What's Happening?
The European Food Safety Agency (EFSA) has released a report highlighting the impact of azole fungicides on azole resistance in Aspergillus species. This report, issued by the European Commission, marks the first multiagency collaboration involving the European Centre
for Disease Prevention and Control, the European Chemicals Agency, the European Environment Agency, and the European Medicines Agency. The report documents resistance selection through azole fungicide exposure, particularly in Aspergillus fumigatus, which is a major cause of Aspergillus diseases in humans. The EFSA report provides a comprehensive analysis of azole fungicides authorized for use in European member states, examining the link between azole fungicide use and the development of azole-resistant Aspergillus disease. It also proposes a risk assessment framework for current and new authorizations of azole fungicides.
Why It's Important?
The findings of the EFSA report are significant as they highlight the potential health risks posed by azole fungicides, which are widely used in agriculture. The resistance of Aspergillus fumigatus to medical azoles due to fungicide exposure can lead to increased mortality rates in patients with invasive aspergillosis. This report calls for urgent action to address the dual-use cross-resistance selection potential, especially with recent authorizations of fungicides sharing modes of action with clinical antifungals. The implications for public health are profound, as azole-resistant strains could compromise the effectiveness of treatments for fungal infections, necessitating regulatory actions and enhanced surveillance.
What's Next?
The EFSA report outlines 23 priority data gaps and 29 recommendations to address these gaps, including the need for better use-data of fungicides and validation of risk assessment methodologies. The report suggests the implementation of One Health surveillance programs and the application of genomics to understand resistance transmission dynamics. Regulatory actions are needed to incorporate the activity of environmental fungicides against human pathogens into the authorization process. The report emphasizes the need for a tiered risk assessment framework for compound authorization, highlighting the urgency of addressing azole resistance to protect human, animal, and ecosystem health.
Beyond the Headlines
The report underscores the ethical and environmental dimensions of azole fungicide use, as the accumulation of azoles in the environment poses unknown risks. The long half-life of azoles in soils could lead to persistent environmental contamination, affecting biodiversity and ecosystem health. The report calls for a holistic approach to fungicide management, considering the interconnectedness of human, animal, and environmental health. The findings challenge current agricultural practices and highlight the need for sustainable solutions to prevent resistance development.
