BioMed Research International

BioMed Research International / 2015 / Article

Research Article | Open Access

Volume 2015 |Article ID 109656 |

Hong Wang, Zhe Wan, Ruoyu Li, Qiaoyun Lu, Jin Yu, "Molecular Identification and Susceptibility of Clinically Relevant Scedosporium spp. in China", BioMed Research International, vol. 2015, Article ID 109656, 9 pages, 2015.

Molecular Identification and Susceptibility of Clinically Relevant Scedosporium spp. in China

Academic Editor: Orazio Romeo
Received25 Jul 2015
Accepted16 Sep 2015
Published07 Oct 2015


As various new sibling species within the Scedosporium spp. have been described recently, this study was conducted to investigate distribution and antifungal susceptibility profiles of the different species of Scedosporium spp. in China. Twenty-one clinical strains of Scedosporium from China and two strains from Japan were reidentified by MLSA. The analysis included BT2, CAL, RPB, SOD, and ACT and the combination of the five loci. Pseudallescheria boydii complex (17 strains) and S. apiospermum (6 strains) were identified. P. boydii complex included four closely related subgroups: P. boydii (9 strains), P. ellipsoidea (6 strains), P. fusoidea (1 strain), and P. angusta (1 strain). There were no significant differences in MICs for neither VOR, POS, nor AMB over all the five species in study. For itraconazole, intraspecific diversity was evident.

1. Introduction

Scedosporium spp. is one of the species of the opportunistic pathogenic fungi that can always be found in environment, especially in sewerage. It infects immunocompromised patients and drowning men, involving lungs, sinuses, bones, joints, eyes, and brain [1].

In recent years, members of the genus Scedosporium are increasingly recognized as opportunistic agents of disease, for example, in transplant recipients. Scedosporium species have been identified as the second most prevalent mold after Aspergillus colonizing the lungs of patients with cystic fibrosis [2]. Scedosporium infections occur worldwide. In European countries, USA and Australia, Scedosporium species were always found in patients with chronic lung diseases, cystic fibrosis (CF), lung or allogenic bone-marrow transplantation, and hematologic malignancies [1, 3, 4]. Accordingly, the common types were pulmonary, nasal sinuses, skin/soft tissues, CNS, and disseminated infection [1, 3, 4].

It is traditionally recognized that Pseudallescheria boydii is the sexual stage of the S. apiospermum. However, recent molecular studies [57] showed that Scedosporium is a species complex comprising at least five distinct groups: S. aurantiacum, P. minutispora, S. dehoogii, S. apiospermum, and P. boydii, the last group consisting of four closely related subgroups called P. boydii, P. angusta, P. ellipsoidea, and P. fusoidea. Furthermore, S. prolificans is now renamed as Lomentospora prolificans [8]. It is important to identify Scedosporium spp. to species level because their virulence, metabolic trait, and in vitro susceptibility may be various based on their different species [39].

2. Materials and Methods

2.1. Strains

From 1990 to 2014, twenty-one Scedosporium strains isolated from patients were reserved in Research Center for Medical Mycology at Peking University. The clinical samples were collected from 14 Chinese hospitals which located mainly in central and south of China. All the isolates were identified as S. apiospermum or P. boydii by morphology. A total of 23 isolates (including two strains from Japan) as shown in Table 1 were investigated in this study. Furthermore, in vitro susceptibility was performed on the same set strains.

BMU numberClinical sampleGenBank accession numberMolecular identification

00488UnknownKP981202KP981130KP981185KP981153KP981107P. boydii
00491UnknownKP981214KP981131KP981179KP981154KP981108S. apiospermum
01112UnknownKP981203KP981132KP981192KP981155KP981109P. boydii
01113UnknownKP981204KP981133KP981181KP981156KP981110P. boydii
01114UnknownKP981199KP981134KP981193KP981157KP981111P. boydii
01115UnknownKP981200KP981135KP981194KP981158KP981112P. angusta
01116UnknownKP981201KP981136KP981186KP981159KP981113P. boydii
01117Eye ballKP981205KP981138KP981180KP981160KP981114S. apiospermum
01118UnknownKP981215KP981137KP981190KP981161KP981115P. ellipsoidea
01272SputumKP981206KP981139KP981182KP981162KP981116P. boydii
01297UnknownKP981221KP981140KP981195KP981163KP981117P. fusoidea
02948Nasal sinusKP981211KP981141KP981196KP981164KP981118P. boydii
03882SputumKP981207KP981142KP981176KP981165KP981119S. apiospermum
04111Joint fluidKP981219KP981143KP981178KP981166KP981120S. apiospermum
04729BALFKP981216KP981144KP981198KP981167KP981121S. apiospermum
04730Nasal sinusKP981217KP981145KP981191KP981168KP981122P. ellipsoidea
04772CSFKP981220KP981146KP981183KP981169KP981123P. ellipsoidea
04780BALFKP981218KP981147KP981187KP981170KP981124P. ellipsoidea
05145UnknownKP981213KP981148KP981189KP981171KP981125P. ellipsoidea
07108SputumKP981208KP981149KP981188KP981172KP981126P. ellipsoidea
07224BrainKP981209KP981150KP981184KP981173KP981127P. boydii
07374PusKP981212KP981151KP981197KP981174KP981128P. boydii
07462CSFKP981210KP981152KP981177KP981175KP981129S. apiospermum

