Landscape-scale exposure to multiazole-resistant Aspergillus fumigatus bioaerosols-猫眼课题宝

DOI：

10.1101/2022.11.07.515445

发表时间：

2022-11

期刊：

bioRxiv

影响因子：

通讯作者：

中科院分区：

其他

文献类型：

作者：

Jennifer M G Shelton;J. Rhodes;C. Uzzell;S. Hemmings;A. Brackin;Thomas R. Sewell;Asmaa Alghamdi;P. Dyer;M. Fraser;A. Borman;Elizabeth M. Johnson;F. Piel;A. Singer;M. Fisher

我们证明了全国范围内暴露于人类真菌病原体烟曲霉的雾化孢子，烟曲霉对一线唑类临床抗真菌药物具有耐药性。在英国公民科学家网络的帮助下，我们发现，这种霉菌的20个可行的气溶胶化孢子中有1个对农业杀菌剂戊唑醇具有抗性，140个孢子中有1个对治疗临床曲霉病感染的四种最常用的唑类具有抗性。季节和接近工业堆肥与A。空气样品中的烟曲霉，但不存在唑类耐药性，热点在采样期间不稳定，表明高度的大气混合。基因组分析表明，在环境和患者中发现的耐药基因型之间没有区别，表明约40%（58/150测序基因组）的唑类耐药A。烟曲霉感染是通过环境暴露获得的。由于这种测量暴露的普遍性，我们确定耐唑A的来源至关重要。烟曲霉菌，谁是最大的风险暴露，以及如何减轻这些暴露，以尽量减少治疗失败的患者与曲霉菌病。一句话总结英国范围内的公民科学监测发现，普遍暴露于人类真菌病原体的雾化孢子，这些病原体在环境中对基本的临床抗真菌药物产生交叉耐药性

We demonstrate country-wide exposures to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to first line azole clinical antifungal drugs. Assisted by a network of citizen scientists across the United Kingdom, we show that 1 in 20 viable aerosolized spores of this mold are resistant to the agricultural fungicide tebuconazole and 1 in 140 spores are resistant to the four most used azoles for treating clinical aspergillosis infections. Season and proximity to industrial composters were associated with growth of A. fumigatus from air samples, but not with the presence of azole resistance, and hotspots were not stable between sampling periods suggesting a high degree of atmospheric mixing. Genomic analysis shows no distinction between those resistant genotypes found in the environment and in patients, indicating that ~40% (58/150 sequenced genomes) of azole-resistant A. fumigatus infections are acquired from environmental exposures. Due to the ubiquity of this measured exposure, it is crucial that we determine source(s) of azole-resistant A. fumigatus, who is at greatest risk of exposure and how to mitigate these exposures, in order to minimize treatment failure in patients with aspergillosis. One sentence summary UK-wide citizen science surveillance finds a ubiquitous exposure to aerosolized spores of a human fungal pathogen that have evolved in the environment cross-resistance to essential clinical antifungal drugs

Landscape-scale exposure to multiazole-resistant Aspergillus fumigatus bioaerosols

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