Citizen science reveals landscape-scale exposures to multiazole-resistant Aspergillus fumigatus bioaerosols

Jennifer M.G. Shelton; Johanna Rhodes; Christopher B. Uzzell; Samuel Hemmings; Amelie P. Brackin; Thomas R. Sewell; Asmaa Alghamdi; Paul S. Dyer; Mark Fraser; Andrew M. Borman; Elizabeth M. Johnson; Frédéric B. Piel; Andrew C. Singer; Matthew C. Fisher

doi:10.1126/sciadv.adh8839

Citizen science reveals landscape-scale exposures to multiazole-resistant Aspergillus fumigatus bioaerosols

Jennifer M.G. Shelton^*, Johanna Rhodes, Christopher B. Uzzell, Samuel Hemmings, Amelie P. Brackin, Thomas R. Sewell, Asmaa Alghamdi, Paul S. Dyer, Mark Fraser, Andrew M. Borman, Elizabeth M. Johnson, Frédéric B. Piel, Andrew C. Singer, Matthew C. Fisher

^*Corresponding author for this work

Bristol Mycology Reference Laboratory General

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Using a citizen science approach, we identify a country-wide exposure to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to the agricultural fungicide tebuconazole and first-line azole clinical antifungal drugs. Genomic analysis shows no distinction between resistant genotypes found in the environment and in patients, indicating that at least 40% of azole-resistant A. fumigatus infections are acquired from environmental exposures. Hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasonal sampling periods. This suggests a high degree of atmospheric mixing resulting in an estimated per capita cumulative annual exposure of 21 days (±2.6). Because of the ubiquity of this measured exposure, it is imperative thatwe determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.

Original language	English
Article number	adh8839
Journal	Science Advances
Volume	9
Issue number	29
DOIs	https://doi.org/10.1126/sciadv.adh8839
Publication status	Published - Jul 2023

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© 2023 The Authors.

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Shelton, J. M. G., Rhodes, J., Uzzell, C. B., Hemmings, S., Brackin, A. P., Sewell, T. R., Alghamdi, A., Dyer, P. S., Fraser, M., Borman, A. M., Johnson, E. M., Piel, F. B., Singer, A. C., & Fisher, M. C. (2023). Citizen science reveals landscape-scale exposures to multiazole-resistant Aspergillus fumigatus bioaerosols. Science Advances, 9(29), Article adh8839. https://doi.org/10.1126/sciadv.adh8839

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abstract = "Using a citizen science approach, we identify a country-wide exposure to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to the agricultural fungicide tebuconazole and first-line azole clinical antifungal drugs. Genomic analysis shows no distinction between resistant genotypes found in the environment and in patients, indicating that at least 40% of azole-resistant A. fumigatus infections are acquired from environmental exposures. Hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasonal sampling periods. This suggests a high degree of atmospheric mixing resulting in an estimated per capita cumulative annual exposure of 21 days (±2.6). Because of the ubiquity of this measured exposure, it is imperative thatwe determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.",

author = "Shelton, {Jennifer M.G.} and Johanna Rhodes and Uzzell, {Christopher B.} and Samuel Hemmings and Brackin, {Amelie P.} and Sewell, {Thomas R.} and Asmaa Alghamdi and Dyer, {Paul S.} and Mark Fraser and Borman, {Andrew M.} and Johnson, {Elizabeth M.} and Piel, {Fr{\'e}d{\'e}ric B.} and Singer, {Andrew C.} and Fisher, {Matthew C.}",

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doi = "10.1126/sciadv.adh8839",

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AU - Shelton, Jennifer M.G.

AU - Rhodes, Johanna

AU - Uzzell, Christopher B.

AU - Hemmings, Samuel

AU - Brackin, Amelie P.

AU - Sewell, Thomas R.

AU - Alghamdi, Asmaa

AU - Dyer, Paul S.

AU - Fraser, Mark

AU - Borman, Andrew M.

AU - Johnson, Elizabeth M.

AU - Piel, Frédéric B.

AU - Singer, Andrew C.

AU - Fisher, Matthew C.

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N2 - Using a citizen science approach, we identify a country-wide exposure to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to the agricultural fungicide tebuconazole and first-line azole clinical antifungal drugs. Genomic analysis shows no distinction between resistant genotypes found in the environment and in patients, indicating that at least 40% of azole-resistant A. fumigatus infections are acquired from environmental exposures. Hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasonal sampling periods. This suggests a high degree of atmospheric mixing resulting in an estimated per capita cumulative annual exposure of 21 days (±2.6). Because of the ubiquity of this measured exposure, it is imperative thatwe determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.

AB - Using a citizen science approach, we identify a country-wide exposure to aerosolized spores of a human fungal pathogen, Aspergillus fumigatus, that has acquired resistance to the agricultural fungicide tebuconazole and first-line azole clinical antifungal drugs. Genomic analysis shows no distinction between resistant genotypes found in the environment and in patients, indicating that at least 40% of azole-resistant A. fumigatus infections are acquired from environmental exposures. Hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasonal sampling periods. This suggests a high degree of atmospheric mixing resulting in an estimated per capita cumulative annual exposure of 21 days (±2.6). Because of the ubiquity of this measured exposure, it is imperative thatwe determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.

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Citizen science reveals landscape-scale exposures to multiazole-resistant Aspergillus fumigatus bioaerosols

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