jats:italic>Aspergillus<\/jats:italic> PCR from January to September 2016. Data were collected regarding concurrent and subsequent culture results, current therapy and serum antifungal levels. PCR\u2010positive patients not on therapy were included as the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three patients were on therapy (15 itraconazole, 4 voriconazole and 4 posaconazole). Cycle threshold (Ct) values ranged from 20.8 to 37.9; no significant difference was found between each treatment and the control group (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.47). In treated patients, concurrent azole\u2010resistant <jats:italic>A fumigatus<\/jats:italic> was found in 75% of <jats:italic>A fumigatus<\/jats:italic>\u2010positive cultures (6\/8). All of the resistant isolates in the itraconazole group showed therapy resistance. Twenty per cent of all itraconazole levels were sub\u2010therapeutic. No significant difference was found in serum itraconazole levels for patients on itraconazole with a positive PCR versus negative PCR (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.44).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Positive sputum, <jats:italic>Aspergillus<\/jats:italic>\u2010specific PCR can be associated with azole resistance in CPA patients on therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13052","type":"journal-article","created":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T09:28:45Z","timestamp":1579944525000},"page":"376-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Positive <i>Aspergillus<\/i> PCR as a marker of azole resistance or sub\u2010therapeutic antifungal therapy in patients with chronic pulmonary aspergillosis"],"prefix":"10.1111","volume":"63","author":[{"given":"Samihah","family":"Moazam","sequence":"first","affiliation":[{"name":"National Aspergillosis Centre Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"},{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2154-1776","authenticated-orcid":false,"given":"Christopher Philip","family":"Eades","sequence":"additional","affiliation":[{"name":"National Aspergillosis Centre Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"},{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4502-0542","authenticated-orcid":false,"given":"Eavan Gabrielle","family":"Muldoon","sequence":"additional","affiliation":[{"name":"National Aspergillosis Centre Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"},{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline B.","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Mycology Reference Centre Manchester ECMM Centre of Mycological Excellence Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5672-9552","authenticated-orcid":false,"given":"Malcolm D.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Mycology Reference Centre Manchester ECMM Centre of Mycological Excellence Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-6040","authenticated-orcid":false,"given":"Riina","family":"Rautemaa\u2010Richardson","sequence":"additional","affiliation":[{"name":"National Aspergillosis Centre Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"},{"name":"Division of Infection, Inflammation and Respiratory Medicine Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Mycology Reference Centre Manchester ECMM Centre of Mycological Excellence Manchester University NHS Foundation Trust Wythenshawe Hospital Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00583-2015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01062-2016"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-206291"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.11.019"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir179"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e3283184611"},{"issue":"11","key":"e_1_2_8_8_1","first-page":"1232","article-title":"Azole resistance in Aspergillus: a growing public health 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