Genesis of Azole Antifungal Resistance from Agriculture to Clinical Settings.
Azole fungal resistance is becoming a major public health problem in medicine in recent years. However, it was known in agriculture since several decades; the extensive use of these compounds results in contamination of air, plants, and soil. The increasing frequency of life-threatening fungal infections and the increase of prophylactical use of azoles in high-risk patients, taken together with the evolutionary biology evidence that drug selection pressure is an important factor for the emergence and spread of drug resistance, can result in a dramatic scenario. This study reviews the azole use in agricultural and medical contexts and discusses the hypothetical link between its extensive use and the emergence of azole resistance among human fungal pathogens.
Department of Microbiology, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|School D. Maria II , Rua da Alegria, 4760-067 Vila Nova de Famalicão, Portugal.
Maria-Manuel
MM
Azevedo
Department of Microbiology, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.
Isabel
I
Faria-Ramos
Department of Microbiology, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.
Luísa Costa
LC
Cruz
Department of Microbiology, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|Department of Clinical Pathology, Centro Hospitalar de São João , 4200-319 Porto, Portugal.
Cidália
C
Pina-Vaz
Department of Microbiology, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.|Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto , 4200-319 Porto, Portugal.
Acácio Gonçalves
AG
Rodrigues
D000383:Agriculture; D000935:Antifungal Agents / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology*; D025141:Drug Resistance, Fungal; D005658:Fungi / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D005659:Fungicides, Industrial / Q000494:pharmacology*; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology
D000935:Antifungal Agents; D001393:Azoles; D005659:Fungicides, Industrial
Aspergillus fumigatus; Candida; Portuguese agriculture; antifungals; azoles; fungal resistance