Antifungal-resistant Mucorales in different indoor environments

Caetano, Liliana Aranha; Faria, Tiago; Springer, Jan; Loeffler, Juergen; Viegas, Carla

doi:10.1080/21501203.2018.1551251

Cited by 25 publications

(22 citation statements)

References 39 publications

(55 reference statements)

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“…The reduced susceptibility of Mucor sp. from environmental samples to ITRA and POSA was contradictory to the results from a previous study on antifungal-resistant Mucorales in bakeries [55].…”

Section: Discussioncontrasting

confidence: 99%

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

et al. 2020

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For decades, occupational exposure to flour dust has been linked to a range of respiratory diseases, including occupational asthma, thought to result from exposure to fungi present in the flour. Antifungal resistance is of increasing prevalence in clinical settings, and the role of occupational and environmental exposures, particularly for specific fungal species, is of concern. Occupational exposure to flour dust can occur in a range of occupational settings, however, few studies have focused on restaurant workers. The objective of this study was to measure occupational exposure to flour and microbial contamination, including azole resistance screening, in two small commercial bakeries and in a pizzeria. Personal full shift inhalable dust measurements were collected from workers, and were analyzed for inhalable dust and fungi, bacteria, azole resistance, and mycotoxins. Samples of settled dust were collected, and electrostatic dust cloths (EDC) were deployed and analyzed for microbial contamination, including azole resistance screening, and mycotoxins. Geometric mean exposures of 6.5 mg m−3 were calculated for inhalable dust, however, exposures of up to 18.30 mg m−3 were measured—70% of personal exposure measurements exceeded the occupational exposure limit for flour dust of 1.0 mg m−3. The air and EDC fungal counts were similar to those reported in previous studies for similar occupational environments. The fungi were dominated by Penicillium genera, however Aspergillus genera, including Fumigati and Flavi sections, were observed using culture-based methods, and the Fumigati section was also observed by molecular tools. Both Aspergillus sections were identified on the azole resistance screening. Mycotoxins were also detected in the settled dust samples, dominated by deoxynivalenol (DON). The role of environmental exposure in both the development of antimicrobial resistance and the total mycotoxin body burden is a growing concern; therefore, the presence of azole-resistant fungi and mycotoxin contamination, although low in magnitude, is of concern and warrants further investigation.

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Section: Discussioncontrasting

confidence: 99%

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

et al. 2020

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“…The outcome of the antifungal susceptibility testing is in accordance with previous reports, mainly due to the fact that Mucorales have innate resistance against some azole drugs [35][36][37][38]. Fluconazole and voriconazole have no or poor activity against most species of this family [37,39,40]. Antifungal resistance profiling is crucial these days due to emerging and increasing antifungal and multidrug resistance even in naturally susceptible fungi.…”

Section: Antifungal Susceptibility Profiling and Biofilm Productionsupporting

confidence: 84%

First reported case of Gilbertella persicaria in human stool: outcome of a community study from Segamat, Johor, Malaysia

et al. 2020

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Species of fungi belonging to the order Mucorales can be found everywhere in the environment. Gilbertella persicaria, which belongs to this order, have often been isolated from fruits and in water systems. However, there has been no report of isolation of this fungus from human samples. During a gut mycobiome study, from the Segamat community, Gilbertella persicaria was isolated from a human fecal sample and was characterized through a series of morphological assessment, biochemical tests, and molecular techniques. The isolate produced a white velvety surface that turned grayish after 24 h. Although no biofilm production was observed, the results indicated that the isolate could form calcium oxalate crystals, produced urease, and was resistant to low pH. The isolate was sensitive to amphotericin but resistant to voriconazole and itraconazole. The features of this fungus that could help in its survival in the human gut are also discussed.

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“…Fungi with acquired azole resistance are likely to have a fitness advantage in azole-contaminated environments [ 18 , 133 , 134 , 135 , 136 , 137 ]. In addition, fungi such as mucormycetes that are intrinsically resistant to short-tailed azoles should benefit from a positive selection pressure in azole-rich environments and outcompete azole-susceptible species [ 137 ]. It is also problematic that agrochemicals such as TDM have very long half-lives, ranging from 110 to 375 days in soil [ 138 ].…”

Section: Discussionmentioning

confidence: 99%

Sterol 14α-Demethylase Ligand-Binding Pocket-Mediated Acquired and Intrinsic Azole Resistance in Fungal Pathogens

Rosam

Monk

Lackner

2020

JoF

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The fungal cytochrome P450 enzyme sterol 14α-demethylase (SDM) is a key enzyme in the ergosterol biosynthesis pathway. The binding of azoles to the active site of SDM results in a depletion of ergosterol, the accumulation of toxic intermediates and growth inhibition. The prevalence of azole-resistant strains and fungi is increasing in both agriculture and medicine. This can lead to major yield loss during food production and therapeutic failure in medical settings. Diverse mechanisms are responsible for azole resistance. They include amino acid (AA) substitutions in SDM and overexpression of SDM and/or efflux pumps. This review considers AA affecting the ligand-binding pocket of SDMs with a primary focus on substitutions that affect interactions between the active site and the substrate and inhibitory ligands. Some of these interactions are particularly important for the binding of short-tailed azoles (e.g., voriconazole). We highlight the occurrence throughout the fungal kingdom of some key AA substitutions. Elucidation of the role of these AAs and their substitutions may assist drug design in overcoming some common forms of innate and acquired azole resistance.

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Antifungal-resistant Mucorales in different indoor environments

Cited by 25 publications

References 39 publications

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

First reported case of Gilbertella persicaria in human stool: outcome of a community study from Segamat, Johor, Malaysia

Sterol 14α-Demethylase Ligand-Binding Pocket-Mediated Acquired and Intrinsic Azole Resistance in Fungal Pathogens

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