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ABSTRACTNatural pigments derived from microorganisms have many advantages and are widely studied in the food industry. A filamentous fungus, DBFL05, was identified as Aspergillus ustus, which produces a bright and abundant brown pigment. This extracellular, water-soluble pigment is highly polar and slightly soluble in alcohol but insoluble in other organic solvents. The pigment is stable under sunlight, at pH 2–10, and below 100°C. However, it is sensitive to Zn2+, Fe3+, Fe2+, and Cu2+. The pigment is mainly composed of two chemical components, pyrropyrazine diketone and dianthrone, and is classified as a polyketone pigment. Both components of the pigment exhibit inhibitory effects on bacteria and scavenging abilities for •OH and DPPH. The pigment showed no significant toxicity to plants and low toxicity to brine shrimp larvae. These findings indicate that the easily obtainable A. ustus pigment is a polyketone with attractive colour, stability, safety, and bioactivity.

Natural pigments derived from microorganisms have many advantages and are widely studied in the food industry. A filamentous fungus, DBFL05, was identified as Aspergillus ustus, which produces a bright and abundant brown pigment. This extracellular, water-soluble pigment is highly polar and slightly soluble in alcohol but insoluble in other organic solvents. The pigment is stable under sunlight, at pH 2–10, and below 100°C. However, it is sensitive to Zn2+, Fe3+, Fe2+, and Cu2+. The pigment is mainly composed of two chemical components, pyrropyrazine diketone and dianthrone, and is classified as a polyketone pigment. Both components of the pigment exhibit inhibitory effects on bacteria and scavenging abilities for •OH and DPPH. The pigment showed no significant toxicity to plants and low toxicity to brine shrimp larvae. These findings indicate that the easily obtainable A. ustus pigment is a polyketone with attractive colour, stability, safety, and bioactivity. [ABSTRACT FROM AUTHOR]

Four new drimane sesquiterpenoids (1–4) and three known ones (5–7) were isolated from the fermentation broth of the mangrove-derived Aspergillus ustus 094102. Compound 5 was further resolved as four purified compounds 5a–5d. By means of extensive spectroscopic and ECD analysis as well as the chemical transformation, their structures were identified as (2R,3R,5S,9R,10S)-2,3,9,11-tetrahydroxydrim-7-en-6-one (ustusol F, 1), (2R,3R,5R,9S,10R)-2,3,11-trihydroxydrim-7-en-6-one (9-deoxyustusol F, 2), (3S,5R,9R,10R)-3,11,12-trihydroxydrim-7-en-6-one (ustusol G, 3), (5S,6R,9S,10S, 11R,2′E,4′E)-(11-dideoxy-11-hydroxystrobilactone A-6-yl)-5-carboxypenta-2,4-dienoate (ustusolate H, 4), ((5S,6R,9S,10S)-strobilactone A-6-yl) (2E,4E)-6,7-dihydroxyocta-2,4-dienoate (ustusolate I, 5), (2′E,4′E;6′,7′-erythro)-ustusolate I (5a) and (2′E,4′E;ent-6′,7′-erythro)-ustusolate I (5b), (2′E,4′E,6′R,7′R)-ustusolate I (5c) and (2′E,4′E,6′S,7′S)-ustusolate I (5d), (5S,6R,9S,10S,2′E,4′E)-(strobilactone A-6-yl)-5-carboxypenta-2,4-dienoate (ustusolate J, 6), and (2S,5S,9R,10S)-2,9,11-trihydroxydrim-7-en-6-one (ustusol B, 7), respectively. Compound 5 showed antiproliferation against the human tumor cells CAL-62 and MG-63 with the IC50 values of 16.3 and 10.1 µM, respectively. [ABSTRACT FROM AUTHOR]

