1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07 Log CFU.m -2 Gloves 1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07 Log CFU.m -2 FRPD Interior layer 1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 Log CFU.m -2 FRPD Exhalation valves Mucorales from FRPD and gloves grew in azole-supplemented media. Mucor sp. and Rhizopus sp. presented reduced susceptibility to itraconazole and posaconazole at tested conditions, besides expected resistance to voriconazole. Liliana A. Caetano 1,2 , Marta Dias 1 , Beatriz Almeida 1 , Carla Viegas 1,3,4 1 H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa. 2 Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal 3 NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa. 4 Comprehensive Health Research Center (CHRC), 1150-090 Lisbon, Portugal. SURVEILLANCE OF MUCORALES RESISTANCE TO AZOLES IN THE WASTE SORTING INDUSTRY: Assessment of Filtering Respiratory Protective Devices and Gloves The use of Filtering Respiratory Protective Devices (FRPD) and Gloves is mandatory in waste-sorting industry in Portugal as preventive of workers' exposure to bioaerosols, including fungi. The emergence of resistance to azoles among fungal species, including Mucorales, in the environment challenges the management of severe fungal infections. The aims of the study were to evaluate: 1. Mucorales burden in Filtering Respiratory Protective Devices (FRPD) and in Gloves used in one Portuguese waste sorting industry. 2. If azole-resistant Mucorales is present in this occupational environment. [email protected] Purpose 1 Methods 2 Passive sampling in one sorting Portuguese waste sorting industry in different workstations from Jan to Feb, 2019. FRPD (interior layer and exhalation valve) and Gloves extracted with 0.1% Tween™ 80 saline solution (NaCl 0.9%) and inoculated on MEA, DG18 and azole-supplemented SDA media plates and incubated at 27 ºC for 5 to 7 days. Mucorales densities (CFU/m2) calculated and genera identified through macro and microscopic characteristics in MEA and DG18. Screening of azole resistance in 4 mg/L itraconazole (ITRA), 1 mg/L voriconazole (VORI), and 0.5 mg/L posaconazole (POSA) supplemented SDA media (EUCAST). Results 3 Mucorales was detected in FRPD interior layers (12.35% MEA; 0.03% DG18) and exhalation valves (0.21% DG18), and in gloves (39.00% MEA; 4.03% DG18). 1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07 Log CFU.m-2 FRPD Interior layer 1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07 Log CFU.m-2 FRPD Exhalation valves 1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07 1,E+08 Log CFU.m-2 Gloves Conclusion 4 • Contamination of FRPD and gloves with Mucorales is present at the waste sorting industry • Reduced susceptibility to clinical azoles such as posaconazole, one of the few effective azole drugs against mucormycosis, can be a risk factor in the waste sorting industry Station Task FRPD Gloves A Feeding machines with waste 33 9 B Sorting waste 54 39 C Machines inspection 12 10 D Machines and special vehicles operator 13 8 Not specified 8 1 Total 120 67 Acknowledgments 5 This work was supported by FCT – Fundação para Ciência e Tecnologia, project EXPOsE (02/SAICT/2016/Project nº 23222), and Instituto Politécnico de Lisboa, Lisbon, Portugal, Project "Waste FRPD” (IPL/2018/WasteFRPD/ESTeSL).