Intensive fungicide use may lead to azole resistance in humans

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Intensive fungicide use may lead to azole resistance in humans

December 1, 2009

(PhysOrg.com) -- A team of scientists from the Netherlands, including Gert

Kema of Plant Research International, published an article in the Lancet

Infectious Diseases about the relationship between fungicide use in

agriculture and azole resistance. In the article the scientists argue that the

intensive use of fungicides may contribute to resistance against

pharmaceuticals in humans with life-threatening lung infections caused by the

Aspergillus

fungus. It is the first time that a probable relationship between

fungicide use in agriculture and human health is demonstrated.

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Azoles - a group of nitrogen compounds - are found in a large number of

natural substances but they are also used in agriculture as fungicide, in

cosmetics, in various materials such as clothing and mattresses for protection

against fungal growth. Azoles are also applied as biocides in

non-agricultural applications.

The Aspergillus _fungus_ (http://www.physorg.com/tags/fungus/) is

occurring throughout the environment. The spores of this fungus are floating

through the air and can be inhaled. When these spores remain in the lungs of

healthy people, they are taken care of by the immune system. In people with a

weakened immune system (e.g. people with leukaemia) the fungus may, however,

cause serious pneumonia which is usually fatal without treatment.

_Resistance_ (http://www.physorg.com/tags/resistance/) rapidly increases

since the emergence of the multiresistant fungus Aspergillus fumigatus in

2000. In 2007 6% of the patients with an Aspergillus pneumonia were infected

by a multiresistant variant. The chance of resistance development in humans

seems small (the chance of patient to patient transmission is very small)

while the uniform way in which the fungus becomes resistant may point at

the role of _fungicides_ (http://www.physorg.com/tags/fungicides/) in the

environment. 94% of the fungal isolates from patients in the Radboud hospital

and 69% of those in other hospitals in the Netherlands were found to be

resistant by two identical mutations. This concerned patients who had never

been treated with azoles. This seems to indicate that all these patients have

inhaled resistant spores from their environment.

The chance that intensive azole use in agriculture may lead to resistance

problems in humans has been subject of debate for years. The evidence that

Aspergillus acquires resistance in the outside environment has become more

convincing with the now published research in the article in the _Lancet

Infectious Diseases_ (http://www.physorg.com/tags/lancet+infectious+diseases/)

..

Provided by Wageningen University