Abstract

Background:

The fungus Aspergillus fumigatus (A. fumigatus) is the leading cause of invasive mold infections, which cause severe disease and death in immunocompromised people. Use of triazole antifungal medications in recent decades has improved patient survival; however, triazole-resistant infections have become common in parts of Europe and are emerging in the United States. Triazoles are also a class of fungicides used in plant agriculture, and certain triazole-resistant A. fumigatus strains found causing disease in humans have been linked to environmental fungicide use.

Objectives:

We examined U.S. temporal and geographic trends in the use of triazole fungicides using U.S. Geological Survey agricultural pesticide use estimates.

Discussion:

Based on our analysis, overall tonnage of triazole fungicide use nationwide was relatively constant during 1992–2005 but increased $>4\text{-fold}$ during 2006–2016 to $2.9\hspace{0.17em}\text{million}\hspace{0.17em}\text{kg}$ in 2016. During 1992–2005, triazole fungicide use occurred mostly in orchards and grapes, wheat, and other crops, but recent increases in use have occurred primarily in wheat, corn, soybeans, and other crops, particularly in Midwest and Southeast states. We conclude that, given the chemical similarities between triazole fungicides and triazole antifungal drugs used in human medicine, increased monitoring for environmental and clinical triazole resistance in A. fumigatus would improve overall understanding of these interactions, as well as help identify strategies to mitigate development and spread of resistance. https://doi.org/10.1289/EHP7484

中文翻译：

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1992-2016年美国农业三唑类杀菌剂的使用趋势及其对人类疾病中抗真菌真菌的潜在影响

摘要

背景：

真菌烟曲霉（烟曲霉）是创模感染，导致免疫功能低下的人严重的疾病和死亡的主要原因。近几十年来，使用三唑类抗真菌药物改善了患者的生存率。然而，耐三唑感染在欧洲部分地区已经很普遍，并且在美国正在出现。三唑也是植物农业中使用的一类杀真菌剂，发现某些导致人类疾病的三唑抗性烟曲霉菌株与环境杀菌剂的使用有关。

目标：

我们使用《美国地质调查局》的农业杀虫剂使用量估算数据研究了美国三唑类杀菌剂使用的时间和地理趋势。

讨论：

根据我们的分析，全国三唑类杀菌剂的总使用量在1992-2005年期间相对稳定，但有所增加 $>4\text{-折叠}$ 在2006–2016年期间 $2.9\hspace{0.17em}\text{百万}\hspace{0.17em}\text{公斤}$在2016年。在1992-2005年期间，三唑类杀菌剂的使用主要发生在果园和葡萄，小麦及其他农作物中，但最近用量的增加主要发生在小麦，玉米，大豆和其他农作物中，特别是在中西部和东南部州。我们得出的结论是，鉴于人类药物中使用的三唑类杀菌剂和三唑类抗真菌药之间的化学相似性，加强对烟曲霉环境和临床三唑耐药性的监测将提高对这些相互作用的总体了解，并有助于确定缓解发展和消亡的策略。阻力扩散。https://doi.org/10.1289/EHP7484