Fungal rhinosinusitis (FRS) represents a substantial yet underrecognized global health burden, with Aspergillus flavus emerging as the predominant pathogen in arid and tropical regions. This thesis comprehensively investigated the epidemiology, virulence, resistance, and diagnostics of A. flavus in FRS. Global meta-analysis revealed distinct climatic partitioning: A. flavus dominates in dry/tropical zones while A. fumigatus prevails in temperate regions. Virulence studies using the Galleria mellonella model demonstrated that A. flavus exhibits higher pathogenicity than its relatives, correlated with aflatoxin production, smaller spore size, and faster growth kinetics. Importantly, unlike A. fumigatus, no evidence of environmental azole resistance selection was found in A. flavus; resistance emerged primarily in-host under antifungal therapy. Finally, combining metagenomic next-generation sequencing with quantitative PCR markedly improved diagnostic sensitivity where conventional culture fails. These findings highlight that the clinical relevance of A. flavus reflects its ecological specialization, underscoring the need for region-specific diagnostic and therapeutic strategies.
Shaoqin Zhou (1990) obtained her Master's degree in Food Science from Guizhou University in 2016 and then worked as a lecturer. In 2021, she began her PhD research in the Medical Mycology Group and the Department of Medical Microbiology at Radboudumc. Currently, she works as a researcher at Guizhou Medical University.