Table 4.

Summary of CYP alterations detected among non-wild-type Aspergillus spp. isolates from pre-COVID (2018–2019) and COVID (2020).

			MIC (mg/l)a				CYP alterations
Year	State and/or country	Organism	Isavuconazoleb	Voriconazole	Itraconazole	Posaconazolec	CYP51A	CYP51B
2018–2019	Germany	A. niger	4 (WT)	4 (NWT)	8 (NWT)	1 (WT)	K77Q	WT
	IN, USA	A. fumigatus	1 (WT)	1 (WT)	2 (NWT)	1 (NWT)	I242V	WT
	Canada	A. fumigatus	1 (WT)	0.5 (WT)	2 (NWT)	0.5 (WT)	I242V	WT
	Australia	A. fumigatus	1 (WT)	2 (NWT)	1 (WT)	0.25 (WT)	WT	Q42L
	VT, USA	A. fumigatus	2 (NWT)	1 (WT)	2 (NWT)	0.5 (WT)	F46Y, M172V, E427K	WT
	Czech Republic	A. fumigatus	2 (NWT)	1 (WT)	2 (NWT)	0.5 (WT)	F46Y, M172V, N248T, D255E, E427K	WT
	Belgium	A. fumigatus	4 (NWT)	2 (NWT)	4 (NWT)	1 (NWT)	TR34/L98H	WT
	Italy	A. fumigatus	8 (NWT)	2 (NWT)	8 (NWT)	1 (NWT)	TR34/L98H	WT
	Italy	A. fumigatus	>8 (NWT)	>8 (NWT)	>8 (NWT)	4 (NWT)	TR34/L98H	WT
	Italy	A. fumigatus	4 (NWT)	2 (NWT)	4 (NWT)	1 (NWT)	TR34/L98H	WT
	Italy	A. fumigatus	4 (NWT)	1 (NWT)	4 (NWT)	0.5 (NWT)	TR34/L98H	WT
	Italy	A. fumigatus	4 (NWT)	2 (NWT)	4 (NWT)	1 (NWT)	TR34/L98H	WT
	Thailand	A. flavus	0.5 (WT)	2 (NWT)	1 (WT)	1 (NWT)	R5H	K165E
	VA, USA	A. fumigatus	1 (WT)	0.5 (WT)	2 (NWT)	0.5 (WT)	I242V	WT
	Slovenia	A. fumigatus	4 (NWT)	2 (NWT)	>8 (NWT)	0.5 (WT)	TR34/L98H	WT
	Italy	A. fumigatus	4 (NWT)	2 (NWT)	2 (NWT)	0.5 (WT)	TR34/L98H	WT
	Italy	A. fumigatus	2 (NWT)	2 (NWT)	2 (NWT)	0.5 (WT)	TR34/L98H	WT
	VA, USA	A. fumigatus	>8 (NWT)	4 (NWT)	>8 (NWT)	0.5 (WT)	G448S	WT
	Belgium	A. fumigatus	>8 (NWT)	>8 (NWT)	8 (NWT)	0.5 (WT)	Y121F, M172I, T289A, G448S, TR46	WT
2020	VT, USA	A. fumigatus	1 (WT)	0.5 (WT)	2 (NWT)	0.5 (WT)	F46Y, M172V, N248T, D255E, E427K	WT
	France	A. fumigatus	4 (NWT)	1 (WT)	4 (NWT)	1 (NWT)	WT	Q42L
	New Zealand	A. fumigatus	>8 (NWT)	8 (NWT)	>8 (NWT)	8 (NWT)	G138C	WT

^aCategorical interpretations of non-wild-type (NWT) and wild-type (WT) are according to CLSI ECVs from document M59.⁴³

^bIsavuconazole ECVs were published by Espinell-Ingrof.⁶⁸

^cThe ECV for posaconazole was 0.5 mg/l.⁴⁷