Environmental Hotspots for Azole Resistance Selection of Aspergillus fumigatus , the Netherlands
Open accessAbstract
Azole resistance is a major concern for treatment of infections with Aspergillus fumigatus. Environmental resistance selection is a main route for Aspergillus spp. to acquire azole resistance. We investigated the presence of environmental hotspots for resistance selection in the Netherlands on the basis of the ability of A. fumigatus to grow and reproduce in the presence of azole fungicide residues. We identified 3 hotspots: flower bulb waste, green waste material, and wood chippings. We recovered azole-resistant A. fumigatus from these sites; all fungi contained cyp51A tandem repeat-mediated resistance mechanisms identical to those found in clinical isolates. Tebuconazole, epoxiconazole, and prothioconazole were the most frequently found fungicide residues. Stockpiles of plant waste contained the highest levels of azole-resistant A. fumigatus, and active aerobic composting reduced Aspergillus colony counts. Preventing plant waste stockpiling or creating unfavorable conditions for A. fumigatus to grow in stockpiles might reduce environmental resistance burden.
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Duplications in the cyp51A gene promoter coupled with TR34/L98H and TR46/Y121F/T289A substitutions are becoming widespread in the environment associated with azole use in agriculture and are also isolated from hospital patients without previous antifungal exposure.
“Alarmingly, duplications in the cyp51A gene promoter coupled with specific amino acid substitutions, TR34/L98H and TR46/Y121F/T289A, are becoming widespread in the environment associated with azole use in agriculture, while also isolated from hospital patients without previous exposure to antifungal drugs19–22.”
From Molecular mechanisms governing antifungal drug resistance (2023) · cites this paper as [20]
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References 30 · Cited by 164
- Authors
- Schoustra, S. E., Debets, A. J. M., Rijs, A. J. M. M., Zhang, J., Snelders, E., Leendertse, P. C., Melchers, W. J. G., Rietveld, A. G., Zwaan, B. J., & Verweij, P. E.
- Affiliations
- Radboud University Medical Center (NL)
- Corresponding author
- Schoustra, Sijmen E.
- ORCID
- Venue
- Emerging Infectious Diseases
- Published
- 2019-07
- Volume
- 25
- Issue
- 7
- Pages
- 1347-1353
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC6590754
- OpenAlex
- W2948172307
- Cited by
- 164
- References
- 30
- Citations by year
- 2026: 26 · 2025: 22 · 2024: 30 · 2023: 17 · 2022: 10 · 2021: 26 · 2020: 29 · 2019: 4
- FWCI
- 13.22
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Ministerie van Volksgezondheid, Welzijn en Sport
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- Aspergillus fumigatus, azole resistance, environmental hotspots, fungicide residues, tebuconazole, epoxiconazole, prothioconazole, green waste, wood chipping, aerobic composting, antifungal resistance, Netherlands
- MeSH terms
- Antifungal Agents, Aspergillosis, Aspergillus fumigatus, Azoles, Environmental Microbiology, Genes, Bacterial, Humans, Microbial Sensitivity Tests, Netherlands, Drug Resistance, Fungal
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