A new austin-type meroterpene, namely, ustusaustin A (1), together with seven related known analogues (2–8), were isolated and identified from the culture extract of Aspergillus ustus TK-5, an endophytic fungus obtained from the marine ascidian Pyura momus. The structures of these compounds were established on the basis of detailed interpretation of their NMR and MS data, and the relative and absolute configurations of 1 was confirmed by X-ray crystallographic analysis. Among them, ustusaustin A (1) represents the first example of 1'-nor-austin analogues with an unique 7-benzoylation. Compounds 1–4, 6, and 7 exhibited potent neuraminidase inhibitory activity and this is the first report of neuraminidase inhibitory activity for austin-type meroterpenes. [ABSTRACT FROM AUTHOR]

One new dihydrobenzofuran derivative (1), known depsipeptide emericellamide A (2), three known drimanes (3–5) and two artifact drimane derivatives (6, 7) were isolated from the marine-derived fungus Aspergillus ustus KMM 4664. Their structures were determined by detailed analysis of spectroscopic data and by comparison with related known compounds. The absolute configuration of 1 was determined by time-dependent density functional theory (TD-DFT) calculations of ECD spectra. Compound 7 showed significant ability of the inhibition of spermatozoa to fertilize egg-cells of the sea urchin Strongylocentrotus intermedius with IC50 value 21 µM. [ABSTRACT FROM AUTHOR]

Accumulation of two benzoyl esters in Aspergillus ustus after feeding with alcohols was reported 30 years ago. To the best of our knowledge, the biosynthesis for these esters has not been elucidated prior to this study. Here, we demonstrate that these compounds are artifical products of the phenethyl polyketide ustethylin A biosynthestic pathway. In addition, four aditional benzoyl esters with different methylation levels were also isolated and identified as shunt products. Feeding experiments provided evidence that the enzyme-bound polyketide acyl intermediates are hijacked by externally fed MeOH or EtOH, leading to the formation of the benzoyl esters. [ABSTRACT FROM AUTHOR]

Background Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections. Methods Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA / CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria. Results Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% of cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16, and 4 µg/mL for amphotericin B, voriconazole, posaconazole, and isavuconazole, respectively. Conclusions Aspergillus ustus IA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined. [ABSTRACT FROM AUTHOR]

Four new drimane sesquiterpenoids (1–4) and three known ones (5–7) were isolated from the fermentation broth of the mangrove-derived Aspergillus ustus 094102. Compound 5 was further resolved as four purified compounds 5a–5d. By means of extensive spectroscopic and ECD analysis as well as the chemical transformation, their structures were identified as (2R,3R,5S,9R,10S)-2,3,9,11-tetrahydroxydrim-7-en-6-one (ustusol F, 1), (2R,3R,5R,9S,10R)-2,3,11-trihydroxydrim-7-en-6-one (9-deoxyustusol F, 2), (3S,5R,9R,10R)-3,11,12-trihydroxydrim-7-en-6-one (ustusol G, 3), (5S,6R,9S,10S, 11R,2′E,4′E)-(11-dideoxy-11-hydroxystrobilactone A-6-yl)-5-carboxypenta-2,4-dienoate (ustusolate H, 4), ((5S,6R,9S,10S)-strobilactone A-6-yl) (2E,4E)-6,7-dihydroxyocta-2,4-dienoate (ustusolate I, 5), (2′E,4′E;6′,7′-erythro)-ustusolate I (5a) and (2′E,4′E;ent-6′,7′-erythro)-ustusolate I (5b), (2′E,4′E,6′R,7′R)-ustusolate I (5c) and (2′E,4′E,6′S,7′S)-ustusolate I (5d), (5S,6R,9S,10S,2′E,4′E)-(strobilactone A-6-yl)-5-carboxypenta-2,4-dienoate (ustusolate J, 6), and (2S,5S,9R,10S)-2,9,11-trihydroxydrim-7-en-6-one (ustusol B, 7), respectively. Compound 5 showed antiproliferation against the human tumor cells CAL-62 and MG-63 with the IC50 values of 16.3 and 10.1 µM, respectively.

