{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T03:36:54Z","timestamp":1789529814768,"version":"build-2803163510"},"reference-count":53,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2013,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aspergillus fumigatus<\/jats:named-content>\n complex comprises\n A. fumigatus<\/jats:named-content>\n and other morphologically indistinguishable cryptic species. We retrospectively studied 362\n A. fumigatus<\/jats:named-content>\n complex isolates (353 samples) from 150 patients with proven or probable invasive aspergillosis or aspergilloma (2, 121, and 6 samples, respectively) admitted to the hospital from 1999 to 2011. Isolates were identified using the \u03b2-tubulin gene, and only 1 isolate per species found in each sample was selected. Antifungal susceptibility to azoles was determined using the CLSI M38-A2 procedure. Isolates were considered resistant if they showed an MIC above the breakpoints for itraconazole, voriconazole, or posaconazole (>2, >2, or >0.5 \u03bcg\/ml). Most of the samples yielded only 1 species (\n A. fumigatus<\/jats:named-content>\n [\n n<\/jats:italic>\n = 335],\n A. novofumigatus<\/jats:named-content>\n [\n n<\/jats:italic>\n = 4],\n A. lentulus<\/jats:named-content>\n [\n n<\/jats:italic>\n = 3],\n A. viridinutans<\/jats:named-content>\n [\n n<\/jats:italic>\n = 1], and\n Neosartorya udagawae<\/jats:named-content>\n [\n n<\/jats:italic>\n = 1]). The remaining samples yielded a combination of 2 species. Most of the patients were infected by a single species (\n A. fumigatus<\/jats:named-content>\n [\n n<\/jats:italic>\n = 143] or\n A. lentulus<\/jats:named-content>\n [\n n<\/jats:italic>\n = 2]). The remaining 5 patients were coinfected with multiple\n A. fumigatus<\/jats:named-content>\n complex species, although\n A. fumigatus<\/jats:named-content>\n was always involved; 4 of the 5 patients were diagnosed in 2009 or later. Cryptic species were less susceptible than\n A. fumigatus<\/jats:named-content>\n . The frequency of resistance among\n A. fumigatus<\/jats:named-content>\n complex and\n A. fumigatus<\/jats:named-content>\n to itraconazole, voriconazole, and posaconazole was 2.5 and 0.3%, 3.1 and 0.3%, and 4.2 and 1.8%, respectively, in the per-isolate analysis and 1.3 and 0.7%, 2.6 and 0.7%, and 6 and 4% in the per-patient analysis. Only 1 of the 6\n A. fumigatus<\/jats:named-content>\n isolates in which the\n cyp51A<\/jats:italic>\n gene was sequenced had a mutation at position G448. The proportion of patients infected by azole-resistant\n A. fumigatus<\/jats:named-content>\n isolates was low.\n <\/jats:p>","DOI":"10.1128\/aac.02487-12","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T03:01:41Z","timestamp":1367290901000},"page":"2815-2820","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":79,"title":["Is Azole Resistance in Aspergillus fumigatus a Problem in Spain?"],"prefix":"10.1128","volume":"57","author":[{"given":"Pilar","family":"Escribano","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES CD06\/06\/0058), Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES CD06\/06\/0058), Palma de Mallorca, Spain"},{"name":"Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES CD06\/06\/0058), Palma de Mallorca, Spain"},{"name":"Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Bouza","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES CD06\/06\/0058), Palma de Mallorca, Spain"},{"name":"Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Guinea","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES CD06\/06\/0058), Palma de Mallorca, Spain"},{"name":"Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, 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