@article{oai:nagasaki-u.repo.nii.ac.jp:00009608,
 author = {Tashiro, Masato and Izumikawa, Koichi and Hirano, Katsuji and Ide, Shotaro and Mihara, Tomo and Hosogaya, Naoki and Takazono, Takahiro and Morinaga, Yoshitomo and Nakamura, Shigeki and Kurihara, Shintaro and Imamura, Yoshifumi and Miyazaki, Taiga and Nishino, Tomoya and Tsukamoto, Misuzu and Kakeya, Hiroshi and Yamamoto, Yoshihiro and Yanagihara, Katsunori and Yasuoka, Akira and Tashiro, Takayoshi and Kohno, Shigeru},
 issue = {9},
 journal = {Antimicrobial Agents and Chemotherapy},
 month = {Sep},
 note = {This is the first report of a detailed relationship between triazole treatment history and triazole MICs for 154 Aspergillus fumigatus clinical isolates. The duration of itraconazole dosage increased as the itraconazole MIC increased, and a positive correlation was observed (r = 0.5700, P < 0.0001). The number of itraconazole-naïve isolates dramatically decreased as the itraconazole MIC increased, particularly for MICs exceeding 2 μg/ml (0.5 μg/ml versus 2 μg/ml, P = 0.03). We also examined the relationship between cumulative itraconazole usage and the MICs of other azoles. A positive correlation existed between itraconazole dosage period and posaconazole MIC (r = 0.5237, P < 0.0001). The number of itraconazole-naïve isolates also decreased as the posaconazole MIC increased, particularly for MICs exceeding 0.5 μg/ml (0.25 μg/ml versus 0.5 μg/ml, P = 0.004). Conversely, the correlation coefficient obtained from the scattergram of itraconazole usage and voriconazole MICs was small (r = -0.2627, P = 0.001). Susceptibility to three triazole agents did not change as the duration of voriconazole exposure changed. In addition, we carried out detailed analysis, including microsatellite genotyping, for isolates obtained from patients infected with azole-resistant A. fumigatus. We confirmed the presence of acquired resistance to itraconazole and posaconazole due to a G54 substitution in the cyp51A gene for a patient with chronic pulmonary aspergillosis after oral itraconazole therapy. We should consider the possible appearance of azole-resistant A. fumigatus if itraconazole is used for extended periods., Antimicrobial Agents and Chemotherapy, 56(9), pp.4870-4875; 2012},
 pages = {4870--4875},
 title = {Correlation between Triazole Treatment History and Susceptibility in Clinically Isolated Aspergillus fumigatus},
 volume = {56},
 year = {2012}
}