{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:01:03Z","timestamp":1791000063157,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Azole resistance complicates treatment of patients with invasive aspergillosis with an increased mortality. Azole resistance in <jats:italic>Aspergillus fumigatus<\/jats:italic> is a growing problem and associated with human and environmental azole use. Denmark has a considerable and highly efficient agricultural sector. Following reports on environmental azole resistance in <jats:italic>A.\u00a0fumigatus<\/jats:italic> from Danish patients, the ministry of health requested a prospective national surveillance of azole\u2010resistant <jats:italic>A.\u00a0fumigatus<\/jats:italic> and particularly that of environmental origin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To present the data from the first 2\u00a0years of the surveillance programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Unique isolates regarded as clinically relevant and any <jats:italic>A.\u00a0fumigatus<\/jats:italic> isolated on a preferred weekday (background samples) were included. EUCAST susceptibility testing was performed and azole\u2010resistant isolates underwent <jats:italic>cyp51A<\/jats:italic> gene sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The azole resistance prevalence was 6.1% (66\/1083) at patient level. The TR<jats:sub>34<\/jats:sub>\/L98H prevalence was 3.6% (39\/1083) and included the variants TR<jats:sub>34<\/jats:sub>\/L98H, TR<jats:sub>34<\/jats:sub><jats:sup>3<\/jats:sup>\/L98H and TR<jats:sub>34<\/jats:sub>\/L98H\/S297T\/F495I. Resistance caused by other Cyp51A variants accounted for 1.3% (14\/1083) and included G54R, P216S, F219L, G54W, M220I, M220K, M220R, G432S, G448S and Y121F alterations. Non\u2010Cyp51A\u2010mediated resistance accounted for 1.2% (13\/1083). Proportionally, TR<jats:sub>34<\/jats:sub>\/L98H, other Cyp51A variants and non\u2010Cyp51A\u2010mediated resistance accounted for 59.1% (39\/66), 21.2% (14\/66) and 19.7% (13\/66), respectively, of all resistance. Azole resistance was detected in all five regions in Denmark, and TR<jats:sub>34<\/jats:sub>\/L98H specifically, in four of five regions during the surveillance period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The azole resistance prevalence does not lead to a change in the initial treatment of aspergillosis at this point, but causes concern and leads to therapeutic challenges in the affected patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13426","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T15:22:55Z","timestamp":1643728975000},"page":"419-428","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Azole resistance in <i>Aspergillus fumigatus<\/i>. The first 2\u2010year's Data from the Danish National Surveillance Study, 2018\u20132020"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-5015","authenticated-orcid":false,"given":"Malene","family":"Risum","sequence":"first","affiliation":[{"name":"Mycology Unit Statens Serum Institut Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9796-023X","authenticated-orcid":false,"given":"Rasmus Kr\u00f8ger","family":"Hare","sequence":"additional","affiliation":[{"name":"Mycology Unit Statens Serum Institut Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Berg","family":"Gertsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming Sch\u00f8nning","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Odense University Hospital and Research Unit of Clinical Microbiology University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Sulim","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Aalborg University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nissrine","family":"Abou\u2010Chakra","sequence":"additional","affiliation":[{"name":"Mycology Unit Statens Serum Institut Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jette","family":"Bangsborg","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Herlev Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bent L\u00f8we","family":"R\u00f8der","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Slagelse Sygehus Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ea Sofie","family":"Marmolin","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Sygehus Lilleb\u00e6lt Vejle Sygehus Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Marie Thyssen","family":"Astvad","sequence":"additional","affiliation":[{"name":"Mycology Unit Statens Serum Institut Copenhagen Denmark"},{"name":"Department of Clinical Microbiology Hvidovre Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Hvidovre Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esad","family":"Dzajic","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Sydvestjysk Sygehus Esbjerg Sygehus Esbjerg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen Lomborg","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Sygehus S\u00f8nderjylland S\u00f8nderborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-0144","authenticated-orcid":false,"given":"Maiken Cavling","family":"Arendrup","sequence":"additional","affiliation":[{"name":"Mycology Unit Statens Serum Institut Copenhagen Denmark"},{"name":"Department of Clinical Microbiology, Rigshospitalet University of Copenhagen Copenhagen Denmark"},{"name":"Department of Clinical Medicine Copenhagen University Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1009711"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof2030021"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050034"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02855-14"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00213-11"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00692-10"},{"key":"e_1_2_9_8_1","unstructured":"RisumM HareRK Abou\u2010ChakraN GertsenJB KristensenL ArendrupMC.Azole resistance in Aspergillus spp. Preliminary six months data from the newly established surveillance in Denmark. 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