New research by British and Dutch scientists has found that Aspergillus – a common fungus that attacks the lungs and is found in soil and other organic matter – has become resistant to life-saving drugs in parts of rural Yorkshire.

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Although much attention has been paid in recent weeks to drug resistance and the overuse of anti-microbials in human and veterinary medicine in recent weeks, there has been little focus on other areas where resistance could potentially build up. At the beginning of the month, David Cameron announced that a government review into antibiotics will investigate why so few new drugs have been developed in the past few years, though experts have claimed the focus of this review misses the point, as unsustainable use of life saving drugs should be the key issue to address.

The University of Manchester scientists said current practice across both health and veterinary services is failing to prevent the inappropriate prescription of antibiotics. The Science and Technology Committee has also warned that the Government needs to set clear responsibilities at all levels of the NHS and veterinary medicine to achieve better stewardship of the antimicrobial drugs vital to modern medicine.

In their three-year study, the Manchester researchers, together with colleagues from Radboud University, in the Netherlands, compared resistance profiles in 230 fungal samples, collected from rural areas in West Yorkshire which were treated with fungicides, to 290 air and soil samples from inner city sites across Greater Manchester. 

They found no resistance from the sites in Greater Manchester compared to 1.7% resistance detected in West Yorkshire, implicating fungicide use in agriculture.

Dr Michael Bromley, Lecturer at The University of Manchester and study leader commented, "Given the frequent finding of resistance across northern Europe, it is not a surprise to see resistance in the UK. However, the clear association with triazole fungicide usage is very worrisome, as some unlucky people at risk will breathe in untreatable Aspergillus, with potentially dire consequences."

Diseases caused by Aspergillus affect millions of people worldwide, causing high morbidity and mortality. The only oral antifungal agents (triazoles) for human use are similar in structure to certain fungicides. The use of certain compounds in agriculture, notably difenoconazole, propiconazole, epoxiconazole, bromuconazole and tebuconazol are particularly likely to lead to resistance, the scientists found, yet they are freely used in agriculture. There is a very limited range of antifungal compounds to treat fungal diseases, and some fungi are already resistant to a range of treatments.

Researchers said growing resistance to fungal treatments presents "a huge threat to patients," as does the reduced effectiveness of key antibiotics, especially to those with weaken immune systems.

The type of resistance identified in West Yorkshire has previously been observed in a few other countries (Netherlands, Denmark, Belgium, Germany, France, India, China, Iran, Tanzania amongst others) raising great concerns among clinicians. No new classes of antifungal agent are currently in clinical development.