{
  "abstract": "Background: Azole resistance in Aspergillus fumigatus (ARAf) is a growing global health threat, with environmental selection driven by agricultural fungicide use now recognised by the 2025 joint EFSA/ECDC/EMA/ECHA/EEA report. In Portugal, environmental ARAf remains under characterised, with prior reports limited to dairy and waste-sorting occupational settings. No study has simultaneously examined resistance across agricultural and educational environments.\n\nMethods: Two cross-sectional environmental surveillance studies were conducted in Portugal using harmonised methodology (EUCAST 10.2/9.4). Study 1 included 11 primary schools in the Lisbon metropolitan area (active air sampling, electrostatic dust collectors, settled dust filters; n = 164 Aspergillus section Fumigati isolates). Study 2 included 14 poultry pavilions in Madeira Island (bedding, feed, air, workers ‘masks; n = 168 Aspergillus section Fumigati isolates). Thermotolerant isolates were screened for azole resistance (itraconazole, voriconazole, posaconazole). Resistant isolates were molecularly identified by sequencing.\n\nResults: In schools, 151/164 isolates (92%) were thermotolerant; 28 showed potential azole resistance, 67.9% with pan-azole resistance. All were confirmed as A. fumigatus sensu stricto. In poultry farms, 168/176 isolates (95%) were thermotolerant; 7 showed potential azole resistance, all with pan-azole resistance. All were confirmed as A. fumigatus sensu stricto. Dust-based matrices (EDC/settled dust; air/bedding) were the main reservoirs in each setting.\n\nConclusions: These findings, from geographically and functionally distinct settings, suggest Portugal may constitute an underrecognized multi-environment hotspot for thermotolerant ARAf. The convergence of resistance in agricultural and community environments reinforces the urgency of integrated One Health surveillance encompassing non-occupational settings, in alignment with current European regulatory priorities.\n\nKey messages: • Portugal shows high azole-resistant A. fumigatus prevalence in both schools and poultry farms, suggesting a multi-environment hotspot requiring urgent One Health surveillance.\n\n• Pan-azole resistance in non-clinical indoor settings signals the need to expand European AMR surveillance beyond known agricultural hotspots.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "RWCF Cervantes"
    },
    {
      "name": "B Gomes"
    },
    {
      "name": "PMN Pena"
    },
    {
      "name": "SPC Viegas"
    },
    {
      "name": "CSC Viegas"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2wrerdx90jz4m.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.808",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699551/",
  "id": "2wrerdx90jz4m",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.808",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "5. Poster Walks"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "heading",
      "S.2. Poster Walk: One Health, environmental surveillance and health security"
    ],
    [
      "openalex",
      "2725|Antifungal resistance and susceptibility"
    ]
  ],
  "openalex": "W7223649329",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699551/pdf/?tool=EBI",
  "pmcid": "PMC13699551",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/2wrerdx90jz4m.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:09Z",
      "native_id": "PMC13699551",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.808"
    },
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "PMC:PMC13699551",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13699551"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Antifungal resistance and susceptibility",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Azole-resistant Aspergillus fumigatus: poultry farms and schools as sentinels in Portugal",
  "title_text": "Azole-resistant Aspergillus fumigatus: poultry farms and schools as sentinels in Portugal",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:07Z",
  "url": "https://research.draconitic.com/paper/2wrerdx90jz4m",
  "venue": "The European Journal of Public Health",
  "versions": []
}