ArticleNature microbiology2022
Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment.
Article in Nature microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 156 papers, 1 of them a synthesis that pooled it.
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Who cites it
156 citing papers in PubMed, 1 synthesis or guideline pooled it, 219 citations in OpenAlex.
- Azole resistance inFrontiers in veterinary science · 2025Pooled it
- Population genomics reveals a long-term increase in azole resistance associated with the emerging cluster AZR amongEmerging microbes & infections · 2026Article
- mSphere of Influence: The age of antifungal resistance.mSphere · 2026Article
- Ten-Year Voriconazole Susceptibility Trends Among 1482 ClinicalJournal of fungi (Basel, Switzerland) · 2026Article
- A review on fungal pathogens in the One Health framework: connecting plant, animal, and human health.Archives of microbiology · 2026Review
- Identification and characterization of non-canonical azole antifungal resistance pathways inmBio · 2026Article
- Emergence of human pathogenic fungi in a changing climate.Nature reviews. Microbiology · 2026Article
- Climate change and antimicrobial resistance.Nature reviews. Microbiology · 2026Review
- Establishment of epidemiological cutoff values againstJournal of clinical microbiology · 2026Article
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- Distribution and Evolutionary Signatures of a Broad-Spectrum Pesticide-Degrading Carboxylesterase TriS From Strain S113.Environmental microbiology · 2026Article
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- Spatiotemporal genomic analysis and risk assessment of the plasmids carrying blaBMC microbiology · 2026Article
- Growth under pressure: The pros and cons of polyploidy induced by stress.Proceedings of the National Academy of Sciences of the United States of America · 2026Review
- Addressing the dual-use of antifungals and fungal antimicrobial resistance (fAMR) through a One Health approach.npj antimicrobials and resistance · 2026Review
- Persistence of azole-resistantmSphere · 2026Article
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- Towards accurate genomic detection of fungal antimicrobial resistance: progress in fungal resistance databases and bioinformatic tools.Microbial genomics · 2026Review
- Biomolecular Corona Remodelling ofJournal of extracellular biology · 2026Article
96 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
28 authors at 13 institutions in 3 countries.
Funding
Abstract
Infections caused by the fungal pathogen Aspergillus fumigatus are increasingly resistant to first-line azole antifungal drugs. However, despite its clinical importance, little is known about how susceptible patients acquire infection from drug-resistant genotypes in the environment. Here, we present a population genomic analysis of 218 A. fumigatus isolates from across the UK and Ireland (comprising 153 clinical isolates from 143 patients and 65 environmental isolates). First, phylogenomic analysis shows strong genetic structuring into two clades (A and B) with little interclade recombination and the majority of environmental azole resistance found within clade A. Second, we show occurrences where azole-resistant isolates of near-identical genotypes were obtained from both environmental and clinical sources, indicating with high confidence the infection of patients with resistant isolates transmitted from the environment. Third, genome-wide scans identified selective sweeps across multiple regions indicating a polygenic basis to the trait in some genetic backgrounds. These signatures of positive selection are seen for loci containing the canonical genes encoding fungicide resistance in the ergosterol biosynthetic pathway, while other regions under selection have no defined function. Lastly, pan-genome analysis identified genes linked to azole resistance and previously unknown resistance mechanisms. Understanding the environmental drivers and genetic basis of evolving fungal drug resistance needs urgent attention, especially in light of increasing numbers of patients with severe viral respiratory tract infections who are susceptible to opportunistic fungal superinfections.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.