Clinical profile and azole resistance in clinical and environmental isolates of Aspergillus flavus complex from Pakistan

Objective

To determine the azole susceptibility profile of Aspergillus flavus (A. flavus) complex isolates from clinical and environmental sources in Pakistan, where data on azole resistance are limited. Materials and Methods: A cross-sectional study was conducted at Aga Khan Hospital, Karachi, from January 2020 to December 2022. A total of 225 A. flavus complex isolates (151 clinical and 74 environmental) were included. Minimum inhibitory concentrations (MICs) for voriconazole, itraconazole, and posaconazole were determined using the broth microdilution method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Epidemiological cut-off values (ECVs) were used to identify non–wild-type (NWT) isolates. Clinical data were available for 94 patients.