The Aspergilli of section Usti (group ustus) are represented by over 20 species, of which Aspergillus calidoustus is the most relevant human pathogen. Invasive aspergillosis (IA) caused by these fungi is rare but could represent an emerging issue among the expanding population of patients with long-term immunosuppression receiving antifungal prophylaxis. Clinicians should be aware of this unusual type of IA, which often exhibits distinct clinical features, such as an insidious and prolonged course and a high occurrence of extra-pulmonary manifestations, such as skin/soft tissue or brain lesions. Moreover, these Aspergillus spp. pose a therapeutic challenge because of their decreased susceptibility to azole drugs. In this review, we outline the microbiological and clinical characteristics of IA due to Aspergillus spp. of section Usti and discuss the therapeutic options. [ABSTRACT FROM AUTHOR]

Invasive aspergillosis (IA) is the most common invasive fungal infection following a hematopoietic cell transplant, with emerging cryptic species exhibiting resistance to commonly used antifungals such as azoles. These species have been increasingly found after the introduction of anti-mold prophylaxis. We report a case of a 56-year-old female with primary myelofibrosis whose allogeneic hematopoietic cell transplant was complicated by disseminated fungal infection (skin, lung) due to Aspergillus calidoustus, a cryptic specie. Treatment of Aspergillus species remains challenging as these cryptic species are usually resistant to azoles including voriconazole which is the first line of treatment of IA. Infection was successfully treated with surgical excision and combination antifungal therapy based on in vitro susceptibility and synergy testing. Therapy included isavuconazole, a drug that has been shown to be non-inferior to voriconazole in the treatment of invasive mold infections. [ABSTRACT FROM AUTHOR]

The bacterial wilt caused by Ralstonia solanacearum seriously affects crop yield and safety and is difficult to control. Biological activity-guided screening led to the isolation of 11 phenolic compounds including three undescribed compounds (carnemycin H-I and stromemycin B) from the secondary metabolites of a marine-derived Aspergillus ustus . One new compound is an unusual phenolic dimer. Their structures were elucidated by comprehensive spectroscopic data and J -based configurational analysis. The antibacterial activities of the isolated compounds against R. solanacearum were evaluated. Compound 3 exhibited excellent inhibitory activity with an MIC value of 3 μg/mL, which was comparable to that of streptomycin sulfate. Additionally, 3 significantly changed the morphology and inhibited the activity of succinate dehydrogenase (SDH) to interfere with the growth of R. solanacearum . Molecular docking was conducted to clarify the potential mechanisms of compound 3 with SDH. Further in vivo experiments demonstrated that 3 could remarkably inhibit the occurrence of bacterial wilt on tomatoes.

The Aspergilli of section Usti (group ustus) are represented by over 20 species, of which Aspergillus calidoustus is the most relevant human pathogen. Invasive aspergillosis (IA) caused by these fungi is rare but could represent an emerging issue among the expanding population of patients with long-term immunosuppression receiving antifungal prophylaxis. Clinicians should be aware of this unusual type of IA, which often exhibits distinct clinical features, such as an insidious and prolonged course and a high occurrence of extra-pulmonary manifestations, such as skin/soft tissue or brain lesions. Moreover, these Aspergillus spp. pose a therapeutic challenge because of their decreased susceptibility to azole drugs. In this review, we outline the microbiological and clinical characteristics of IA due to Aspergillus spp. of section Usti and discuss the therapeutic options.

Aspergillus calidoustus, previously classified as Aspergillus ustus, is an emerging pathogen in immunocompromised persons. We describe four recent cases of A. calidoustus and review 37 additional cases of A. calidoustus (n = 8) or A. ustus (n = 29) published through June 2016. Twenty (49%) cases occurred in patients with hematologic malignancy and/or receipt of hematopoietic cell transplantation, and 13 (32%) occurred in solid organ transplant recipients. Antifungal susceptibility was reported in 49% of cases and in 42% treatment failed. Overall mortality was 66% and, where reported, attributable mortality was 30%. A. calidoustus infection is associated with a high mortality rate and frequently displays in vitro antifungal resistance. [ABSTRACT FROM AUTHOR]

