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Volume 30, Number 8—August 2024
Research

Environmental Hot Spots and Resistance-Associated Application Practices for Azole-Resistant Aspergillus fumigatus, Denmark, 2020–2023

Maiken Cavling ArendrupComments to Author , Rasmus Krøger Hare, Karin Meinike Jørgensen, Ulla E. Bollmann, Tina B. Bech, Cecilie Cetti Hansen, Thies M. Heick, and Lise Nistrup Jørgensen
Author affiliations: Rigshospitalet, Copenhagen University, Copenhagen, Denmark (M.C. Arendrup); Statens Serum Institut, Copenhagen (M.C. Arendrup, R.K. Hare, K.M. Jørgensen); Geological Survey of Denmark and Greenland, Copenhagen (U.E. Bollmann, T.B. Bech, C.C. Hansen); Aarhus University, Flakkebjerg, Slagelse, Denmark (T.M. Heick, L.N. Jørgensen)

Main Article

Table 1

Overview of Aspergillus fumigatus and ARAf showing total and TR34/L98H-related [TR34] and TR46/Y121F/T289A-related [TR46] isolates from the environment, Denmark, 2020–2022*

Location (samples/sites), date Samples, no. (%)
Isolates of Af and ARAf
A. fumigatus ARAf TR34 TR46 Af, no. (no./sample) ARAf,
no. (%)
TR34,
no. (%)
TR46,
no. (%)
Field soil (84/7)
Cereal and potato (44/5), 2020 43 (98) 1 (2.3) 1 (2.3) 2 318 (7.2) 1 (0.3) 1 (0.3) 0
Cereal (40/2), 2022 May–Sep
40
8 (20)
5 (13)
1 (3)

360 (9.0)
10 (2.8)
7 (1.9)
1 (0.3)
Field air (63/3)
Field air (26/1), 2020 23 (100) 2 (7.7) 2 (7.7) 0 181 (7.0) 3 (1.7) 3 (1.7) 0
Field air (37/2), 2021
35 (95)
8 (21.6)
5 (13.5)
1 (2.7)

273 (7.4)
18 (6.6)
14 (5.1)
1 (0.4)
Vegetables (40/10), 2020
Potato-supermarkets (24/6) 7 (29) 0 0 0 9 (0.4) 0 0 0
Potato-farm shop (8/2) 8 (100) 2 (25) 2 (25) 0 19 (2.4) 2 (10.5) 2 (10.5) 0
Potato-field (Flakkebjerg) (8/2)
8 (100)
2 (25)
2 (25)
0

127 (15.9)
4 (3.1)
4 (3.1)
0
Flower-producers soil (50/3), 2020 and 2021
Poinsettia (20/2), Campanula (10/1), 
2020 30 (100) 8 (27) 6 (20) 0 516 (17.2) 13 (2.5) 11 (2.1) 0
Cactus (10/1), 2020 10 (100) 0 0 0 200 (20.0) 0 0 0
Poinsettia (10/1), 2021
10 (100)
2 (20)
2 (20)
1 (10)

289 (28.9)
14† (4.8)
10 (3.5)
3 (1.0)
Flower-producers air (10/1), 2021
9 (90)
0
0
0

24 (2.4)
0
0
0
Park & garden flowerbed soil (60/5), 2021
59 (98)
18 (30)
14 (23.3)
4 (6.7)

1,476 (24.6)
52 (3.5)
44 (3.0)
8 (0.5)
Allotment near soil (14/14), 2021
Allotment houses (14)†
14 (100)
2 (14.3)
2 (14.3)
0

358 (25.6)
4† (1.1)
3 (0.8)
0
Compost related (20/3), 2022
Recycle soil from garden waste (5) 5 (100) 4 (80) 4 (80) 0 219 (43.8) 6 (2.7) 6 (2.7) 0
Compost heap garden waste (10) 10 (100)‡ 5 (NP) 5 (NP) 4 (NP) 12‡ (100) 11 (92) 7 (58) 3 (25)
Compost heap vegetable production (5)
5 (100)
5 (100)
5 (100)
3 (60)

21§ (100)
21 (100)
17 (81)
4 (19)
Manure heaps from horses (12/2), 2022
Center 1 (7), 2022 Feb 5 3 (43) 3 (43) 0 54 ((7.7) 14 (25.9) 14 (25.9) 0
Center 2 (5), 2022 Nov
3
0
0
0

19 (3.8)
0
0
0
Horse stable and beddings (13/1), 2022
Stable bedding with wheat (2) 2 0 0 0 8 0 0 0
Stable bedding with barley (3) 3 2 1 1 33 (11) 13 (39) 12 (36) 1 (3)
Stable bedding with peat (2) 1 1 1 0 5 (2.5) 2 (40) 2 (40) 0
Fresh wheat (2) 2 0 0 0 10 0 0 0
Fresh barley (2) 1 0 0 0 5 0 0 0
Fresh peat (2)
1
0
0
0

2
0
0
0
Total (366) 334 (91.0) 73 (20.0) 60 
(16.0) 15 (0.04) 4,538 
(12.4) 188 
(4.2) 157 
(3.5) 21 (0.5)

*Darker red indicates increasing percentage. ARAf, azole-resistant A. fumigatus, NP, not possible to determine exact denominator because of uncountable number of colonies on the plate. †One ARAf from poinsettia harbored an Hmg1 F262-deletion and 1 from painted wood–related soil harbored an Hmg1 E306K alteration within the sterol- sensing domain. ‡Plates were massively overgrown by Mucorales spp. From 5 samples, it was possible to perform A. fumigatus PCR and direct target gene sequencing yielding TR34/L98H, TR46/Y121F/T289A, or both. §Of >200 resistant colonies per sample (growing on tebuconazole containing agars), 21 individual colonies were selected for susceptibility testing and target gene sequencing.

Main Article

Page created: June 14, 2024
Page updated: July 20, 2024
Page reviewed: July 20, 2024
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