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Eur Respir J 39: 411&ndash;8, 2012.","DOI":"10.1183\/09031936.00096110"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5) Lowes D, Al-Shair K, Newton PJ, Morris J, Harris C, Rautemaa-Richardson R, et al: Predictors of mortality in chronic pulmonary aspergillosis. Eur Respir J 49: 1601062, 2017.","DOI":"10.1183\/13993003.01062-2016"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6) Sehgal IS, Dhooria S, Muthu V, Prasad KT, Aggarwal AN, Chakrabarti A, et al: Efficacy of 12-months oral itraconazole versus 6-months oral itraconazole to prevent relapses of chronic pulmonary aspergillosis: An open-label, randomised controlled trial in India. Lancet Infect Dis 22: 1052&ndash;61, 2022.","DOI":"10.1016\/S1473-3099(22)00057-3"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7) Takeda K, Suzuki J, Watanabe A, Arai T, Koiwa T, Shinfuku K, et al: High detection rate of azole-resistant <i>Aspergillus fumigatus<\/i> after treatment with azole antifungal drugs among patients with chronic pulmonary aspergillosis in a single hospital setting with low azole resistance. Med Mycol 59: 327&ndash;34, 2021.","DOI":"10.1093\/mmy\/myaa052"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8) Patterson TF, Thompson GR 3rd, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al: Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. 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J Infect Chemother 29: 163&ndash;70, 2023.","DOI":"10.1016\/j.jiac.2022.10.010"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12) Jean SS, Yang HJ, Hsieh PC, Huang YT, Ko WC, Hsueh PR: <i>In vitro<\/i> susceptibilities of worldwide isolates of intrapulmonary <i>Aspergillus<\/i> species and important <i>Candida<\/i> species in sterile body sites against important antifungals: Data from the antimicrobial testing leadership and surveillance program, 2017&ndash;2020. Microbiol Spectr 10: e0296522, 2022.","DOI":"10.1128\/spectrum.02965-22"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13) Ellsworth M, Ostrosky-Zeichner L: Isavuconazole: Mechanism of action, clinical efficacy, and resistance. 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J Infect Chemother 23: 579&ndash;81, 2017.","DOI":"10.1016\/j.jiac.2016.12.004"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17) Onishi K, Muhammad Sarumoh B, Hagiwara D, Watanabe A, Kamei K, Toyotome T: Azole-resistant <i>Aspergillus fumigatus<\/i> containing a 34-bp tandem repeat in cyp51A promoter is isolated from the environment in Japan. Med Mycol J 58: E67&ndash;E70, 2017.","DOI":"10.3314\/mmj.17-00002"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18) Burks C, Darby A, G\u00f3mez Londo\u00f1o L, Momany M, Brewer MT: Azole-resistant <i>Aspergillus fumigatus<\/i> in the environment: Identifying key reservoirs and hotspots of antifungal resistance. PLoS Pathog 17: e1009711, 2021.","DOI":"10.1371\/journal.ppat.1009711"},{"key":"19","unstructured":"19) World Health Organization: WHO fungal priority pathogens list to guide research, development and public health action. 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Wayne, PA: Clinical and Laboratory Standards Institute, 2020."},{"key":"30","doi-asserted-by":"crossref","unstructured":"30) Arendrup MC, Cuenca-Estrella M, Lass-Fl\u00f6rl C, Hope WW: Breakpoints for antifungal agents: an update from EUCAST focussing on echinocandins against <i>Candida<\/i> spp. and triazoles against <i>Aspergillus<\/i> spp. Drug Resist Updat 16: 81&ndash;95, 2013.","DOI":"10.1016\/j.drup.2014.01.001"},{"key":"31","unstructured":"31) EUCAST. Testing TECoAS: Overview of antifungal ECOFFs and clinical breakpoints for yeasts, moulds and dermatophytes using the EUCAST E.Def 7.4, E.Def 9.4 and E.Def 11.0 procedures. 2023."},{"key":"32","doi-asserted-by":"crossref","unstructured":"32) Balajee SA, Kano R, Baddley JW, Moser SA, Marr KA, Alexander BD, et al: Molecular identification of <i>Aspergillus<\/i> species collected for the Transplant-Associated Infection Surveillance Network. 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Antimicrob Agents Chemother 52: 1244&ndash;51, 2008.","DOI":"10.1128\/AAC.00942-07"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35) Kwizera R, Abdolrasouli A, Garcia-Effron G, Denning DW: Antifungal susceptibility testing: applicability of methods and strategies for improving access in resource-constrained settings. Lancet Infect Dis 24: e782&ndash;e93, 2024.","DOI":"10.1016\/S1473-3099(24)00429-8"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36) Florensia Dana Carla B, Fachriza A, Thaufik Umar M, Unawekla JE, Anggraini WA, Mir M, et al: Nanostructured lipid carriers-loaded dry powder inhaler for pulmonary delivery of amphotericin B in treatment of allergic bronchopulmonary aspergillosis. 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Intern Med 58: 1137&ndash;40, 2019.","DOI":"10.2169\/internalmedicine.1930-18"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40) Kushima H, Tsunoda T, Matsumoto T, Kinoshita Y, Izumikawa K, Shirasawa S, et al: Effects of <i>Aspergillus fumigatus<\/i> conidia on apoptosis and proliferation in an <i>in vitro<\/i> model of the lung microenvironment. Microorganisms 9: 1435, 2021.","DOI":"10.3390\/microorganisms9071435"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41) Casadevall A: Global warming could drive the emergence of new fungal pathogens. Nat Microbiol 8: 2217&ndash;9, 2023.","DOI":"10.1038\/s41564-023-01512-w"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42) Wang Z, Shao J: Fungal vaccines and adjuvants: A tool to reveal the interaction between host and fungi. 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