Strains from Japan.
2.2. Molecular Studies

The isolates were cultured on PDA at 28°C for 7 days. For fungal DNA extraction, glass beads method previously described by van Burik et al. was followed [10]. Adapted from earlier genotyping studies [1114], PCR amplification with different primer pairs was attempted for Scedosporium species for the following genes: β-tubulin (BT2, exons 2–4) [11], calmodulin (CAL, exons 3–4) [12], the second largest subunit of RNA polymerase II (RPB) [13], superoxide dismutase (SOD), and actin (ACT) [14].

The PCR assay (25 μL) included 2 μL of fungal DNA extract, 1 μM of each gene-specific primer, 2.5 mmol dNTP Mix 1 μL, 10x PCR buffer 2.5 μL, and LA Taq polymerase 0.25 μL (Fermentas, St. Leon-Rot, Germany). The amplification for all targeted genes was performed in a Eppendorf PCR machine (AG22331) as follows: 5 min of initial denaturation at 95°C, followed by 35 cycles at 95°C for 30 s, gene-specific annealing temperature for 30 s, and 72°C for 1 min (for RPB2 the annealing time was 2.5 min). The PCR products were visualized by electrophoresis on a 1% (w/v) agarose gel. Both strands of the PCR fragments were sequenced using the above-mentioned primers. The consensus sequences were obtained using SeqMan (DNAStar-Lasergene, Madison, WI, USA) software. Newly obtained sequences were deposited in GenBank under accession numbers KP 981107 to KP 981221 (Table 1). They were used to conduct alignment analysis for preliminary species identification in the NCBI genomic database ( and CBS database ( The sequences were aligned using MUSCLE. For the maximum likelihood analysis, the distances between sequences were calculated using the best parameter model found by MEGA 6.0 6 ( A bootstrap analysis was conducted with 1000 replications.

2.3. Susceptibility Test

The in vitro susceptibility of the 23 Scedosporium isolates against four antifungal agents was evaluated by using the Clinical and Laboratory Standards Institute (CLSI) M38-A2 broth microdilution method [15]. The inocula suspensions were prepared in new sterile tubes and adjusted to 0.4−5 × 106 colony-forming units per milliliter (CFU/mL) by counting spores in a hemocytometer and subsequently verifying them through quantitative colony counts on PDA plates. The nongerminated spore suspensions were diluted 1 : 100 in an RPMI 1640 to achieve a final inoculum concentration of 0.4–5 × 104 CFU/mL. The following antifungal agents were used: voriconazole (VOR; Shouguang Fukang Pharmaceutical Co., Ltd., China), posaconazole (POS; Merck, Rahway, NJ, USA), itraconazole (ITR; Shouguang Pharm), and amphotericin B (AMB; Sigma-Aldrich Co., St. Louis, USA). They were all diluted in 100% dimethyl sulphoxide as a stock solution with a concentration of 1.600 mg/L. Final drug concentrations ranged from 16 to 0.03 mg/L for all the four drugs. The minimal inhibitory concentrations (MIC) endpoints were defined as the lowest concentration at which there was a complete inhibition of growth. Aspergillus flavus ATCC 204304 served as a quality control strain. The microtiter panels were incubated at 35°C and the results were read after 72 h. All tests were performed in triplicate on three different days.

