Abstract
Resistance of the human pathogenic fungus Aspergillus fumigatus to antifungal agents is on the rise. However, links between patient infections, their potential acquisition from local environmental sources, and links to global diversity remain cryptic. Here, we used genotyping analyses using nine microsatellites in A. fumigatus, in order to study patterns of diversity in France. In this study, we genotyped 225 local A. fumigatus isolates, 112 azole susceptible and 113 azole resistant, collected from the Bourgogne-Franche-Comté region (Eastern France) and sampled from both clinical (n = 34) and environmental (n = 191) sources. Azole-resistant clinical isolates (n = 29) were recovered mainly from cystic fibrosis patients and environmental isolates (n = 84) from market gardens and sawmills. In common with previous studies, the TR34/L98H allele predominated and comprised 80% of resistant isolates. The genotypes obtained for these local TR34/L98H isolates were integrated into a broader analysis including all genotypes for which data are available worldwide. We found that dominant local TR34/L98H genotypes were isolated in different sample types at different dates (different patients and types of environments) with hospital air and patient’s isolates linked. Therefore, we are not able to rule out the possibility of some nosocomial transmission. We also found genotypes in these same environments to be highly diverse, emphasizing the highly mixed nature of A. fumigatus populations. Identical clonal genotypes were found to occur both in the French Eastern region and in the rest of the world (notably Australia), while others have not yet been observed and could be specific to our region. Our study demonstrates the need to integrate patient, healthcare, and environmental sampling with global databases in order to contextualize the local-scale epidemiology of antifungal resistant aspergillosis.
Highlights
Fungal pathogens pose a growing threat to the health of humans, animals, ecosystems, food security, and the global economy, making their effective control necessary (Fisher et al, 2012)
The total number of multilocus genotypes (MLGs) was higher in the sensitive group than in the resistant group with 102 MLGs found in the 112 ASAf isolates and 53 MLGs observed among the 113 barcoded azoleresistant A fumigatus (ARAf)
When comparing the two most abundant groups (ASAf and TR34/L98H ARAf), it was apparent that genotypic richness, represented by the total number of MLG or expected MLG, was lower in the TR34/L98H ARAf group (Table 2)
Summary
Fungal pathogens pose a growing threat to the health of humans, animals, ecosystems, food security, and the global economy, making their effective control necessary (Fisher et al, 2012). With more than 30 compounds available (Fisher et al, 2018), are widely used in agriculture to protect cereal, vegetables, and vines from phytopathogenic fungi, as well as in the cultivation of ornamental plants and to preserve materials such as timber These fungicides are used worldwide, in Europe and Asia, where they represent one of the most commonly used classes of pesticides (Chowdhary et al, 2015; Chen et al, 2016). Due to their broad-spectrum action across the fungal kingdom, the azoles are widely used as first-line drugs in medicine (human and animals) for the treatment of superficial and invasive fungal infections. Highly related genotypes of azole-resistant A. fumigatus have been described in clinical and environmental samples, suggesting that humans are increasingly exposed to drugresistant aerosolized A. fumigatus spores with broad public health consequences (Sewell et al, 2019; Rhodes et al, 2021)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
