Combination of the mutations in hmg1 and in cyp51A results in high-level triazole-resistance in Aspergillus fumigatus causing chronic cavitary pulmonary aspergillosis.
By using Cas9-RNP editing method, we constructed several mutants of A. fumigatus. Further susceptibility testing confirmed that the contribution of the combined mutations in cyp51A (M263I) and hmg1 (E306K) to triazole-resistance, which was observed in an isolate of A. fumigatus causing chronic cavitary pulmonary aspergillosis (CCPA) and bronchopulmonary fistula in a patient.