3. Results

3.1. Molecular Phylogeny

We were able to amplify and sequence 470 bp, 645 bp, 935 bp, 775 bp, and 396 bp of the BT2, CAL, RPB, ACT, and SOD loci, respectively. Of the 3221 nucleotides sequenced, 209 (6.5%) were informative for parsimony in the different Scedosporium isolates. For identification, reference sequence of Scedosporium species available in public database were used including BT2 and CAL, but no sequences for RPB, SOD, and ACT were available. The sequences for BT2, CAL, RPB, SOD, and ACT yielded phylogenetic trees with the same topology (Figures 15). In the combination phylogenetic trees based on BT2 and CAL (Figure 6), 23 strains in our study were reidentified to the species level according to the reference strains, which were analyzed in the Gilgado literature. P. boydii (9/23) and its closely related subtypes P. ellipsoidea (6/23), P. fusoidea (1/23), and P. angusta (1/23) were the most common, and the other 6 of 23 strains were identified as S. apiospermum.

The topology of the combined tree (Figure 7) of all five loci was similar to those observed in the trees of individual locus and the combined tree of BT2 and CAL. Four principal clades were obtained. The four clades were the P. boydii clade, P. ellipsoidea clade, P. fusoidea/P. angusta clade, and S. apiospermum clade. P. fusoidea and P. angusta always assemble together, and P. boydii and P. ellipsoidea were very closely related. S. apiospermum has the highest intraspecies variability (genetic distance = 0.008), which is comparable to the interspecies variability between P. fusoidea and P. angusta (genetic distance = 0.008).

3.2. In Vitro Susceptibility Test

The MIC values for the four antifungal agents examined by the CLSI M-38A2 microdilution method against the 23 strains are presented in Table 2. VOR was the most active agent against all 23 strains with a MIC range from 0.25 to 1 μg/mL and a 0.46 μg/mL GM. POS was the second most active agent with MIC values of 2 or 4 μg/mL. For ITR, the intraspecific diversity was obvious as most strains had a MIC between 2 and 4 μg/mL, but five strains were higher at a MIC of 32 μg/mL. AMB is the least effective with high MIC values ranging from 4 to 32 μg/mL in vitro.

Strain speciesStrain ID numberMIC (g/mL)

P. boydiiBMU 004880.25244
BMU 011120.252232
BMU 011130.254432
BMU 011140.5248
BMU 011160.5244
BMU 012720.5228
BMU 029480.5224
BMU 072240.252416
BMU 073740.25244

P. ellipsoideaBMU 0111814324
BMU 047300.5224
BMU 047720.543232
BMU 047800.54416
BMU 051450.54328
BMU 071080.25448

P. angustaBMU 011150.5248

P. fusoideaBMU 012970.52232

S. apiospermumBMU 004910.5444
BMU 011170.5448
BMU 038820.5248
BMU 04111143216
BMU 047290.5228
BMU 0746212328

The MIC50 and MIC90 for the four antifungal agents against P. boydii, P. ellipsoidea, and S. apiospermum are presented in Table 3. There were similar MIC50 and MIC90 for VOR, POS, or AMB of the three species above. For ITR, the MIC90 of P. boydii (4 μg/mL) was lower than that of P. ellipsoidea (32 μg/mL) and S. apiospermum (32 μg/mL).

Species (number of isolates)Drug concentration (g/mL)

P. boydii (9)0.250.52444832
P. ellipsoidea (6)0.5144432832
S. apiospermum (6)0.5124432816

4. Discussions and Literature Review

Scedosporiosis is a rare infection in China. Sporadic cases of Scedosporium infection have been reported since 1990, but most cases were identified in recent years. We reviewed 39 cases reported in China from 1990 to 2013 [1631]. We found that infection in the nasal sinuses (16 cases) was the most frequently involved location, followed by eye (13), CNS (5), lung (4), skin/soft tissues (2), arthritis or osteomyelitis (1), and disseminated infection (1). The risk factors included trauma, drowning, and a compromised immune system (bone marrow transplant or stem cell transplantation). Trauma is the most common risk factor for scedosporiosis in Chinese patients, as nearly half of these patients have trauma history. Because cystic fibrosis is extremely rare in the Chinese population, no scedosporiosis in CF was reported in China.

Based on molecular identification, we found that P. boydii complex and S. apiospermum were the only two species in our study. Actually, P. boydii and S. apiospermum demonstrated a closely phylogenetic relationship. This is also reflected by their undifferentiated morphological characteristics, assimilation of different sugars, and growth temperature (data not shown). In P. boydii complex, four closely related subgroups, P. boydii (9 strains), P. ellipsoidea (6 strains), P. fusoidea (1 strain), and P. angusta (1 strain), were present in the study.

