{
  "abstract": "Introduction\n\nInvasive aspergillosis (IA) represents one of the most frequent invasive fungal infections in paediatric patients with risk factors. An increase in cases of azole-resistant IA has been reported in adult patients. The aim of this study is to present a series of 11 cases of paediatric patients with this pathology.Methods\n\nA retrospective descriptive study including paediatric patients with probable or proven azole-resistant IA treated between January 2019 and June 2024 in four tertiary hospitals in Spain.Results\n\nEleven cases are reported, all patients with risk factors for IA, mainly with haematopoietic stem cell transplantation (HCT) due to haematological malignancies and heart transplant in the early post-transplant period. These patients represent 22% of all proven or probable paediatric IA cases (n = 50) diagnosed in the study centres during the period. Five were previously receiving azole-based antifungal prophylaxis. The most frequently isolated species was Aspergillus fumigatus. Despite receiving at least partially active antifungals plus adjunctive treatment therapy from diagnosis, attributable mortality was high (8/11 patients).Conclusion\n\nAzole-resistant IA should be suspected in paediatric patients with risk factors, especially if they show poor clinical course or have received azole prophylaxis. The performance of invasive tests, as well as species identification and resistance testing, is essential to optimise treatment. In breakthrough IA it should be considered empirical treatment with an antifungal from a different class than the one used for prophylaxis, alone or in combination.",
  "abstract_shown": true,
  "affiliations": [
    "Paediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital, Vall D'hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain.",
    "Infection and Immunity in Children, Vall D'hebron Institut de Recerca (VHIR), Vall D'hebron Barcelona Hospital Campus, Barcelona, Spain.",
    "Paediatric Infectious Diseases Department, Hospital Universitario La Paz (Madrid), Madrid, Spain.",
    "Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.",
    "Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.",
    "Paediatric Infectious Diseases and Immunodeficiencies, Málaga Regional University Hospital, Málaga, Spain.",
    "Paediatric Infectious Diseases Unit, Gregorio Marañon General Hospital, Madrid, Spain.",
    "Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III (CIBERINFEC), Madrid, Spain.",
    "Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain.",
    "Clinical Microbiology Department, Hospital Universitario La Paz (Madrid), Madrid, Spain.",
    "Paediatric Hemato-Oncology Department, Hospital Universitario La Paz (Madrid), Madrid, Spain.",
    "Paediatric Department, Hospital Costa del Sol, Málaga, Spain.",
    "Universidad Complutense de Madrid (UCM), Madrid, Spain.",
    "Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.",
    "Faculty of Health Sciences - HM Hospitals, Universidad Camilo José Cela, Madrid, Spain.",
    "CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.",
    "Microbiology Department, Málaga Regional University Hospital, Málaga, Spain.",
    "Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia, Spain.",
    "Microbiology Department, Vall D'hebron Hospital Campus, Barcelona, Catalonia, Spain.",
    "Microbiology, Vall D'hebron Institut de Recerca (VHIR), Vall D'hebron Barcelona Hospital Campus, Barcelona, Spain."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Natalia Mendoza-Palomar",
      "orcid": "0000-0002-2035-8291"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Carlos Grasa Lozano",
      "orcid": "0000-0002-9323-2024"
    },
    {
      "affs": [
        5
      ],
      "name": "Begoña Carazo-Gallego",
      "orcid": "0000-0003-4807-436X"
    },
    {
      "affs": [
        6,
        7,
        8
      ],
      "name": "Elena María Rincón-López",
      "orcid": "0000-0002-0982-1636"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Maria Pinyol-Sarrias",
      "orcid": "0009-0007-5643-507X"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Anna Creus-Costa",
      "orcid": "0000-0002-9861-5550"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Ana Méndez-Echevarría",
      "orcid": "0000-0002-7455-9080"
    },
    {
      "affs": [
        3,
        4,
        9
      ],
      "name": "Alfredo Maldonado-Barrueco",
      "orcid": "0000-0002-1856-1725"
    },
    {
      "affs": [
        10
      ],
      "name": "Yasmina Mozo",
      "orcid": "0000-0002-5666-1911"
    },
    {
      "affs": [
        11
      ],
      "name": "Diego Lozano-Durán"
    },
    {
      "affs": [
        6,
        7,
        8,
        12
      ],
      "name": "Maria Luisa Navarro Gómez",
      "orcid": "0000-0002-1234-6936"
    },
    {
      "affs": [
        8,
        13,
        14,
        15
      ],
      "name": "Jesús Guinea",
      "orcid": "0000-0002-7901-8355"
    },
    {
      "affs": [
        16
      ],
      "name": "Maria Concepción Mediavilla Gradolph",
      "orcid": "0000-0001-7660-4386"
    },
    {
      "affs": [
        0,
        1,
        17
      ],
      "name": "Pere Soler-Palacín",
      "orcid": "0000-0002-0346-5570"
    },
    {
      "affs": [
        18,
        19
      ],
      "name": "María Teresa Martín-Gómez",
      "orcid": "0000-0001-7679-1054"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/93tcbed3f7ea3.bib",
  "cited_by": 0,
  "doi": "10.1111/myc.70206",
  "fulltext_url": "https://europepmc.org/articles/PMC13720326",
  "id": "93tcbed3f7ea3",
  "issns": [
    "0933-7407",
    "1439-0507"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958853",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2725|Antifungal resistance and susceptibility"
    ]
  ],
  "openalex": "W7224741435",
  "pdf_url": "https://europepmc.org/articles/PMC13720326?pdf=render",
  "pmcid": "PMC13720326",
  "pmid": "42958853",
  "published": "2026-10-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/93tcbed3f7ea3.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:36Z",
      "native_id": "MED:42958853",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958853"
    },
    {
      "first_seen": "2026-11-03T12:21:13Z",
      "native_id": "PMC13720326",
      "source": "pmc",
      "url": "https://doi.org/10.1111/myc.70206"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Antifungal resistance and susceptibility",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Azole-Resistant Aspergillosis: An Emerging Diagnostic and Therapeutic Challenge in Paediatrics.",
  "title_text": "Azole-Resistant Aspergillosis: An Emerging Diagnostic and Therapeutic Challenge in Paediatrics.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:13Z",
  "url": "https://research.draconitic.com/paper/93tcbed3f7ea3",
  "venue": "Mycoses",
  "versions": []
}