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

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.

Automated summary

Using a citizen science approach, researchers found that at least 40% of azole-resistant A. Fumigatus infections are acquired from environmental exposures. The study also revealed that hotspots and coldspots of aerosolized azole-resistant spores were not stable between seasons. The ubiquity of this measured exposure highlights the importance of determining sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.