In a set of clinical and environmental strains from Austria, Germany, and Netherlands, S. apiospermum was the most prevalent, followed by P. boydii [32, 33]. In Australia, S. apiospermum and S. aurantiacum were the Scedosporium species with a high incidence except for L. prolificans [4]. Based on our study, we found that in China the P. boydii complex represents the most prevalent species (16/21) followed by S. apiospermum (5/21), which is the same as in Northern Spain and France [34, 35]. In the Chinese strains, we could not find S. aurantiacum, which had a high incidence in Australia and a relatively low incidence in Europe.

Antifungal susceptibility profiles for clinical breakpoint of Scedosporium species are still under study. Of the four antifungal tested in this study, VOR was found to be the most active agent against Scedosporium species; POS was the second, and AMB had limited antifungal activity. For ITR, the intraspecific diversity was obvious as the range of MIC from 2 to 32 μg/mL and P. boydii had a lower MIC90 than that of P. ellipsoidea and S. apiospermum. This in vitro susceptibility data is consistent with previous reports [32, 34, 3638]. In China, most cases caused by Scedosporium were treated with either ITR or VOR. Although Scedosporium strains have relatively high MIC values for ITR (GM = 5.25) in vitro, studies have verified that they are clinically effective [7].

5. Conclusion

The P. boydii complex and S. apiospermum were the main Scedosporium species in clinical samples in China. Scedosporium species can be distinguished unambiguously by all the five loci in this study. VOR is the most active agent in vitro against the set of Scedosporium species in this study, followed by POS and ITR.

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.


This work was supported by the grants from the National Natural Science Foundation of China (31570015 and 81401713).


