Impact of the use of azole fungicides on the development of azole-resistant Aspergillus spp.

EFSA Journal published a report on the impact of the use of azole fungicide on the development of azole resistance Aspergillus spp. The use of azoles in the European Union and European Economic Area (EU/EEA) other than as human medicines has raised concerns about the emergence and spread of azole-resistant Aspergillus species. EU agencies, with the support of JRC, reviewed the evidence and provided conclusions and recommendations on this topic. Incomplete data from 2010 to 2021 showed that around 120,000 tonnes of azoles were sold in EU/EEA for uses other than as human medicines. The majority are used as plant protection products (119,000 tonnes), with a stable temporal trend. Evidence supported a link between environmental azole exposure and cross-resistance selection to medical azoles in Aspergillus species (primarily shown for A. fumigatus). Prevalence of azole-resistant A. fumigatus in human A. fumigates infections ranges from 0.7% to 63.6% among different disease presentations and geographic regions; mortality rates range from 36% to 100% for invasive aspergillosis (IA). It was concluded that azole usage outside the human domain is likely to contribute to the selection of azole-resistant. A. fumigatus isolates that could cause severe diseases like IA. Recommendations on measures to prevent and control selection of azole resistance in A. fumigatus, including implementation of good agricultural/horticultural practices, proper agricultural and wood waste storage and management, and approval of new azole fungicides or renewal of existing fungicides.  @ https://efsa.onlinelibrary.wiley.com/doi/full/10.2903/j.efsa.2025.9200

 

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