{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:47:38Z","timestamp":1791557258266,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,27]],"date-time":"2021-11-27T00:00:00Z","timestamp":1637971200000},"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":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Aspergillus<\/jats:italic> spp. is identified morphologically without antifungal susceptibility tests (ASTs) in most clinical laboratories. The aim of this study was to examine the clinical impact of the morphological identification of <jats:italic>Aspergillus<\/jats:italic> spp. to ensure the adequate clinical management of <jats:italic>Aspergillus<\/jats:italic> infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p><jats:italic>Aspergillus<\/jats:italic> isolates (<jats:italic>n<\/jats:italic>\u00a0=\u00a0126) from distinct antifungal treatment\u2010na\u00efve patients with aspergillosis were first identified morphologically, followed by species\u2010level identification via DNA sequencing. An AST for itraconazole (ITC) and voriconazole (VRC) was performed on each <jats:italic>Aspergillus<\/jats:italic> isolate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the genetic test results, morphology\u2010based identification was accurate for &gt;95% of the isolates at the species sensu lato level although the test concordance of <jats:italic>Aspergillus<\/jats:italic> spp. with low detection rates was low. The rates of cryptic species were found to be 1.2% among the isolates of <jats:italic>A.\u00a0fumigatus<\/jats:italic> complex and 96.8% in the <jats:italic>A.\u00a0niger<\/jats:italic> complex. Cryptic species with lower susceptibilities to antifungal drugs than sensu stricto species among the same <jats:italic>Aspergillus<\/jats:italic> section were as follows: The <jats:italic>A.\u00a0lentulus<\/jats:italic> (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) isolates had low susceptibilities to azoles among the <jats:italic>A.\u00a0fumigatus<\/jats:italic> complex species (<jats:italic>n<\/jats:italic>\u00a0=\u00a086), and <jats:italic>A.\u00a0tubingensis<\/jats:italic> isolates (<jats:italic>n<\/jats:italic>\u00a0=\u00a018) exhibited lower susceptibility to azoles among the <jats:italic>A.\u00a0niger<\/jats:italic> complex species (<jats:italic>n<\/jats:italic>\u00a0=\u00a031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diagnostic accuracy was high at the <jats:italic>A.\u00a0fumigatus<\/jats:italic> and <jats:italic>A.\u00a0niger<\/jats:italic> complex level. However, in the presence of cryptic species, a solely morphological identification was insufficient. Particularly, ITC and VRC might be inappropriate for aspergillosis treatment when the <jats:italic>A.\u00a0niger<\/jats:italic> complex is identified morphologically because it is possible that the <jats:italic>Aspergillus<\/jats:italic> isolate is <jats:italic>A.\u00a0tubingensis<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13397","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T11:55:45Z","timestamp":1637063745000},"page":"164-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The accuracy and clinical impact of the morphological identification of <i>Aspergillus<\/i> species in the age of cryptic species: A single\u2010centre study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2935-5553","authenticated-orcid":false,"given":"Keita","family":"Takeda","sequence":"first","affiliation":[{"name":"Center for Pulmonary 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