Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013–2018
Pieter P.A. Lestrade, Jochem B. Buil, Martha T. van der Beek, Ed J. Kuijper, Karin van Dijk, Greetje A. Kampinga, Bart J.A. Rijnders, Alieke G. Vonk, Sabine C. de Greeff, Annelot F. Schoffelen, Jaap van Dissel, Jacques F. Meis, Willem J.G. Melchers, Paul E. Verweij
, and Kuijper
Author affiliations: VieCuri Hospital, Venlo, the Netherlands (P.P.A. Lestrade); Center of Expertise in Mycology Radboud University Medical Center/Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands (J.B. Buil, J.F. Meis, W.J.G. Melchers, P.E. Verweij); Leiden University Medical Center, Leiden, the Netherlands (M.T. van der Beek, E.J. Kuijper); Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (K. van Dijk); University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (G.A. Kampinga); Erasmus Medical Center, Rotterdam, the Netherlands (B.J.A. Rijnders, A.G. Vonk); Center for Infectious Disease Control, Dutch National Institute for Public Health and the Environment, Bilthoven, the Netherlands (S.C. de Greeff, A.F. Schoffelen, J. van Dissel)
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Figure 4
Figure 4. Trends in voriconazole (A) and isavuconazole (B) MIC distributions in Aspergillus fumigatus harboring TR34/L98H, as observed in a national multicenter surveillance program in the Netherlands, 2013–2018. MIC distribution is displayed as a bubble graph for each year, where the diameter corresponds with the number of isolates with the corresponding MIC. The number of isolates is presented for each MIC. Mean MIC with 95% CIs are plotted for each year as a line with error bars. The clinical interpretation is shown on the right of the diagram. I, intermediate; R, resistant; S, susceptible.
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