Vol3-1Art4

Julie Muller^1,2, Cécile Garnaud¹, Semcheddine Cherrad², Sébastien Vacher², Muriel Cornet^1,#, Delphine Aldebert¹

¹VetAgroSup, Grenoble Institut National Polytechnique, Translational Innovation in Medicine and Complexity (TIMC), Université Grenoble Alpes, Centre National de la Recherche Scientifique (CNRS), Grenoble, France; ²Conidia Coniphy, Parc d’Activité En Chuel, Quincieux, France

Abstract

Fungal pathogens threaten both human health and global food security, but research on resistance and surveillance remains compartmentalized between medical mycology and fungal phytopathology. In clinical settings, invasive fungal infections may cause significant mortality, whereas high disease pressure in agriculture necessitates the use of fungicides to maintain crop productivity. This selective pressure intersects in shared environmental niches in which saprophytic, phytopathogenic, and opportunistic human pathogenic fungi evolve in response to antifungal agents and fungicides. There is growing evidence that agricultural fungicides reduce susceptibility to medical antifungal agents, particularly in pathogens acquired from the environment, highlighting the need for a One Health framework. 
This review aims to integrate medical mycology and fungal phytopathology through three main approaches. First, it provides a description of antifungal drugs and fungicide classes, their modes of action, and the molecular mechanisms underlying resistance. Second, it analyzes the environment as a selective interface linking fungicide application to clinical resistance to antifungal drugs, focusing on cross-pathogens, environmental reservoirs, and cross-resistance associated with common molecular targets. Third, it compares methodologies for testing sensitivity to antifungal drugs and fungicides, highlighting common biological principles and their potential for transferability. Finally, a harmonized environmental surveillance pipeline is proposed to detect and monitor cross-resistance, and to preserve the efficacy of the few antifungal drugs available for treating life-threatening fungal infections in humans. 

#Correspondence:
mcornet@chu-grenoble.fr

Article info:
Received 11 March 2026
Revised 13 April 2026
Accepted 19 April 2026
Appeared online 4 May 2026
One Health Mycology 3(1): 37-70, 2026
doi.org/10.63049/OHM.26.31.4 

Cite this article:
Muller J, Garnaud C, Cherrad S, Vacher S, Cornet M, Aldebert D 2026. A One Health perspective reconciling medical mycology and fungal phytopathology. One Health Mycology 3(1), 37-70
This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/ licenses/by-nc-nd/4.0/)

ISSN: 3050-4627
doi.org/10.63049/OHM.26.31.4

Keywords:
antifungal, fungicide, resistance, medical mycology, phytopathology, cross-resistance 

Article highlights:

• One Health integration of medical mycology and fungal plant pathology is essential to limit antifungal resistance induced by agricultural fungicides.
• Comprehensive knowledge of mode of action and mechanisms of resistance of both antifungals and fungicides is crucial to anticipate cross resistance development.
• Environmental reservoirs are key sources of fungal human pathogens and resistance hotspots.
• Aspergillus fumigatus is the most obvious example of azole resistance acquired in the environment. Research efforts should continue for other cross-environment and cross-kingdom species which are human pathogens.
• Targeted resistance surveillance should prioritize high-risk fungal species and environments using standardized sampling strategies and methods.
• Data sharing, coordinated stewardship and regulatory measures are needed to limit dual-use and to maintain antifungal protection.
• Joint R&D efforts for the development of innovative translational technologies are encouraged.