Azole resistance is a concern for the management of diseases caused by Aspergillus fumigatus in humans. Azole fungicide use in the environment has been identified as possible cause for resistance development, and thus increases the complexity and number of stakeholders involved in this emerging problem. We aim to bring together relevant stakeholders including medical and agricultural researchers, representatives from the government, fungicide producers and users, and public health to review the current evidence supporting environmental resistance selection and to discuss which research and measures are needed to retain the azole class for environmental and medical applications.
prof. P. Verweij
prof J. Lucas
dr B. Fraaije
prof B. Zwaan
31 January & 1 February 2019
Trippenhuis Royal Netherlands Society of Arts and Sciences
Amsterdam, The Netherlands
programme 31 January 2019
The patient
Chair: prof. K. Lagrou
09:00 Invitro susceptibility testing and surveillance prof. M. Arendrup
09:20 Diagnostic challenges and possible solutions dr. W. Melchers
09:40 Medical implications of resistance and management prof. P. Verweij
10:00 break
10:20 The lung mycobiome prof. P. Bowyer
10:40 Azole resistance in the global AMR perspective prof. D. Denning
11:00 Consensus discussion – medical needs
12:00 Lunch
The environment
Chair: prof. P. Dyer
13:00 Resistance risk assessment model revisited prof. U. Gisi
13:20 Fungicide resistance in different habitats and produce dr. B. Fraaije
13:40 Azole resistance and the concept of hotspots prof. B. Zwaan
14:00 break
14:20 Whole genome sequencing to unravel the origin and spread of resistance mutations dr. J. Rhodes
14:40 Experimental evolution experiments as tool to understand resistance selection dr. S. Schoustra
15:00 Fungicide resistance risk evaluation, resistance management – FRAC position dr. K. Stenzel
15:30 Break-out session 1
I – Resistance selection environments: the concept of the hotspot
II – From hotspot to lung lesion: relation between environment and human aspergillus disease
16:30 Reporting back and round-up day 1
17:30 Closing
programme 1 February 2019
Stakeholder views
Chair: dr. A. Rietveld
9:00 Fungicide producer drs. E. Kiers
9:20 Fungicide use in hot spots, example flower bulb production process drs. A. Hoogendijk
9:40 Connection to compost production as natural habitat of Aspergillus t.b.a.
10:00 Policy maker t.b.a.
10:20 break
10:30 Break-out session 2
I – Which research is needed?
II – Which measures are needed?
11:30 Reporting back and discussion
12:30 Lunch
Integrated research plan and prioritization
Chair: prof. J. Lucas
Prevention of resistance selection – risk matrix and hot spot areas, hot spot processes e.g. composting; Antifungal stewardship; Fungicide replacement; Diagnostic tools; Resistance surveillance; resistance management measures in medical and non-medical areas, Fungicide authorization procedure
13:30 Integrated plan
15:30 Priorities and summary
16:00 Closing
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