  1. K. J. Cortez, E. Roilides, F. Quiroz-Telles et al., “Infections caused by Scedosporium spp,” Clinical Microbiology Reviews, vol. 21, no. 1, pp. 157–197, 2008. View at: Publisher Site | Google Scholar
  2. A. M. Borman, M. D. Palmer, L. Delhaes et al., “Lack of standardization in the procedures for mycological examination of sputum samples from CF patients: a possible cause for variations in the prevalence of filamentous fungi,” Medical Mycology, vol. 48, supplement 1, pp. S88–S97, 2010. View at: Publisher Site | Google Scholar
  3. J. Guarro, A. S. Kantarcioglu, R. Horré et al., “Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist,” Medical Mycology, vol. 44, no. 4, pp. 295–327, 2006. View at: Publisher Site | Google Scholar
  4. C. H. Heath, M. A. Slavin, T. C. Sorrell et al., “Population-based surveillance for scedosporiosis in Australia: epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection,” Clinical Microbiology and Infection, vol. 15, no. 7, pp. 689–693, 2009. View at: Publisher Site | Google Scholar
  5. M. Cuenca-Estrella, A. Gomez-Lopez, E. Mellado, G. Garcia-Effron, A. Monzon, and J. L. Rodriguez-Tudela, “In vitro activity of ravuconazole against 923 clinical isolates of nondermatophyte filamentous fungi,” Antimicrobial Agents and Chemotherapy, vol. 49, no. 12, pp. 5136–5138, 2005. View at: Publisher Site | Google Scholar
  6. M. Lackner, F. Hagen, J. F. Meis et al., “Susceptibility and diversity in the therapy-refractory genus Scedosporium,” Antimicrobial Agents and Chemotherapy, vol. 58, no. 10, pp. 5877–5885, 2014. View at: Publisher Site | Google Scholar
  7. M. A. Saracli, U. Erdem, A. Gonlum, and S. T. Yildiran, “Scedosporium apiospermum keratitis treated with itraconazole,” Medical Mycology, vol. 41, no. 2, pp. 111–114, 2003. View at: Google Scholar
  8. M. Lackner, G. S. de Hoog, L. Y. Yang et al., “Proposed nomenclature for Pseudallescheria, Scedosporium and related genera,” Fungal Diversity, vol. 67, no. 1, pp. 1–10, 2014. View at: Publisher Site | Google Scholar
  9. F. Gilgado, J. Cano, J. Gené, C. Serena, and J. Guarro, “Different virulence of the species of the Pseudallescheria boydii complex,” Medical Mycology, vol. 47, no. 4, pp. 371–374, 2009. View at: Publisher Site | Google Scholar
  10. J.-A. H. van Burik, R. W. Schreckhise, T. C. White, and R. A. Bowden, “Comparison of six extraction techniques for isolation of DNA from filamentous fungi,” Journal of Medical and Veterinary Mycology, vol. 36, no. 5, pp. 299–303, 1998. View at: Publisher Site | Google Scholar
  11. N. L. Glass and G. C. Donaldson, “Development of primer sets designed for use with the PCR to amplify conserved genes from filamentous ascomycetes,” Applied and Environmental Microbiology, vol. 61, no. 4, pp. 1323–1330, 1995. View at: Google Scholar
  12. A. Bernhardt, L. Sedlacek, S. Wagner, C. Schwarz, B. Würstl, and K. Tintelnot, “Multilocus sequence typing of Scedosporium apiospermum and Pseudallescheria boydii isolates from cystic fibrosis patients,” Journal of Cystic Fibrosis, vol. 12, no. 6, pp. 592–598, 2013. View at: Publisher Site | Google Scholar
  13. Y. J. Liu, S. Whelen, and B. D. Hall, “Phylogenetic relationships among ascomycetes: evidence from an RNA polymerse II subunit,” Molecular Biology and Evolution, vol. 16, no. 12, pp. 1799–1808, 1999. View at: Publisher Site | Google Scholar
  14. K. Hoffmann, S. Discher, and K. Voigt, “Revision of the genus Absidia (Mucorales, Zygomycetes) based on physiological, phylogenetic, and morphological characters; thermotolerant Absidia spp. form a coherent group, Mycocladiaceae fam. nov.,” Mycological Research, vol. 111, no. 10, pp. 1169–1183, 2007. View at: Publisher Site | Google Scholar
  15. Clinical and Laboratory Standards Institute, Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi, Approved Standard. CLSI Document M38-A2, Clinical and Laboratory Standards Institute, Wayne, Pa, USA, 2nd edition, 2008.
  16. X. Y. Yin, J. K. Chen, Z. Y. Yu et al., “Scedosporium apiospermum in patient with acute leukemia and bacterial multiple infections: experimental diagnosis and treatment,” Chinese Journal of Nosocomiology, vol. 20, no. 23, pp. 3833–3835, 2010 (Chinese). View at: Google Scholar
  17. P. Wang, Y. C. Xu, H. T. Dou et al., “Invasive Scedosporium apiospermum and Scedosporium prolificans infections: case report and review,” Chinese Journal of Mycology, vol. 2, no. 4, pp. 210–213, 2007 (Chinese). View at: Google Scholar
  18. S.-S. Zhou, S.-H. Cheng, B. Liu, L.-L. Zhang, J.-S. Zhao, and X.-L. Gao, “Invasive Scedosporium apiospermum infection: one case report,” Chinese Journal of Infection and Chemotherapy, vol. 9, no. 6, pp. 466–468, 2009 (Chinese). View at: Google Scholar
