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A Novel Environmental Azole Resistance Mutation in Aspergillus fumigatus and a Possible Role of Sexual Reproduction in Its Emergence
Open accessAbstract
ABSTRACT This study investigated the dynamics of Aspergillus fumigatus azole-resistant phenotypes in two compost heaps with contrasting azole exposures: azole free and azole exposed. After heat shock, to which sexual but not asexual spores are highly resistant, the azole-free compost yielded 98% (49/50) wild-type and 2% (1/50) azole-resistant isolates, whereas the azole-containing compost yielded 9% (4/45) wild-type and 91% (41/45) resistant isolates. From the latter compost, 80% (36/45) of the isolates contained the TR 46 /Y121F/T289A genotype, 2% (1/45) harbored the TR 46 /Y121F/M172I/T289A/G448S genotype, and 9% (4/45) had a novel pan-triazole-resistant mutation (TR 46 3 /Y121F/M172I/T289A/G448S) with a triple 46-bp promoter repeat. Subsequent screening of a representative set of clinical A. fumigatus isolates showed that the novel TR 46 3 mutant was already present in samples from three Dutch medical centers collected since 2012. Furthermore, a second new resistance mutation was found in this set that harbored four TR 46 repeats. Importantly, in the laboratory, we recovered the TR 46 3 mutation from a sexual cross between two TR 46 isolates from the same azole-containing compost, possibly through unequal crossing over between the double tandem repeats (TRs) during meiosis. This possible role of sexual reproduction in the emergence of the mutation was further implicated by the high level of genetic diversity of STR genotypes in the azole-containing compost. Our study confirms that azole resistance mutations continue to emerge in the environment and indicates compost containing azole residues as a possible hot spot. Better insight into the biology of environmental resistance selection is needed to retain the azole class for use in food production and treatment of Aspergillus diseases. IMPORTANCE Composting of organic matter containing azole residues might be important for resistance development and subsequent spread of resistance mutations in Aspergillus fumigatus . In this article, we show the dominance of azole-resistant A. fumigatus in azole-exposed compost and the discovery of a new resistance mutation with clinical relevance. Furthermore, our study indicates that current fungicide application is not sustainable as new resistance mutations continue to emerge, thereby threatening the use of triazoles in medicine. We provide evidence that the sexual part of the fungal life cycle may play a role in the emergence of resistance mutations because under laboratory conditions, we reconstructed the resistance mutation through sexual crossing of two azole-resistant A. fumigatus isolates derived from the same compost heap. Understanding the mechanisms of resistance selection in the environment is needed to design strategies against the accumulation of resistance mutations in order to retain the azole class for crop protection and treatment of Aspergillus diseases.
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![FIG 2 Locations and positions of samples taken from azole-free compost in Wageningen (W1 to W6 [30 cm apart from top to bottom]) and azole-containing compost in Hillegom (H1 to H6).](/paper-figures/4998930014d64f61836be1364e9695c5/a-novel-environmental-azole-resistance-mutation-in-i-aspergillus-fumigatus-i-and-figure-2.jpg)
![FIG 3 A. fumigatus CFU density (CFU per gram of compost) before and after heat shock in samples taken at different positions in an azole-free compost heap (W1 to W6 [dark blue bars]) and an azole-containing compost heap (H1 to H6 [light blue bars]).](/paper-figures/94ca192c664849a2abef2072c3dda2af/a-novel-environmental-azole-resistance-mutation-in-i-aspergillus-fumigatus-i-and-figure-3.jpg)
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“As shown in some publications, compost is one of the major sources of Aspergillus [37].”
From Nationwide Survey about the Occurrence of Aspergillosis in Captive Penguins in Zoos and Aquariums in Japan (2023) · cites this paper as [37]
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Citations
Cites
Hypervariable ‘minisatellite’ regions in human DNA
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Emergence of Azole Resistance in Aspergillus fumigatus and Spread of a Single Resistance Mechanism
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Self-citationAzole resistance in Aspergillus fumigatus: a side-effect of environmental fungicide use?
Verweij, P. E., Snelders, E., Kema, G. H., Mellado, E., & Melchers, W. J. (2009) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(09)70265-8 · Cited by 604
Self-citationVerweij, P. E., Chowdhary, A., Melchers, W. J. G., & Meis, J. F. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/civ885 · Cited by 561
Self-citationDiscovery of a sexual cycle in the opportunistic fungal pathogen Aspergillus fumigatus
O’Gorman, C. M., Fuller, H. T., & Dyer, P. S. (2009) · Nature · doi:10.1038/nature07528 · Cited by 555
Clinical Implications of Azole Resistance inAspergillus fumigatus, the Netherlands, 2007–2009
van der Linden, J. W. M., Snelders, E., Kampinga, G. A., Rijnders, B. J. A., Mattsson, E., Debets-Ossenkopp, Y. J., Kuijper, E. J., van Tiel, F. H., Melchers, W. J. G., & Verweij, P. E. (2011) · Emerging infectious diseases · doi:10.3201/eid1710.110226 · Cited by 451
Self-citationSex speeds adaptation by altering the dynamics of molecular evolution
McDonald, M. J., Rice, D. P., & Desai, M. M. (2016) · Nature · doi:10.1038/nature17143 · Cited by 436
Triazole Fungicides Can Induce Cross-Resistance to Medical Triazoles in Aspergillus fumigatus
Snelders, E., Camps, S. M. T., Karawajczyk, A., Schaftenaar, G., Kema, G. H. J., van der Lee, H. A., Klaassen, C. H. W., Melchers, W. J. G., & Verweij, P. E. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031801 · Cited by 427
Self-citationPossible Environmental Origin of Resistance of Aspergillus fumigatus to Medical Triazoles
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. (2009) · Applied and Environmental Microbiology · doi:10.1128/aem.00231-09 · Cited by 423
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Self-citationThe rapid emergence of antifungal-resistant human-pathogenic fungi
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Triazole resistance in Aspergillus fumigatus: recent insights and challenges for patient management
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Metadata
- Authors
- Zhang, J., Snelders, E., Zwaan, B. J., Schoustra, S. E., Meis, J. F., van Dijk, K., Hagen, F., van der Beek, M. T., Kampinga, G. A., Zoll, J., Melchers, W. J. G., Verweij, P. E., & Debets, A. J. M.
- Affiliations
- Wageningen University & Research (NL)
- Radboud University Nijmegen (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Leiden University Medical Center (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Zhang, Jianhua
- ORCID
- Venue
- mBio
- Publisher
- American Society for Microbiology
- Published
- 2017-07-05
- Volume
- 8
- Issue
- 3
- ISSN
- 2150-7511 (ISSN-L)
- 2161-2129
- PMC
- PMC5487732
- OpenAlex
- W2729257211
- Cited by
- 129
- References
- 68
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 26 · 2020: 20 · 2019: 21 · 2018: 9 · 2017: 7
- FWCI
- 12.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- mBio (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Socio-Environmental Systems Modeling (submittedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- China Scholarship Council (CSC No.2011677021)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Fungal Plant Pathogen Control
- Keywords
- azole resistance, sexual reproduction, composting, unequal crossover, tandem repeats, genetic diversity, clinical isolates, heat shock, meiosis, molecular epidemiology
- MeSH terms
- Composting, Antifungal Agents, Aspergillosis, Aspergillus fumigatus, Azoles, Crosses, Genetic, Genotype, Humans, Mutation, Netherlands, Soil Microbiology, Drug Resistance, Fungal
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