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Possible Environmental Origin of Resistance of Aspergillus fumigatus to Medical Triazoles
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We reported the emergence of resistance to medical triazoles of Aspergillus fumigatus isolates from patients with invasive aspergillosis. A dominant resistance mechanism was found, and we hypothesized that azole resistance might develop through azole exposure in the environment rather than in azole-treated patients. We investigated if A. fumigatus isolates resistant to medical triazoles are present in our environment by sampling the hospital indoor environment and soil from the outdoor environment. Antifungal susceptibility, resistance mechanisms, and genetic relatedness were compared with those of azole-resistant clinical isolates collected in a previous study. Itraconazole-resistant A. fumigatus (five isolates) was cultured from the indoor hospital environment as well as from soil obtained from flower beds in proximity to the hospital (six isolates) but never from natural soil. Additional samples of commercial compost, leaves, and seeds obtained from a garden center and a plant nursery were also positive (four isolates). Cross-resistance was observed for voriconazole, posaconazole, and the azole fungicides metconazole and tebuconazole. Molecular analysis showed the presence of the dominant resistance mechanism, which was identical to that found in clinical isolates, in 13 of 15 environmental isolates, and it showed that environmental and clinical isolates were genetically clustered apart from nonresistant isolates. Patients with azole-resistant aspergillosis might have been colonized with azole-resistant isolates from the environment.
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“The Aspergillus species [4,5,6,7,8,9,10,11,12,13] are common fungi found in the environment, such as soil and air [14,15,16,17,18,19].”
From Nationwide Survey about the Occurrence of Aspergillosis in Captive Penguins in Zoos and Aquariums in Japan (2023) · cites this paper as [15]
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Metadata
- Authors
- Snelders, E., Huis in 't Veld, R. A. G., Rijs, A. J. M. M., Kema, G. H. J., Melchers, W. J. G., & Verweij, P. E.
- Affiliations
- Radboud University Nijmegen (NL)
- Department of Medical Microbiology
- Wageningen University & Research (NL)
- Venue
- Applied and Environmental Microbiology
- Publisher
- American Society for Microbiology
- Published
- 2009-06-15
- Volume
- 75
- Issue
- 12
- Pages
- 4053-4057
- ISSN
- 0099-2240 (ISSN-L)
- 1098-5336
- PMC
- PMC2698372
- OpenAlex
- W2146843443
- Cited by
- 423
- References
- 23
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 28 · 2023: 18 · 2022: 13 · 2021: 40 · 2020: 23 · 2019: 25 · 2018: 36 · 2017: 40 · 2016: 27 · 2015: 29 · 2014: 21 · 2013: 19 · 2012: 24
- FWCI
- 15.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Applied and Environmental Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Fungal Plant Pathogen Control
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Keywords
- Aspergillus fumigatus, azole resistance, itraconazole, invasive aspergillosis, hospital indoor environment, soil, cross-resistance, metconazole, tebuconazole, voriconazole, posaconazole, antifungal susceptibility, genetic relatedness, environmental colonization
- MeSH terms
- Antifungal Agents, Aspergillosis, Aspergillus fumigatus, Cross Infection, DNA, Fungal, Environmental Microbiology, Genotype, Humans, Microbial Sensitivity Tests, Triazoles, Cluster Analysis, DNA Fingerprinting, Mycological Typing Techniques, Molecular Epidemiology, Microsatellite Repeats, Drug Resistance, Fungal
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