  19. Y. L. Wang, J. M. Sun, X. Z. Zhou et al., “Fungal rhinosinusitis casused by Scedosporium apiospermum: a case report and literature review,” Chinese Journal of Mycology, vol. 6, no. 5, pp. 285–289, 2011 (Chinese). View at: Google Scholar
  20. F. Dong, “A case report of Scedosporium apiospermum infection,” Journal of Jining Medical College, vol. 36, no. 1, p. 76, 2013 (Chinese). View at: Google Scholar
  21. X. Y. Zhou, “A case report of Scedosporium apiospermum infection in bronchial mucosa,” Journal of Harbin Medical University, vol. 45, no. 4, p. 395, 2011 (Chinese). View at: Google Scholar
  22. Y. C. Zheng, J. S. Zeng, J. X. Yue et al., “A case report of Pseudallescheria boydii brain abscess,” National Medical Journal of China, vol. 87, no. 14, p. 1007, 2007 (Chinese). View at: Google Scholar
  23. H. H. Lin, L. H. Xu, Y. S. Dong et al., “The first case of Pseudallescheria boydii brain abscess in China,” Journal of Tongji University (Medical Science), vol. 19, no. 6, p. 399, 1990 (Chinese). View at: Google Scholar
  24. A. Paride, Y. Takashi, D. M. Luo et al., “A case report of sinusitis due to Scedosporium prolificans: identification of causative agent and antifungal susceptibility testing in vitro,” Chinese Journal of Mycology, vol. 5, no. 1, pp. 1–4, 2010 (Chinese). View at: Google Scholar
  25. Y. Xu, F. Hao, B. Y. Zhong et al., “A case report of aspiration pneumonitis caused by Scedosporium apiospermum,” Chinese Journal of Mycology, vol. 3, no. 5, pp. 292–294, 2008 (Chinese). View at: Google Scholar
  26. J. J. Li, H. Li, and Z. L. Hua, “Endophthalmitis caused by Scedosporium apiospemum after eye injury,” Chinese Journal of Ocular Trauma and Occupational Eye Disease, vol. 33, no. 3, pp. 161–162, 2011 (Chinese). View at: Google Scholar
  27. L. Zhang, W. Zhao, and M. X. Jin, “Pathogens Nasal sinus of fungal infection,” Chinese Journal of Nosocomiology, vol. 1, no. 10, pp. 1492–1493, 2008 (Chinese). View at: Google Scholar
  28. Y. X. Wang, M. Liu, and H. C. Liu, “Ten cases of nasal sinus of fungal infection,” Chinese Journal of Medicine, vol. 32, no. 6, pp. 42–44, 1997 (Chinese). View at: Google Scholar
  29. X. M. Yang, Y. X. Wang, M. Liu et al., “Analysis of pathogenic agents in 100 cases with mycotogenic sinusitis,” Chinese Journal of Otorhinolaryngology, vol. 7, no. 1, pp. 9–12, 2000 (Chinese). View at: Google Scholar
  30. Y. X. Wang, M. Liu, H. C. Liu et al., “Analysis of pathogenic agents from 34 cases of mycotic infection in masosinuses,” Chinese Journal of Laboratory Medicine, vol. 19, no. 5, pp. 265–266, 1996 (Chinese). View at: Google Scholar
  31. L. Y. Xi, C. M. Lu, A. M. Liu et al., “A case of pseudallescheriasis in brain,” Chinese Journal of Laboratory Medicine, vol. 23, no. 1, p. 25, 2000 (Chinese). View at: Google Scholar
  32. M. Lackner, G. S. de Hoog, P. E. Verweij et al., “Species-specific antifungal susceptibility patterns of Scedosporium and Pseudallescheria species,” Antimicrobial Agents and Chemotherapy, vol. 56, no. 5, pp. 2635–2642, 2012. View at: Publisher Site | Google Scholar
  33. K. Tintelnot, G. Just-Nübling, R. Horré et al., “A review of German Scedosporium prolificans cases from 1993 to 2007,” Medical Mycology, vol. 47, no. 4, pp. 351–358, 2009. View at: Publisher Site | Google Scholar
  34. M. Lackner, A. Rezusta, M. C. Villuendas, M. P. Palacian, J. F. Meis, and C. H. Klaassen, “Infection and colonisation due to Scedosporium in Northern Spain, an in vitro antifungal susceptibility and molecular epidemiology study of 60 isolates,” Mycoses, vol. 54, supplement 3, pp. 12–21, 2011. View at: Publisher Site | Google Scholar
  35. R. Zouhair, A. Rougeron, B. Razafimandimby, A. Kobi, J.-P. Bouchara, and S. Giraud, “Distribution of the different species of the Pseudallescheria boydii/Scedosporium apiospermum complex in French patients with cystic fibrosis,” Medical Mycology, vol. 51, no. 6, pp. 603–613, 2013. View at: Publisher Site | Google Scholar
  36. A. Alastruey-Izquierdo, M. Cuenca-Estrella, A. Monzón, and J. L. Rodriguez-Tudela, “Prevalence and susceptibility testing of new species of Pseudallescheria and Scedosporium in a collection of clinical mold isolates,” Antimicrobial Agents and Chemotherapy, vol. 51, no. 2, pp. 748–751, 2007. View at: Publisher Site | Google Scholar
  37. M. Cuenca-Estrella, A. Alastruey-Izquierdo, L. Alcazar-Fuoli et al., “In vitro activities of 35 double combinations of antifungal agents against Scedosporium apiospermum and Scedosporium prolificans,” Antimicrobial Agents and Chemotherapy, vol. 52, no. 3, pp. 1136–1139, 2008. View at: Publisher Site | Google Scholar
  38. A. J. Carrillo and J. Guarro, “In vitro activities of four novel triazoles against Scedosporium spp,” Antimicrobial Agents and Chemotherapy, vol. 45, no. 7, pp. 2151–2153, 2001. View at: Publisher Site | Google Scholar

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