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Invasive Aspergillosis (IA) is an important cause of mortality and morbidity in the immunocompromised host such as, neutropenic individuals, chronic granulomatous disorder, leukemia, those undergoing solid organ transplantation, patients using broad spectrum antibiotics and steroids, patients with severe underlying diseases and patients with chronic pulmonary obstructive disease are among the main risk groups. Successful management in the treatment of IA depends on early diagnosis and treatment, the adequate choice of therapy, and antifungal resistance. The diagnosis of IA remains difficult and significant proportions of cases of IA remain undetected, thus in case of IA treatment should be considered as early as possible and carried out until the improvements. The treatment is usually based on surgery, antifungal therapy and reduction of immunosuppression. Azole-resistant Aspergillus fumigatus was first observed in Netherlands in 1999. Full mechanism of evolution of azole resistance is not completely known, however, increasing evidence indicates a role for azole fungicide used in agriculture. Due to the presence of A. fumigatus as an agent of IA in our environment and risk for patients, understanding the evolution of the increasing azole resistance in A. fumigatus is crucially recommended. Therefore, induction of azole resistance or its spread can be possibly prevented to allow future treatment of IA due to A. fumigatus.

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Recently, despite the application of surgery and antifungal therapy, mortality rate of invasive fungal infections due to opportunistic fungi such as Candida and Aspergillus species has dramatically increased specially in immunocompromised host. The status of the immune system plays a key role in controlling the disease, yet antifungal therapy is of great benefit in saving involved patients. Today some efficient antifungal agents are available which are very expensive compared to amphotericin B deoxycholate. The empiric treatment of Candida bloodstream infections is fluconazole therapy which is the best choice for neutropenic patients with and without septic shock. However, amphotericin B deoxycholate and caspofungin therapy are the optional treatments for patients who previously used azole agents. These drugs are considered as the first choice of treatment in patients with neutropenia. Fluconazole therapy is recommended for fungal infections due to C. albicans, C. tropicalis and C. parapsilosis and amphotericin B deoxycholate or caspofungin are applied for C. glabrata and C. krusei. Primary teherapy for invasive aspergillosis includes combination therapy in critically ill patients. Voriconazole and caspofungin (if not used as primary treatment) and liposomal amphotericin B are recommended in patients resistant to conventional treatments. Moreover, combination therapy with caspofungin with voriconazole and liposomal amphotericin B should be considered in severely ill patients. In clinical decision making clinicians should consider the results of different studies and also the cost of treatment.

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Conidia of Aspergillus species are widely distributed and ubiquitous in outdoor and hospital environments. There are high numbers of patients with weakened immune systems, therefore Aspergillus infections are increasing in hospitals. Molecular typing of Aspergillus strains obtained from patients and their environment is an important tool for epidemiological and public health studies. Fingerprinting for Aspergillus species especially fumigatus and flavus adjusted from respiratory samples and environment requires high quality typing methods. In recent years several molecular typing methods have been established for different Aspergillus species. These methods are more useful than conventional methods and are of great importance due to being more practically accessible, easy to use, having high ability in diagnosis, repeatable and sensitive to change in one laboratory and between different laboratories, and easy interpretation of data. Today accurate typing methods include Multilocus Sequence Typing (MLST) and micro satellites. In ccurrent review different molecular methods for Aspergillus species genotyping are discussed to obtain a better insight into epidemiology of this pathogen.