Citizen science reveals landscape-scale exposures to multiazole-resistant Aspergillus fumigatus bioaerosols

Sci Adv. 2023 Jul 21;9(29):eadh8839. doi: 10.1126/sciadv.adh8839. Epub 2023 Jul 21.

Abstract

Using a citizen science approach, we identify a country-wide exposure to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to the agricultural fungicide tebuconazole and first-line azole clinical antifungal drugs. Genomic analysis shows no distinction between resistant genotypes found in the environment and in patients, indicating that at least 40% of azole-resistant A. fumigatus infections are acquired from environmental exposures. Hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasonal sampling periods. This suggests a high degree of atmospheric mixing resulting in an estimated per capita cumulative annual exposure of 21 days (±2.6). Because of the ubiquity of this measured exposure, it is imperative that we determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.

MeSH terms

  • Antifungal Agents / pharmacology
  • Aspergillosis* / drug therapy
  • Aspergillosis* / microbiology
  • Aspergillus fumigatus / genetics
  • Azoles / pharmacology
  • Citizen Science*
  • Drug Resistance, Fungal / genetics
  • Humans

Substances

  • Antifungal Agents
  • Azoles