Bridging the gap between environment and patient; investigating the risk and transmission of antifungal resistance in Aspergillus fumigatus

弥合环境与患者之间的差距；

• 批准号: MR/Y034465/1
• 负责人: Michael John Bromley
• 金额: $ 46.37万
• 依托单位: University of Manchester
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY034465%2F1
• 关键词: Bridging; gap; between; environment; patient

Aspergillosis is an infectious disease caused by a fungus, which kills around one million people each year. Fungal spores are found ubiquitous in the air and in plant waste material, flower beds and garden soil. People with poorly functioning immune systems are particularly at risk of infection. The azole-class of antifungals are frontline medicines for treatment of aspergillosis and at the same time simultaneously playing an essential role in agriculture and horticulture to protect crops. Inevitably, this dual-use of azoles in agricultural and clinical settings has resulted in resistance spreading from the field to vulnerable patients. Some treatment centres are now finding more than 20% of aspergillosis patients infected with a drug resistant strain of the fungus. There are few alternative treatments and those that do exist are far less effective and less well tolerated by patients. The absence of environmental surveillance to monitor emerging antifungal resistance has hindered the development of strategies to mitigate resistance and alert healthcare sectors about potential problems. To address this problem, we need to develop methods to monitor the emergence of environmental azole resistance and resistance to upcoming dual-use antifungals in this important pathogen. Ultimately this study will provide a foundation to support the development of approaches that disconnects antifungal use in the clinic from its use in agriculture. Within the One-health framework, our knowledge is therefore also relevant for the development of responsible and sustainable crop protection.

曲霉菌病是一种由真菌引起的传染病，每年导致约一百万人死亡。真菌孢子在空气中、植物废料、花坛和花园土壤中无处不在。免疫系统功能不佳的人特别容易受到感染。唑类抗真菌药是治疗曲霉病的一线药物，同时在农业和园艺中保护作物发挥着重要作用。不可避免的是，唑类在农业和临床环境中的双重用途导致耐药性从田间蔓延到弱势患者。一些治疗中心现在发现超过 20% 的曲霉病患者感染了耐药真菌菌株。替代疗法很少，而且现有的疗法效果较差，患者的耐受性也较差。由于缺乏环境监测来监测新出现的抗真菌耐药性，这阻碍了减轻耐药性和提醒医疗部门潜在问题的策略的制定。为了解决这个问题，我们需要开发方法来监测这种重要病原体中环境唑类耐药性和对即将推出的双重用途抗真菌药物的耐药性的出现。最终，这项研究将为支持开发将抗真菌药物在临床上的使用与农业中的使用脱节的方法奠定基础。因此，在“同一个健康”框架内，我们的知识也与负责任和可持续作物保护的发展相关。