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               <mods:identifier type="citation">Gonzalez-Jimenez I, Garcia-Rubio R, Monzon S, Lucio J, Cuesta I, Mellado E. Multiresistance to Nonazole Fungicides in Aspergillus fumigatus TR34/L98H Azole-Resistant Isolates. Antimicrob Agents Chemother. 2021 Aug 17;65(9):e0064221. doi: 10.1128/AAC.00642-21.</mods:identifier>
               <mods:identifier type="doi">10.1128/AAC.00642-21</mods:identifier>
               <mods:identifier type="e-issn">1098-6596</mods:identifier>
               <mods:identifier type="issn">0066-4804</mods:identifier>
               <mods:identifier type="journal">Antimicrobial agents and chemotherapy</mods:identifier>
               <mods:identifier type="other">https://pmc.ncbi.nlm.nih.gov/articles/PMC8370240/</mods:identifier>
               <mods:identifier type="pubmedID">34152819</mods:identifier>
               <mods:identifier type="uri">https://hdl.handle.net/20.500.12105/25971</mods:identifier>
               <mods:abstract>Drug resistance is a worldwide problem affecting all pathogens. The human fungal pathogen Aspergillus fumigatus coexists in the environment with other fungi targeted by crop protection compounds, being unintentionally exposed to the selective pressure of multiple antifungal classes and leading to the selection of resistant strains. A. fumigatus azole-resistant isolates are emerging in both clinical and environmental settings. Since their approval, azole drugs have dominated clinical treatment for aspergillosis infections and the agriculture fungicide market. However, other antifungal classes are used for crop protection, including benzimidazoles (methyl benzimidazole carbamates [MBCs]), strobilurins (quinolone oxidation inhibitors [QoIs]), and succinate dehydrogenase inhibitors (SDHIs). Mutations responsible for resistance to these fungicides have been widely researched in plant pathogens, but resistance has not been explored in A. fumigatus. In this work, the genetic basis underlying resistance to MBCs, QoIs, and SDHIs was studied in azole-susceptible and -resistant A. fumigatus strains. E198A/Q and F200Y mutations in β-tubulin conferred resistance to MBCs, G143A and F129L substitutions in cytochrome  conferred resistance to QoIs, and H270R/Y mutations in SdhB conferred resistance to SDHIs. Characterization of susceptibility to azoles showed a correlation between strains resistant to these fungicides and the ones with tandem-repeat (TR)-based azole resistance mechanisms. Whole-genome sequencing analysis showed a genetic relationship among fungicide multiresistant strains, which grouped into subclusters that included only strains carrying the TR-based azole resistance mechanisms, indicating a common ancestor/evolution pattern and confirming the environmental origin of this type of azole-resistant A. fumigatus.</mods:abstract>
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                  <mods:topic>Aspergillus fumigatus</mods:topic>
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                  <mods:topic>Fungicide classes</mods:topic>
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               <mods:subject>
                  <mods:topic>Fungicide cross-resistance</mods:topic>
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                  <mods:topic>Resistance origin and development</mods:topic>
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                  <mods:title>Multiresistance to Nonazole Fungicides in Aspergillus fumigatus TR/L98H Azole-Resistant Isolates</mods:title>
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