{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:46:16Z","timestamp":1747187176351,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"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":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Studies comparing gradient diffusion strips (GDSs) and the EUCAST E.Def 9.4 microdilution method are scarce, thwarted by a low number of isolates, and restricted to selected antifungal agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We evaluated the performance of GDSs to detect azole resistance in <jats:italic>A. fumigatus<\/jats:italic>, including cryptic species.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p><jats:italic>A. fumigatus<\/jats:italic> sensu stricto (<jats:italic>n<\/jats:italic>\u00a0=\u00a089) and cryptic species (<jats:italic>n<\/jats:italic>\u00a0=\u00a052) were classified as susceptible or resistant to itraconazole, voriconazole, posaconazole and isavuconazole (EUCAST E.Def 9.4; clinical breakpoints v10). <jats:italic>A. fumigatus<\/jats:italic> sensu stricto azole\u2010resistant isolates had the following <jats:italic>cyp51A<\/jats:italic> gene mutations: TR<jats:sub>34<\/jats:sub>\u2010L98H (<jats:italic>n<\/jats:italic>\u00a0=\u00a024), G54R (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), TR<jats:sub>46<\/jats:sub>\u2010Y121F\u2010T289A (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), F46Y\u2010M172V\u2010N248T\u2010D255E\u2010E427K (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), F165L (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) and <jats:italic>cyp51A<\/jats:italic> gene wild type (<jats:italic>n<\/jats:italic>\u00a0=\u00a03). GDSs (ETEST\u00ae, bioM\u00e8rieux, Marcy\u2010l'Etoile, France and Liofilchem\u00ae, Roseto degli Abruzzi, Italy) MICs were obtained by following the manufacturer's guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For <jats:italic>A. fumigatus<\/jats:italic> sensu stricto, itraconazole MICs &gt;1.5\u00a0mg\/L, voriconazole &gt;0.38\u2009mg\/L, posaconazole &gt;0.75\u2009mg\/L, and isavuconazole &gt;0.5\u00a0mg\/L correctly separated resistant from susceptible isolates with two exceptions. Considering the aforementioned cut\u2010off MICs, sensitivity\/specificity values of GDSs to detect azole resistance were: itraconazole (97%\/100%), voriconazole (97%\/100%), posaconazole (97%\/100%) and isavuconazole (93.3%\/100%). For cryptic species isolates, voriconazole MICs &gt;1\u00a0mg\/L and isavuconazole &gt;0.75\u2009mg\/L separated resistant isolates from susceptible isolates with 15 and 27 exceptions, respectively. Considering the aforementioned cut\u2010off MICs, sensitivity\/specificity values were as follows: voriconazole (68.1%\/100%) and isavuconazole (25%\/100%). For itraconazole and posaconazole, it was not possible to establish cut\u2010off values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We set tentative cut\u2010off MIC values to correctly spot resistant <jats:italic>Aspergillus fumigatus<\/jats:italic> sensu stricto isolates using GDSs. The performance against cryptic species was poor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13541","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T15:03:53Z","timestamp":1666969433000},"page":"196-201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gradient diffusion strips for detecting azole resistance in <i>Aspergillus fumigatus<\/i> sensu lato"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4537-6549","authenticated-orcid":false,"given":"Julia","family":"Serrano\u2010Lobo","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8169-4005","authenticated-orcid":false,"given":"Ana","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0609-1305","authenticated-orcid":false,"given":"Elena","family":"Reigadas","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"CIBER Enfermedades Respiratorias\u2010CIBERES (CB06\/06\/0058)  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-5583","authenticated-orcid":false,"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"CIBER Enfermedades Respiratorias\u2010CIBERES (CB06\/06\/0058)  Madrid Spain"},{"name":"Medicine Department, Faculty of Medicine Universidad Complutense de Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6254-4570","authenticated-orcid":false,"given":"Pilar","family":"Escribano","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7901-8355","authenticated-orcid":false,"given":"Jes\u00fas","family":"Guinea","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"CIBER Enfermedades Respiratorias\u2010CIBERES (CB06\/06\/0058)  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the ASPEIN Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.11.027"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1710.110226"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dku566"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.09.042"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.01.003"},{"issue":"61","key":"e_1_2_9_7_1","first-page":"e01659","article-title":"Evaluation of MIC strip Isavuconazole test for susceptibility testing of wild\u2010type and non\u2010wild\u2010type Aspergillus fumigatus isolates","volume":"27","author":"Arendrup MC","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02487-12"},{"key":"e_1_2_9_9_1","unstructured":"GuineaJ MJ Arikan\u2010AkdagliS MuehlethalerK KahlmeterG ArendrupMC.EUCAST Definitive Document E.Def 9.4. 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