Could Fungicides Lead to Azole Drug Resistance in a Cross-Resistance Manner among Environmental Cryptococcus Strains?

Purpose of Review Acquired resistance among fungal strains is a growing concern. The reasons for the emergence of this phenomenon, with great clinical implications, are only partially explained and related to the frequent use of fluconazole prophylaxis or therapeutic regimens in medical practice, and evidence of environmental origin of resistance is warranted. Recent Findings Soil exposed to azole fungicides may select acquired resistant fungal strains and improve the proliferation and maintenance of phenotypes in this environment. So far, the greatest focus on cross-resistance in relation to azoles is with genus Aspergillus. In view of fungicides and drugs present similar triazole chemical structure and mechanisms of action, our results showed that fungicides in agricultural areas may decrease fungal sensibility to azole drugs, becoming a potential source of resistance for invasive human mycoses agents. The abusive usage of fungicide in agriculture could play a role in the therapeutic failure of cryptococcosis.