{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:15:45Z","timestamp":1790230545014,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Brazilian Federal Agency for Support and Evaluation of Gradate Education","award":["409184\/2022-5, 443861\/2023-4"],"award-info":[{"award-number":["409184\/2022-5, 443861\/2023-4"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["ZIA CL090088 to AS"],"award-info":[{"award-number":["ZIA CL090088 to AS"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["Myco\/9\/3\/2021-ECD-II"],"award-info":[{"award-number":["Myco\/9\/3\/2021-ECD-II"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,8,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Fonsecaea monophora<\/jats:italic>\n                      is a dematiaceous fungus with worldwide distribution that can cause chromoblastomycosis, an implantation mycosis and a neglected tropical disease.\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      also causes phaeohyphomycosis, including central nervous system infections like brain abscesses, with high mortality rates. In the absence of clinical breakpoints, epidemiological cutoff values (ECVs) can aid clinicians in monitoring antifungal resistance trends and guide initial antifungal selection. To establish\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      MIC distribution and ECVs, we performed antifungal susceptibility testing (AFST) on\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      isolates. AFST data on\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      isolates were collected at 14 laboratories during September 2023\u2013May 2026. Species identification was previously confirmed by DNA sequence analysis. AFST was performed by CLSI M38 standard broth microdilution method for itraconazole, voriconazole, posaconazole, isavuconazole, ketoconazole, terbinafine, flucytosine, and amphotericin B. The ECVs were established using the iterative statistical method with ECOFFinder (v2.1) following CLSI M57 guidelines. We analyzed MIC results from 137\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      isolates. The calculated ECVs were itraconazole, 2 \u03bcg\/mL; voriconazole, 0.25 \u03bcg\/mL; posaconazole, 1 \u03bcg\/mL; isavuconazole, 0.25 \u03bcg\/mL; and terbinafine, 0.5 \u03bcg\/mL. Amphotericin B and flucytosine had bimodal distributions, and no ECVs were set. Ketoconazole did not have data from \u2265100 isolates. These\n                      <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                      ECVs can detect non-wild-type isolates to reevaluate antifungal treatment and investigate treatment failure associated with potential clinical resistance. Established through a global multicenter collaboration, these values provide a baseline to better understand the\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      antifungal susceptibility profile of this species and monitor resistance.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Fonsecaea monophora<\/jats:italic>\n                        is a dematiaceous fungus with worldwide distribution that can cause chromoblastomycosis, an implantation mycosis and neglected tropical disease of the skin and subcutaneous tissue.\n                        <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                        also causes phaeohyphomycosis, including central nervous system infections like brain abscesses with high mortality rates. The paucity of antifungal susceptibility testing data on\n                        <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                        complicates interpretation of minimum inhibitory concentration (MIC) values. We performed antifungal susceptibility testing on 137\n                        <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                        isolates to establish MIC distributions and epidemiological cutoff values (ECVs) for eight antifungals, including those commonly used to treat\n                        <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                        infections. The calculated ECVs for commonly used antifungals were 2 \u03bcg\/mL for itraconazole, 0.25 \u03bcg\/mL for voriconazole, 1 \u03bcg\/mL for posaconazole, and 0.5 \u03bcg\/mL for terbinafine. ECVs can assist in selecting potential treatments for\n                        <jats:italic toggle=\"yes\">F. monophora<\/jats:italic>\n                        and tracking antifungal resistance trends.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01846-25","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:00:51Z","timestamp":1782392451000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Establishment of epidemiological cutoff values against\n                    <i>Fonsecaea monophora<\/i>\n                    , an agent of chromoblastomycosis and cerebral phaeohyphomycosis"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5707-528X","authenticated-orcid":true,"given":"Dallas J.","family":"Smith","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/042twtr12","id-type":"ROR","asserted-by":"publisher"}],"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tijmen","family":"van Beurden","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030a5r161","id-type":"ROR","asserted-by":"publisher"}],"name":"Westerdijk Fungal Biodiversity Institute","place":["Utrecht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalong","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02z1vqm45","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venerology, Peking University First Hospital","place":["Beijing, China"]},{"id":[{"id":"https:\/\/ror.org\/02v51f717","id-type":"ROR","asserted-by":"publisher"}],"name":"Research Center for Medical Mycology, Peking University","place":["Beijing, China"]},{"id":[{"id":"https:\/\/ror.org\/03ddkvp86","id-type":"ROR","asserted-by":"publisher"}],"name":"National Clinical Research Center for Skin and Sexually Transmitted Diseases","place":["Beijing, China"]},{"name":"Beijing Key Laboratory of Molecular Diagnosis on Dermatoses","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Almeida-Paes","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Funda\u00e7\u00e3o Oswaldo Cruz, Fiocruz","place":["Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna","family":"Jacomel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05syd6y78","id-type":"ROR","asserted-by":"publisher"}],"name":"Postgraduate Program of Microbiology, Parasitology and Pathology, Federal University of Parana","place":["Curitiba, Brazil"]},{"id":[{"id":"https:\/\/ror.org\/05wg1m734","id-type":"ROR","asserted-by":"publisher"}],"name":"Radboudumc-CWZ Center of Expertise for Mycology","place":["Nijmegen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-4861","authenticated-orcid":true,"given":"Vania Aparecida","family":"Vicente","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05syd6y78","id-type":"ROR","asserted-by":"publisher"}],"name":"Postgraduate Program of Microbiology, Parasitology and Pathology, Federal University of Parana","place":["Curitiba, Brazil"]},{"id":[{"id":"https:\/\/ror.org\/05syd6y78","id-type":"ROR","asserted-by":"publisher"}],"name":"Post-graduation Program of Engineering Bioprocess and Biotechnology, Federal University of Parana","place":["Curitiba, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno P. 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