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Our previous epidemiological analysis revealed a remarkably high frequency (~80%) of azole-resistant\n              <jats:italic>A. fumigatus<\/jats:italic>\n              in Yunnan\u2019s greenhouse environments, prompting increased local and regional research for targeted control strategies. In this study, we analyzed 94 clinical\n              <jats:italic>A. fumigatus<\/jats:italic>\n              isolates from Yunnan, comparing their susceptibility profiles and genotypic characteristics with environmental strains previously isolated. While the overall frequency of azole resistance in clinical isolates was lower than that in environmental samples, a significant prevalence of cross-resistance, with varying resistance patterns based on minimum inhibitory concentration (MIC) levels was observed, which exceeded rates in other regions of China. Specific mutation combinations in the\n              <jats:italic>cyp51A<\/jats:italic>\n              gene were linked to elevated MIC values in clinical and\/or environmental samples, while some resistant strains with wild-type\n              <jats:italic>cyp51A<\/jats:italic>\n              remain unexplained, indicating a need for further investigation into their resistance mechanisms. The differences in unique genetic elements and the distinct genetic differentiation observed between clinical and environmental isolates can be attributed to Yunnan\u2019s unique geomorphology and potential genotype importation from other provinces and abroad. Extensive allele exchanges and sharing contributed to the selection of azole-resistant clinical isolates, suggesting a common environmental origin, and the transmission routes of local drug-resistant strains cannot be excluded. These findings emphasize the imperative for regional and targeted surveillance to monitor resistance trends and guide effective antifungal therapy, and management strategies to mitigate invasive aspergillosis risk in this region.\n            <\/jats:p>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>\n                Azole resistance in\n                <jats:italic>Aspergillus fumigatus<\/jats:italic>\n                is a major global health concern, with particularly high rates (~80%) observed in Yunnan\u2019s greenhouse environments. This study compares azole resistance in 94 clinical isolates from Yunnan with environmental strains, revealing lower clinical resistance but significant cross-resistance and distinct resistance patterns. Specific mutations in the\n                <jats:italic>cyp51A<\/jats:italic>\n                gene were associated with elevated minimum inhibitory concentration values, though some resistant strains had wild-type\n                <jats:italic>cyp51A<\/jats:italic>\n                , highlighting the need for further research. The unique genetic profiles and potential external genotype influences in Yunnan emphasize the need for targeted regional surveillance. Effective monitoring and control strategies are essential to manage and mitigate the risk of invasive aspergillosis.\n              <\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.01594-24","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T13:02:14Z","timestamp":1730206934000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":15,"title":["Unveiling environmental transmission risks: comparative analysis of azole resistance in\n            <i>Aspergillus fumigatus<\/i>\n            clinical and environmental isolates from Yunnan, China"],"prefix":"10.1128","volume":"12","author":[{"given":"Jianchuan","family":"Gong","sequence":"first","affiliation":[{"name":"State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Chenggong District","place":["Kunming, China"]},{"name":"College of Life Science, Yunnan University, Chenggong District","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiarui","family":"Huang","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Chenggong District","place":["Kunming, China"]},{"name":"College of Life Science, Yunnan University, Chenggong District","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongju","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Chenggong District","place":["Kunming, China"]},{"name":"College of Life Science, Yunnan University, Chenggong District","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3995-531X","authenticated-orcid":true,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Chenggong District","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5459-7706","authenticated-orcid":false,"given":"Yuhong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of clinical laboratory, The First People\u2019s Hospital of Yunnan Province, Xishan District","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9122439"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.18502\/cmm.7.1.6180"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a019786"},{"key":"e_1_3_4_5_2","first-page":"1","article-title":"Bioremediation of heavy metals using isolates of filamentous fungus Aspergillus fumigatus collected from polluted soil of Kasur, Pakistan","volume":"2","author":"Shazia UR","year":"2013","unstructured":"Shazia UR, Sadia AT. 2013. 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