Cited by 424Antifungal resistance and susceptibilityFungal Plant Pathogen ControlFungal and yeast genetics research

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Possible Environmental Origin of Resistance of Aspergillus fumigatus to Medical Triazoles

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Snelders, Eveline, Huis in 't Veld, Robert A. G., Rijs, Anthonius J. M. M., Kema, Gert H. J., Melchers, Willem J. G., Verweij, Paul E.·2009·Applied and Environmental Microbiology

DOI 10.1128/aem.00231-09PMC PMC2698372

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Abstract

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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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)
ORCID: Snelders, Eveline
Kema, Gert H. J.
Melchers, Willem J. G.
Verweij, Paul E.
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
DOI: 10.1128/aem.00231-09
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
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
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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Possible Environmental Origin of Resistance of Aspergillus fumigatus to Medical Triazoles

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