Published in

American Association for the Advancement of Science, Science Advances, 29(9), 2023

DOI: 10.1126/sciadv.adh8839

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

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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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 that we determine sources of azole-resistant A. fumigatus to reduce treatment failure in patients with aspergillosis.