One year later: The effect of changing azole-treated bulbs for organic tulips bulbs in hospital environment on the azole-resistant Aspergillus fumigatus rate

Med Mycol. 2021 Jul 6;59(7):741-743. doi: 10.1093/mmy/myab007.


Azole-treated plant bulbs have already been evoked as a potential explanation of the worldwide spread of azole-resistant Aspergillus fumigatus (ARAf). We previously pointed out the presence of a high rate of ARAf (71% of A. fumigatus detected on azole-supplemented media) in flower beds containing azole-treated bulbs at the hospital's surroundings. We show here that planting organic bulbs can be a solution to reduce ARAf burden (from 71% rate to below 3%). The results suggest that replacing treated bulbs with organic bulbs may be sufficient to regain a population that is predominantly susceptible in just 1 year.

Lay summary: Antifungal resistance is increasingly observed in fungal pathogens. This study argues that planting organic bulbs in hospitals' outdoor surroundings could be a good alternative to continue to beautify green spaces, without the risk of dissipating antifungal-resistant fungal pathogens.

Keywords: Aspergillus fumigatus; TR34/L98H qPCR detection; azole resistance; hospital environment; organic tulips bulbs.

MeSH terms

  • Antifungal Agents / pharmacology*
  • Aspergillus fumigatus / drug effects*
  • Azoles / pharmacology*
  • Drug Resistance, Fungal*
  • Fungal Proteins / genetics
  • Genotype
  • Hospitals
  • Microbial Sensitivity Tests
  • Organic Agriculture
  • Plant Roots / drug effects*
  • Plant Roots / microbiology
  • Tulipa / drug effects*
  • Tulipa / microbiology


  • Antifungal Agents
  • Azoles
  • Fungal Proteins

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