{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T01:18:11Z","timestamp":1774315091803,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The number of patients infected with <jats:italic>Aspergillus<\/jats:italic> rose dramatically in recent years. However, studies on the clinical spectrum and antifungal susceptibilities of non\u2010classical (non\u2010<jats:italic>fumigatus<\/jats:italic>, non\u2010<jats:italic>flavus<\/jats:italic>, non\u2010<jats:italic>niger<\/jats:italic> and non\u2010<jats:italic>terreus<\/jats:italic>) pathogenic <jats:italic>Aspergillus<\/jats:italic> species are very limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We examined the clinical spectrum and antifungal susceptibilities of 34 non\u2010duplicated, non\u2010classical <jats:italic>Aspergillus<\/jats:italic> isolates collected from Hong Kong, Shenzhen and Shanghai.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:italic>Aspergillus<\/jats:italic> isolates were identified by internal transcribed spacer, partial <jats:italic>BenA<\/jats:italic> and partial <jats:italic>CaM<\/jats:italic> sequencing and phylogenetic analyses. Susceptibility testing against eight antifungals was performed following the European Committee for Antimicrobial Susceptibility Testing's methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 34 <jats:italic>Aspergillus<\/jats:italic> isolates were identified as 14 different rare\/cryptic species of four sections (<jats:italic>Flavi<\/jats:italic> [n\u00a0=\u00a08], <jats:italic>Nidulantes<\/jats:italic> [n\u00a0=\u00a08], <jats:italic>Nigri<\/jats:italic> [n\u00a0=\u00a017] and <jats:italic>Restricti<\/jats:italic> [n\u00a0=\u00a01]). Except for one patient whose clinical history could not be retrieved, 72.7% of the remaining patients had underlying conditions predisposing them to <jats:italic>Aspergillus<\/jats:italic> infections. The most common diseases were pulmonary infections (n\u00a0=\u00a015), followed by skin\/nail infections (n\u00a0=\u00a06), chronic otitis externa and\/or media (n\u00a0=\u00a05), wound infections (n\u00a0=\u00a02) and mastoiditis\/radionecrosis (n\u00a0=\u00a01), while three were colonisations. Five patients succumbed due to the infections during the admission, and another two died 5\u00a0years later because of chronic pulmonary aspergillosis. Antifungal susceptibility testing showed that they possessed different susceptibility profiles compared to the classical <jats:italic>Aspergillus<\/jats:italic> species. The majority of isolates characterised were sensitive or wild\u2010type to amphotericin B. The minimum effective concentrations for all the three echinocandins were also low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Susceptibility testing should be performed for infections due to these rare\/cryptic <jats:italic>Aspergillus<\/jats:italic> species to guide proper patient management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13158","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T06:53:08Z","timestamp":1601189588000},"page":"1283-1298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Rare\/cryptic <i>Aspergillus<\/i> species infections and importance of antifungal susceptibility testing"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-2866","authenticated-orcid":false,"given":"Chi\u2010Ching","family":"Tsang","sequence":"first","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3521-5688","authenticated-orcid":false,"given":"James Y. M.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyan","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infection Control The University of Hong Kong\u2013Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanfan","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infection Control The University of Hong Kong\u2013Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon K. F.","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infection Control The University of Hong Kong\u2013Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenlu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"},{"name":"Department of Laboratory Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China"},{"name":"Department of Clinical Microbiology Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizhong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China"},{"name":"Department of Clinical Microbiology Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan K. L.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology Pamela Youde Nethersole Eastern Hospital Chai Wan Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio H. Y.","family":"Ngan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwok\u2010Cheung","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"},{"name":"Department of Clinical Pathology Tuen Mun Hospital Tuen Mun Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying\u2010Nam","family":"To","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"},{"name":"Department of Clinical Pathology Tuen Mun Hospital Tuen Mun Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy T. T.","family":"Sze","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"},{"name":"Department of Pathology Hong Kong Sanatorium &amp; Hospital Happy Valley Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar H. Y.","family":"Chim","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa W. S.","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Microbiology Li Ka Shing Faculty of Medicine The University of Hong Kong Pokfulam Hong Kong"},{"name":"Department of Clinical Pathology Tuen Mun Hospital Tuen Mun Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl W. 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