intensively Paul Verwei, who works in the care ward of Radboud University Medical Center, a sprawling hospital in the southeast of the Netherlands, was concerned. Physicians-scientists were accustomed to working with very sick patients. As Chief of Medical Microbiology, his job was to identify devastating pathogens so that appropriate treatments could be prescribed.
One group of patients had serious illnesses common in the ICU, including blood cancers, immune disorders, and end-stage lung disease. But in addition to them, they all suffered from an invasion called a rapidly growing and life-threatening environmental fungus. Aspergillus fumigatusIn the past, a class of drugs called azoles would reliably cure Aspergillusbut these fungal infections were strangely drug-resistant: five of the six patients died.
Those deaths were tragic, but also strange. It is common for organisms to become resistant to drugs taken by patients for long periods of time. However, these patients were not prescribed azoles. The fungus was already resistant when infected. In his lab, Verweij was able to see the explanation. Aspergillus It had a new mutation that he hadn’t seen in his decades as a microbiologist. We found that the same pattern was seen in patients.
Verweij realizes that it’s not just one hospital that’s to blame. There had to be something outside the healthcare system that existed across Holland and exerted as much mutational pressure as prescription drugs. With the help of other researchers, he identified it: a class of pesticides functionally identical to azole drugs and important in food and flower cultivation. country of flower production. Dutch farmers protected their plants from disease, but unwittingly endangered the health of their neighbors.
“We created a niche,” says Verweij.
That realization happened over a decade ago. rarely reported outside of that. Since then, that pattern of resistance has spread to more than 40 countries, including the US and UK. 3 out of 5 patients develop azole resistance Aspergillus then die. Disease experts and plant pathologists hoped that the parallel development of azoles in medicine and agriculture would be his one-off. They felt that if they kept an eye on each other’s research, this would never happen again.
Except that. Experts are concerned that medicine may be in danger of losing a much-needed new drug as pesticide chemistry once again first rolled out similar compounds.
The looming conflict arises from the emergence of two compounds, one for pharmaceutical use and one for agriculture, that share a new mechanism for killing fungi. Ororofime and the fungicide ipflufenoquine (brand name Kinoprol), drugs in human clinical trials. It was registered by the US Environmental Protection Agency last year. Ipflufenocine, manufactured by Nisso America, is intended to combat diseases in important tree crops such as almonds, apples and pears. Ororofime, developed by the British company F2G, is a desperately needed new treatment. Aspergillus Valley fever affects up to 150,000 people in the United States each year, with the most dense outbreaks in parts of California where most almonds are grown.
