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Abstract
The emergence of azole-resistant Aspergillus fumigatus (ARAf) complicates the treatment of aspergillosis and can nearly double the mortality from invasive aspergillosis (IA). ARAf has been isolated from many different environmental sites and indoor environments and thus presents a significant risk for susceptible patients. Local surveillance of environmental ARAf can guide antifungal prescribing and improve patient outcomes. In this study, seventy-four soils samples collected from the surface of a variety of root vegetables from farm shops and private gardens covering a wide geographical area of the UK, were cultured to assess the presence of A. fumigatus, and the prevalence and nature of any resistance mechanisms. A high-throughput in-house antifungal susceptibility screening method was developed and validated using the EUCAST MIC reference method, E.DEF 9.3.1. A total of 146 isolates were recovered and analysed. Even though the study premise was that soil-covered root vegetables and other fresh produce could represent a conduit for ARAf exposure in vulnerable patients, no ARAf were found in the soil samples despite 55% of samples harbouring A. fumigatus. The sample type and screening method used could be suitable for more extensive monitoring of the soil to detect trends in the prevalence of ARAf.
Highlights
Saprophytic moulds of the genus Aspergillus, mainly found in various horizons of soil, leaf litter and decomposing plant matter [1], cause a variety of fungal diseases in crops, animals and humans [2,3,4,5]
The emerging azole resistance of A. fumigatus is a global challenge to clinical care
Our study did not find azole-resistant Aspergillus fumigatus (ARAf) in samples collected from the soil adhering to root vegetables despite the fact that 55% were positive for A. fumigatus complex growth, with a total of 146 isolates recovered
Summary
Saprophytic moulds of the genus Aspergillus, mainly found in various horizons of soil (humus), leaf litter and decomposing plant matter [1], cause a variety of fungal diseases in crops, animals and humans [2,3,4,5]. The production of airborne spores and their ability to adapt to a wide range of environmental conditions play an important role in pathogenesis [6]. This adaptation extends to human pathogenesis, of immunocompromised patients or those with underlying lung conditions. Aspergillosis, commonly caused by A. fumigatus, affects millions of people worldwide as allergic, invasive or chronic disease, which can be fatal especially when treatment is not effective [7].
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