In recent years, resistance towards commonly used antifungal drugs has been observed for previously susceptible fungal species. Accumulative evidence suggests that the observed resistance can in part be attributed to the use of fungicides in agriculture, due to structural similarities between the agents used in the environment and in the clinic. While antifungal resistant fungi have repeatedly been found in environmental samples, the extent to which humans are exposed to these remains elusive. This study aimed to investigate the human exposure to resistant fungi across different working environments during a span of twenty years. To this end, more than 500 personal air samples taken from 12 different types of working environments were utilized and potentially pathogenic fungi present in the samples underwent susceptibility testing against medical triazoles, Itraconazole, Voriconazole and Posaconazole, as well as the polyne drug Amphotericin B. Working environments varied significantly in their overall fungal exposure and showed vastly different species compositions. Resistance was observed for 34 fungal isolates, most of which were found to be cryptic species of the Aspergillus niger complex. The results indicate that the working environment significantly contributes to the exposure to resistant fungi. Work in biofuel plants was associated with the highest exposure to resistant fungi overall and to resistant Aspergillus fumigatus, which is arguably the most concerning species from the perspective of workers health.
Human exposure to antifungal resistant fungi across working environments and time
Pesticide Research 223, October 2024