| Summary: | Background. Pulmonary aspergillosis is a lung infection caused by <i>Aspergillus</i> spp., which can cause severe illnesses in immunocompromised patients with underlying lung disease or who have asthma and inhale their spores. This study aimed to screen the antifungal susceptibility of <i>Aspergillus</i> spp. isolated from patients with underlying pulmonary infections and characterize the isolates using PCR and sequencing. Method. Three hundred and eighty-four sputum or bronchoalveolar lavage samples were collected and processed for the isolation and identification, and characterization of <i>Aspergillus</i> species and molecular amplification of the ITS1-5.8S-ITS2 region by the PCR and Sanger sequencing method. Antifungal susceptibility tests for itraconazole and voriconazole were performed using the E-test. Result. The overall results revealed that out of 384 patients, 32 (8.3%) were positive for fungal growth, including 28 (87.5%) <i>Aspergillus</i> spp. The highest resistance rate (100 and 44.4%) was obtained from itraconazole against <i>A. niger</i> and <i>A. fumigatus</i>. In contrast, voriconazole revealed the best activities against all tested fungi compared to itraconazole. All <i>A. flavus</i> were sensitive to voriconazole, while only 54.5% were sensitive to itraconazole. The MICs of E-test for <i>Aspergillus</i> spp were 1.6 ± 1.8 and 0.6 ± 0.93 for itraconazole and voriconazole, respectively. Conclusions. The prevalence of aspergillosis was high, with a significant association with underlying lung diseases. Voriconazole was the drug of choice for isolated fungi.
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