Strengthening the One Health Agenda: The Role of Molecular Epidemiology in Aspergillus Threat Management

Abstract

The United Nations’ One Health initiative advocates the collaboration of multiple sectors within the global and local health authorities toward the goal of better public health management outcomes. The emerging global health threat posed by Aspergillus species is an example of a management challenge that would benefit from the One Health approach. In this paper, we explore the potential role of molecular epidemiology in Aspergillus threat management and strengthening of the One Health initiative. Effective management of Aspergillus at a public health level requires the development of rapid and accurate diagnostic tools to not only identify the infecting pathogen to species level, but also to the level of individual genotype, including drug susceptibility patterns. While a variety of molecular methods have been developed for Aspergillus diagnosis, their use at below-species level in clinical settings has been very limited, especially in resource-poor countries and regions. Here we provide a framework for Aspergillus threat management and describe how molecular epidemiology and experimental evolution methods could be used for predicting resistance through drug exposure. Our analyses highlight the need for standardization of loci and methods used for molecular diagnostics, and surveillance across Aspergillus species and geographic regions. Such standardization will enable comparisons at national and global levels and through the One Health approach, strengthen Aspergillus threat management efforts.

Aspergillus Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance

“…frequently differ in their susceptibilities to antifungal drugs and geographical differences exist in the prevalence of different Aspergillus spp. 42 , 43 The results of our study expand the knowledge on species diversity and antifungal susceptibility of Aspergillus spp. from hospitalized patients in Shanghai, China.…”

Combatting the evolution of antifungal resistance in Cryptococcus neoformans

“…Another effective method to combat antifungal resistance is to collect surveillance data to gain a more comprehensive scope of emerging resistance (Ashu and Jianping, 2018). Additionally, monitoring resistance among antifungal agents is essential to elucidate and understand the mechanisms of how fungal pathogens evade antifungal activity of clinical drugs.…”

Current Practices for Reference Gene Selection in RT-qPCR of Aspergillus: Outlook and Recommendations for the Future

“…The ascomycete genus Aspergillus is among the first described filamentous fungi, dating back to 1729, as recorded by Pier Antonio Micheli, an Italian biologist and priest. Under a microscope, the asexual spore-forming structure of these fungi looks like an aspergillum, a “holy water sprinkler”, and Micheli named these fungi in the genus Aspergillus [ 1 , 2 ]. Since then, over 300 species have been described and recognised in this genus [ 3 ].…”

“…Aspergillus fungi are broadly distributed across the globe, and are found in diverse ecological niches such as soil, composts, water, buildings, air, and in or on plants [ 4 ]. Species in this genus have significant impacts on many fields, including biotechnology (e.g., antibiotics production) [ 5 ], fermented food production [ 6 ], food safety (e.g., mycotoxin production and food contamination) [ 7 ] and human health [ 2 ]. In addition, several Aspergillus species have been model organisms for understanding the fundamental biology, including physiology and genetics, of fungi and eukaryotes [ 8 , 9 ].…”