Secondary metabolites of 22 fungal strains (genus Aspergillus, section Usti) isolated at diverse geographic regions, including the Arctic permafrost deposits, were studied. The studied strains were found to synthesize a variety of biologically active compounds, structurally identified as drimane sesqueterpenoids, isoquinoline alkaloids (TMC-120 A−C, derivative 1), meroterpenoids (austalides О and J), and anthraquinone pigments (averufin, versicolorin C). Desferritriacetylfusigen production by A. calidoustus isolates is reported for the first time. The individual spectra of secondary metabolites were used for reidentification of 17 strains, of which 15 were identified as A. calidoustus and two, as A. pseudodeflectus. [ABSTRACT FROM AUTHOR]

The deterioration of wood on account of microbiological agents is an acknowledged fact. Botryodiplodia theobromae - Trichoderma longibrachiatum - Aspergillus candidus - Aspergillus ustus and Aspergillus terreus were isolated from two wooden masks dating back to the Greek- Roman period in Egypt. The chemical composition of wood is easily affected after any attack and visible changes can be noticed clearly after some time, but the degree of deterioration of wood constituents cannot be estimated unless the wood is closely studied. Ficus sycomorus wood samples, which had been infected by the fungi isolated from the masks, were studied by using X Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy with Attenuation Total Reflection (FTIR-ATR).

ABSTRACT The fungus Aspergillus ustus was isolated from external ear inflammation. This fungus rarely infects human because it infects immunocompromised patients causing cutaneous, endocarditis and pneumonia infections. It is also a pathogenic plant and contaminating the crops. The effect of alcoholic extract of leaves of Achillea millefolium (yarrow), Salvia officinalis (sage) and Cassia spp.(seena), was tested by using four concentrations for each extract 5,10,15,20 mg/ml. Results were compared with the antifungal ketoconazole and with the biocontrol agents Trichoderma viride and Trichoderma harzianum. It is noticed that the highest percentage of inhibition was at concentration 20mg/ml for all the plant extracts used for inhibition percentage for A. millefolium, S. officinalis and Cassia spp.were 56.6%, 83.3% and 100% respectively. For ketoconazole the percentage of inhibition was 100% for all concentrations used in this study. The biocontrol agents T. harzianum and T. viride proved to have a high antagonistic ability against the pathogen. This proves that the alcoholic leaves extracts of these plants were more inhibitory for the fungus in addition to biocontrol agents.

Penggunaan mikroba sebagai sumber senyawa bioaktif memiliki beberapa kelebihan di antaranya mempersingkat waktu produksi dan menghindari pemanfaatan sumberdaya laut secara berlebih. Penelitian terdahulu menghasilkan beberapa isolat mikroba yang berpotensi sebagai penghasil senyawa bioaktif, di antaranya adalah isolat kapang MFW 26-08. Penelitian ini bertujuan untuk melakukan optimasi pertumbuhan isolat kapang MFW 26-08 dan produksi senyawa bioaktif yang disekresikan oleh kapang tersebut. Optimasi dilakukan dengan menggunakan 3 jenis media: Malt Extract Broth (MEB), Glucose Peptone Yeast (GPY), dan Minimal Fungal Media(MFM); serta waktu kultivasi 2, 4, 6, 8, dan 10 minggu. Hasil riset menunjukkan bahwa ekstrak kasar kapang MFW 26-08 hasil kultivasi 2 minggu dalam medium MFM, pada konsentrasi 30 µg/mL, mampu menghambat 89% pertumbuhan sel kanker payudara T47D. Sedangkan pada konsentrasi 100 µg/mL ekstrak kapang yang dikultivasi dalam medium MEB selama 6 minggu, mampu menghambat pembentukan radikal bebas sampai 56%. Hasil identifikasi berdasarkan sifat-sifat morfologi dan molekuler menggunakan 18S rRNA, ITS1, dan ITS4 menunjukkan bahwa isolat MFW 26-08 memiliki kemiripan dengan Aspergillus ustussebesar 99%

