Azole Use in Medicine and Agriculture

How Aspergillus becomes antimicrobial-resistant

What to know

  • A. fumigatus is a fungus in the environment that can cause severe illness in some people.
  • Azole antifungal medications usually kill A. fumigatus and treat infections, but antifungal resistance can develop after long-term use.
  • Azole fungicides work similarly to kill A. fumigatus that threatens plants but can also cause A. fumigatus to become resistant.
  • People can get infected with antifungal-resistant A. fumigatus following long-term azole use or from breathing resistant A. fumigatus in the environment.
A farmer, doctor and vet

Two ways A. fumigatus develops antifungal resistance

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Antifungal resistance is increasing in the species Aspergillus fumigatus (A. fumigatus) and can cause severe illness. Use of azole antifungals in medicine and azole fungicides in agriculture contribute to the emergence of resistant infections.

A. fumigatus can develop resistance in a patient

Calendar with several days crossed off beside a bottle of azole antifungal medication.
Some patients with chronic A. fumigatus infections take azole antifungals for a long time.
illustration of a person breathing in spores from A. fumigatus, represented in purple, with an arrow and image of bottle of azole medication, indicating use. image after use is the same person but shows that some of the spores inhaled in the lungs are red, to symbolize developing resistance.
Azole antifungals kill most of the A. fumigatus in the body, but resistant A. fumigatus can survive and multiply.

A. fumigatus can develop azole resistance in the environment

Illustration of an airplane spraying azole fungicides over a field of plants.
Azole fungicides are sometimes used to kill fungi that harm plants. These fungicides are similar to the azole antifungal medicine used to treat people who become sick with A. fumigatus.
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Azole spores represented in purple are around one plant with an arrow to indicate a second illustration of the same plant after azole spraying. Some spores turned to red to represent resistance.
Azole fungicides kill most A. fumigatus in the environment, but resistant A. fumigatus can survive and multiply.

Azole-resistant A. fumigatus infections

Patient in a hospital bed
People with weakened immune systems can become infected with resistant A. fumigatus.

People can get infected with antifungal-resistant A. fumigatus following long-term azole use or from breathing resistant A. fumigatus in the environment.

Azole-resistant A. fumgatus is increasing. Infections are hard to treat and can be life-threatening.

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)