{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:39:06Z","timestamp":1780465146345,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"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":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A wide range of frequency of azole\u2010resistance in <jats:italic>A fumigatus<\/jats:italic> in different patient populations worldwide was observed threatening to reduce therapeutic options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Estimate the prevalence of azole\u2010resistance, investigate the molecular mechanisms of resistance, compare the genotypes of resistant clinical isolates with those from the surrounding environment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>Aspergillus<\/jats:italic> isolates were collected by seven Italian hospital microbiology laboratories. Strains were isolated from different clinical samples from unselected patients. The azole\u2010resistance was evaluated using screening test and microdilution EUCAST method. The molecular mechanism of resistance was performed sequencing the <jats:italic>cyp51A<\/jats:italic> gene. Resistant isolates were genotyped by microsatellite analysis and their profiles compared with those of azole\u2010resistant isolates from previous Italian studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>425 <jats:italic>Aspergillus<\/jats:italic> isolates from 367 patients were analysed. The azole\u2010resistance rates were 4.9% and 6.6% considering all <jats:italic>Aspergillus<\/jats:italic> spp. isolates and the <jats:italic>A fumigatus<\/jats:italic> sensu <jats:italic>stricto<\/jats:italic>, respectively. All resistant isolates except one were from a single hospital. Two rare azole\u2010resistant species were identified: <jats:italic>A thermomutatus<\/jats:italic> and <jats:italic>A lentulus<\/jats:italic>. The predominant resistance mechanism was TR<jats:sub>34<\/jats:sub>\/L98H. No correlation between the clinical resistant strains and environmental isolates from patients\u2019 home\/work\/ward was observed. The analysis of the molecular correlation between the resistant clinical strains collected in the present study and those of environmental and clinical origin collected in previous Italian studies reveals a progressive diversification of azole\u2010resistant genotypes starting from a founder azole\u2010resistant genotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study confirms the trend of azole\u2010resistance rate in Italy, showing a geographical difference. Data reinforce the importance of surveillance programmes to monitor the local epidemiological situation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13241","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T11:47:18Z","timestamp":1610711238000},"page":"528-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Azole resistance in <i>Aspergillus<\/i> isolates by different types of patients and correlation with environment \u2010 An Italian prospective multicentre study (ARiA study)"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8221-7542","authenticated-orcid":false,"given":"Anna","family":"Prigitano","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Esposto","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Grancini","sequence":"additional","affiliation":[{"name":"UOS Microbiology Central Laboratory IRCCS Foundation C\u00e0 Granda Ospedale Maggiore Policlinico Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3786-2929","authenticated-orcid":false,"given":"Arianna","family":"Biffi","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Microbiology Laboratory and Cystic Fibrosis Center Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Innocenti","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology and Virology Comprensorio Sanitario di Bolzano\u2010A.S. Alto Adige Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Cavanna","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Lallitto","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Maria Giada","family":"Mollaschi","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Bandettini","sequence":"additional","affiliation":[{"name":"Clinical Pathology and Microbiology Laboratory Unit Istituto Giannina Gaslini Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Oltolini","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Passera","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit ASST \u2018Papa Giovanni XXIII\u2019 Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"De Lorenzis","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Environmental Sciences\u2010Production, Landscape, Agroenergy Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Sargolzaei","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Environmental Sciences\u2010Production, Landscape, Agroenergy Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manna","family":"Crespan","sequence":"additional","affiliation":[{"name":"CREA\u2010 Research Center for Viticulture and Enology Conegliano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-4817","authenticated-orcid":false,"given":"Massimo","family":"Cogliati","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Tortorano","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Roman\u00f2","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.12.20747"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2018.10.017"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02234-15"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2016.06.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2020.01.016"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00231-09"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031801"},{"key":"e_1_2_8_9_1","first-page":"121","article-title":"High azole resistance rate of Aspergillus fumigatus at intensive care unit in a Dutch tertiary hospital","volume":"2","author":"Russcher A","year":"2014","journal-title":"Ned Tijdschr Med Microbiol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv177"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks160"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00167-13"},{"key":"e_1_2_8_13_1","first-page":"e1\u2010e38","article-title":"Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID\u2010ECMM\u2010ERS guideline Clin Microbiol Infect","volume":"1","author":"Ullmann AJ","year":"2018","journal-title":"Suppl"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2009.09.002"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit321"},{"key":"e_1_2_8_16_1","unstructured":"Rodriguez\u2010TudelaJL ArendrupMC et al.European Committee on Antimicrobial Susceptibility Testing. EUCAST definitive document E.DEF 9.1: method for determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia\u2010forming moulds 2008.https:\/\/www.researchgate.net\/publication\/242279976_EUCAST_DEFINITIVE_DOCUMENT_EDEF_91_Method_for_the_determination_of_broth_dilution_minimum_inhibitory_concentrations_of_antifungal_agents_for_conidia_forming_moulds"},{"key":"e_1_2_8_17_1","unstructured":"European Committee on Antimicrobial Susceptibility Testing.Antifungal agents\u2019 breakpoint tables for interpretation of MICs\u2014version 10.0.https:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/AFST\/Clinical_breakpoints\/AFST_BP_v10.0_200204.pdf"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.61.4.1323-1330.1995"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.7.2431-2438.2001"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4112-4120.2005"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-13-87"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-10-152"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.06.007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.09.042"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2106.140717"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00233-15"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1710.110226"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000255"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr443"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02240-17"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky187"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13064"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2017.12.007"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00335-12"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0052871"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6040199"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01358-10"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05990-11"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix210"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T05:13:08Z","timestamp":1693631588000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/myc.13241"],"URL":"https:\/\/doi.org\/10.1111\/myc.13241","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,28]]},"assertion":[{"value":"2020-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}