Aspergillus ustus is a mold that rarely infects humans; only 15 systemic cases have been reported. We report the first outbreak of invasive infection caused by A. ustus among hematopoietic stem cell transplant (HSCT) recipients. Six patients with infections were identified; 3 infections each occurred in both 2001 and 2003. Molecular typing by using randomly amplified polymorphic DNA (RAPD) and antifungal drug susceptibility testing were performed on clinical and environmental isolates recovered from our hospital from 1999 to 2003. The highest overall attack rate in HSCT patients was 1.6%. The overall death rate was 50%, and death occurred within 8 days after diagnostic culture collection. Clinical isolates exhibited decreased susceptibility to antifungal drugs, especially azoles. RAPD and phylogenetic analysis showed genetic similarity between isolates from different patients. Based on the clustering of cases in space and time and molecular data, common-source acquisition of this unusual drug-resistant species is possible.

Breakthrough invasive mold infections (IMIs) that occur during posaconazole or voriconazole prophylaxis are rare complications for which epidemiological data are lacking. This retrospective analysis comparing 24 microbiologically documented breakthrough with 66 nonbreakthrough IMIs shows a shift towards non-Aspergillus molds with a significantly increased proportion of rare multidrug-resistant molds. [ABSTRACT FROM AUTHOR]

The deterioration of wood on account of microbiological agents is an acknowledged fact. Botryodiplodia theobromae - Trichoderma longibrachiatum - Aspergillus candidus - Aspergillus ustus and Aspergillus terreus were isolated from two wooden masks dating back to the Greek- Roman period in Egypt. The chemical composition of wood is easily affected after any attack and visible changes can be noticed clearly after some time, but the degree of deterioration of wood constituents cannot be estimated unless the wood is closely studied. Ficus sycomorus wood samples, which had been infected by the fungi isolated from the masks, were studied by using X Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy with Attenuation Total Reflection (FTIR-ATR). [ABSTRACT FROM AUTHOR]

Abstract: Heat inactivated Aspergillus ustus (Asp), silicon dioxide-nano-powder (N―Si), and silicon dioxide nano-powder-combined-heat inactivated Aspergillus ustus (N―Si―Asp) were used to study the biosorption of Cd(II) from aqueous solutions via batch equilibrium technique. Surface characterization and immobilization of the fungal cells on silicon dioxide-nano-powder were examined and confirmed by using FT-IR and ESM analysis. Cadmium biosorption processes were investigated under the effect of pH, contact time, sorbent dosage and initial metal concentration. The three examined sorbents were found to exhibit maximum μmolg-1 capacity values in pH 7.0. The maximum determined cadmium capacity by silicon dioxide-nano-powder (N―Si) (600μmolg−1) was found higher than that exhibited by the heat inactivated fungal cells (Asp) (400μmolg−1). However, (N―Si―Asp) exhibited the highest sorption cadmium capacity (1000μmolg−1) as a combined behavior of both silicon dioxide nano-powder and Aspergillus ustus units. Sorption equilibria were established in 20min and their data were well described by both Langmuir and Freundlich models. The potential applications of these sorbents for biosorptive removal of Cd(II) from real samples contaminated with cadmium, were successfully accomplished via a micro-column under constant flow rate. [Copyright &y& Elsevier]

We report a case of primary cutaneous Aspergillus caldioustus infection caused by nerve block therapy. A 67-year-old Japanese woman had been treated with oral predonisolon and tacrolimus for adult-onset Still disease and interstitial pneumonia. She presented with a 2-month-history of the lesions on the left back. A biopsy specimen from the skin lesion revealed granulomatous inflammation with hyphae. Culture of the pus and the skin specimen confirmed the diagnosis of cutaneous Aspergillus infection. The sequence of 13- tubulin gene was analyzed to confirm the mycological diagnosis and the causative agent was identified as A. caldioustus. The patient was treated with surgical removal of the lesions and oral 200 mg/day itraconazole but she died of infectious interstitial pneumonia due to Pneumocystis jiroveci and Cytomegalovirus infection Percutaneous infection may have been responsible for the incidence of localized infection. There was no evidence of systemic aspergillosis. A. caldioustus is an emerging opportunistic fungal pathogen in immunocompromised patients. Immunocompromised patients who have persistent traumatic atypical skin lesion need to be ruled out of such rare fungus infection. An opportunistic infection in Immunocompromised patients can be life-threatening and prompt treatment based on accurate diagnosis is important. [ABSTRACT FROM AUTHOR]

