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This is partially attributable to the global spread of only a few resistance alleles through the environment. Secondary resistance is a significant clinical concern, as invasive aspergillosis with drug-susceptible strains is already difficult to treat, and exclusion of azole-based antifungals from prophylaxis or first-line treatment of invasive aspergillosis in high-risk patients would dramatically limit drug choices, thus increasing mortality rates for immunocompromised patients. Management options for invasive aspergillosis caused by azole-resistant\n              <jats:named-content content-type=\"genus-species\">A. fumigatus<\/jats:named-content>\n              strains were recently reevaluated by an international expert panel, which concluded that drug resistance testing of cultured isolates is highly indicated when antifungal therapy is intended. In geographical regions with a high environmental prevalence of azole-resistant strains, initial therapy should be guided by such analyses. More environmental and clinical screening studies are therefore needed to generate the local epidemiologic data if such measures are to be implemented on a sound basis. Here we propose a first workflow for evaluating isolates from screening studies, and we compile the MIC values correlating with individual amino acid substitutions in the products of\n              <jats:italic>cyp51<\/jats:italic>\n              genes for interpretation of DNA sequencing data, especially in the absence of cultured isolates.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/cmr.00095-16","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:25:46Z","timestamp":1505348746000},"page":"1065-1091","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":108,"title":["Molecular Tools for the Detection and Deduction of Azole Antifungal Drug Resistance Phenotypes in Aspergillus Species"],"prefix":"10.1128","volume":"30","author":[{"given":"Anna","family":"Dudakova","sequence":"first","affiliation":[{"name":"Institute for Medical Microbiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Spiess","sequence":"additional","affiliation":[{"name":"3rd Department of Internal Medicine, Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marut","family":"Tangwattanachuleeporn","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"},{"name":"Unit of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chon Buri, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Sasse","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Genetics, Department of Molecular Microbiology &amp; Genetics, Georg August Universit\u00e4t G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-6134","authenticated-orcid":false,"given":"Dieter","family":"Buchheidt","sequence":"additional","affiliation":[{"name":"3rd Department of Internal Medicine, Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Weig","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Gro\u00df","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1534-440X","authenticated-orcid":false,"given":"Oliver","family":"Bader","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00001011"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.71"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050219"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ885"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1562894"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02159-07"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.72.4.2581-2585.2006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12154-014-0121-1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ps.4029"},{"key":"e_1_3_2_11_2","unstructured":"FRAC. 2017. 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