REVIEW article
Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1656723
From Crops to Clinic: The Impact of Dual Azole Use on Antifungal Resistance in Candida and Candida Associated Yeasts
Provisionally accepted
- Queen's University Belfast, Belfast, United Kingdom
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Invasive fungal infections caused by pathogenic yeasts are an escalating global health crisis that demands urgent attention within a One Health framework. This review critically examines mounting evidence that widespread agricultural azole fungicide use is a key driver accelerating antifungal resistance in pathogenic yeast. We dissect the shared molecular targets and resistance pathways that underpin dangerous cross-resistance between environmental fungicides and clinical azoles. Traditionally viewed as human commensals, we provide a comprehensive account of the evidenced environmental reservoirs of yeast pathogens, including agricultural soils, wastewater, and the food chain. Ecosystems burdened by persistent azole contamination that create hotspots for resistance evolution and amplification. With antifungal treatment options rapidly diminishing and resistant infections causing rising morbidity and mortality worldwide, we identify vulnerabilities in our shared environment and consider integrated surveillance, stewardship, and environmental interventions to help preserve the efficacy of life-saving antifungals and mitigate the growing threat of fungal disease.
Keywords: cross-resistance, Candida, antifungal resistance, Azoles, One Health
Received: 30 Jun 2025; Accepted: 11 Sep 2025.
Copyright: © 2025 Hyland and Allison. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Edel Hyland, e.hyland@qub.ac.uk
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.