This is a case report of a 61-year-old cardiac transplant patient who developed a disseminated infection involving the upper extremity with a rare fungus known as Aspergillus ustus. The patient was successfully treated with aggressive serial debridements, antifungal medications, and reduction of immunosuppression. With these interventions, the patient avoided amputation despite the aggressive nature of this infection. [ABSTRACT FROM AUTHOR]

This report describes the first case of cerebral aspergillosis in a heart transplantation patient caused by Aspergillus ustus and reviews 15 previously reported cases of invasive aspergillosis in immunocompromised hosts caused by this mold. The utility of molecular analysis for the identification of unusual fungal pathogens is also described. The refractory nature of A. ustus to treatment is similar to other Aspergillus species and treatment options are reviewed. [ABSTRACT FROM AUTHOR]

Abstract: Aspergillus ustus infections are associated with a high mortality in immunocompromised hosts, and the mold has decreased susceptibility to most antifungal drugs, especially azoles. We report primary cutaneous A. ustus infection in a patient who failed itraconazole therapy and was switched to voriconazole (VRC). During VRC therapy, the MICs of VRC, amphotericin B (AMB), caspofungin (CFG), and terbinafine (TBF) were 4, 2, 64, and 0.13 μg/mL, respectively. Because the MIC to VRC was high, TBF was added to VRC for synergy based on anecdotal data from other mycoses. After treatment with VRC and TBF for 5 months, MICs of VRC, AMB, CFG, and TBF of A. ustus were 8, 1, 64, and 4 μg/mL respectively. Although the MICs of VRC and TBF increased during antifungal therapy, the patient responded well to the combination antifungal therapy with surgical debridement. With a successful outcome despite high MICs and with limited therapeutic options currently available, we investigated the in vitro activity of posaconazole (PCZ) and VRC individually and in combination with AMB, CFG, or TBF using the fractional inhibitory concentration index (FICI) method. Combination of VRC with TBF showed synergistic activity (FICI = 0.5). Therefore, combination of VRC and TBF with surgical debridement, when appropriate, may be a viable treatment option for refractory A. ustus infections. [Copyright &y& Elsevier]

Abstract: Higher plants are ubiquitously colonized with fungal endophytes that often lack readily detectable structures. This study examines the diverse endophyte population within a single line of micropropagated Bouteloua eriopoda (Torr.) Torr., using microscopy and comparison of internal spacer (ITS) gene sequences obtained from both plant and isolated fungal tissues. Microscopy revealed fungal hyphae and lipid bodies, the majority of which lacked distinguishing characters. Internal transcribed spacer (ITS) sequences amplified from fungal isolates and micropropagated plant tissues were subjected to Bayesian analysis, which clearly distinguished six endophyte taxa. Results confirm a diverse, cryptic endophyte consortium is retained within this micropropagated plant line. The probability of similar complexity in other plant species is discussed. The development of controlled systems in which to study single plant-fungal interactions within such consortia presents significant technical challenges. However, potential for such systems to reveal species interactions that influence plant growth and development is high. [Copyright &y& Elsevier]

The first case of postoperative endophthalmitis after cataract surgery caused by Aspergillus ustus, a species that has only rarely been implicated in human disease, is described. Six weeks after cataract surgery, a 67-year-old medically controlled diabetic patient presented with uveitis, mild ciliary injection and ocular discomfort. Anterior chamber paracentesis, vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed and several sets of culture yielded A. ustus. Despite vigorous systemic (itraconazole and caspofungin) and intravitreal (amphotericin B and caspofungin) antifungal therapy, the endophthalmitis did not improve. The painful eye with marked inflammation was finally enucleated. In vitro susceptibility testing of the isolate showed that it appeared resistant to amphotericin B, caspofungin, itraconazole, voriconazole, and posaconazole, and susceptible to terbinafine. [ABSTRACT FROM AUTHOR]