Some medicines against fungi such as Aspergillus fumigatus and Candida are becoming less effective (resistance). As a result, these fungal infections are harder to treat in humans. Substances in these medicines, especially azoles, are also frequently used in agriculture. Fungi that have become resistant to these substances in agriculture are also insensitive to similar medicines in humans (cross-resistance). Therefore, the RIVM recommends considering cross-resistance when approving antifungal agents for agriculture. So far, this has not been the case.
Additionally, the RIVM recommends limiting the use of antifungal agents in agriculture where possible and using certain substances exclusively for humans. Further research is needed on how resistant fungi from the environment manage to infect patients in hospitals.
Getting sick from fungal infections
People can become ill from fungi. A fungal infection is often harmless but can also be life-threatening, especially for people with weakened immune systems, such as those with cancer, AIDS, or organ transplants. Cross-resistance to azoles has already been demonstrated in the fungus Aspergillus fumigatus. An infection with this fungus is therefore more difficult to treat in humans.
Indications for resistant Candida species
According to the RIVM, there are also indications that cross-resistance can occur in various Candida species. Resistant Candida have been found in the environment. Furthermore, there is a chance that new types of antifungal agents currently in development, which are used both in agriculture and for humans, could also lead to cross-resistance.
The RIVM conducted this research on behalf of the Ministry of Agriculture, Fisheries, Food Security and Nature (LVVN).
