With every breath on a city street you take in about 10,000 fungal spores. Beside a rubbish dump the count runs to hundreds of thousands, or millions. In the mountains it drops to almost nothing. No hospital can keep them out. They come in through the ventilation, and through doors that open for a minute.
Mikhail Vishnevsky, a mycologist, military doctor and author of more than twenty books on fungi, asks where those particular spores grew up. They didn't "come of age in the hospital", he says. People raised them, out in the farmland.
Here is why that matters to anyone who might one day lie in an intensive care ward. The pill given to a patient with a fungal infection and the spray poured on wheat are the same substance. "Antimycotic" is the name on the human side and "fungicide" the name on the farm side. Both come from three or four classes of chemistry, identical for wheat and for Homo sapiens. A fungus that learns to shrug off a spray in a field has learned to shrug off the medicine.
And the field is a very good school. Every year agricultural companies pour about ten million tonnes of fungicide onto the world's crops. Vishnevsky asks you to stop on that number. They cannot do otherwise. Skip the spraying and a third of the harvest is gone in the first year, half in the second. By the third there is nothing left, because the fungi have eaten all of it.
The chemicals break down slowly, so they sit in the soil day after day, season after season. Fungi are among the fastest-evolving forms of life, and a poison that never leaves gives them endless material to practise on. The survivors of that course are fully resistant, and they are the ones whose spores drift on the wind.
Then they reach the ward. Alcohol wipes do nothing to a fungal spore, Vishnevsky says; for it, alcohol is a snack of tasty carbon. In intensive care the team is saving a life and is not thinking about a black Aspergillus sitting on the tip of a catheter. Bacterial hospital infection is old news, and medicine has made a kind of peace with it. A fungal component that nothing can remove appeared only in the last ten years or so. New classes of antifungal drugs are developed slowly, cost huge sums, and for now do not exist. There are only hopes.
And so on the farm fields, having gone through evolution and gained full resistance to all fungicides, fungal spores fly in through the window, where they become part of the hospital infection that resists antimycotics.
И поэтому на сельхозполях, пройдя эволюцию и получив полную устойчивость ко всем фунгицидам, споры грибов залетают в форточки, в госпитале, где они становятся частью больничной инфекции, устойчивой к антимикотикам.
— Mikhail Vishnevsky, Gleb Solomin Podcast, 12:56
Researchers who work with these moulds have seen the same pattern. A paper in the EFSA Journal in January 2025 reported evidence that azole fungicides in the environment are linked to cross-resistance to medical azoles in Aspergillus species, shown mainly for Aspergillus fumigatus. In a Nature Microbiology paper in January 2024, Norman van Rhijn and colleagues exposed A. fumigatus in the lab to ipflufenoquin, an agricultural fungicide. They got strains resistant to olorofim, a first-in-class clinical antifungal that works the same way.
So what would it take to break the loop? Vishnevsky does the arithmetic and corrects himself as he goes. Agribusiness would have to give up fungicides for roughly, no, at a minimum, thirty years. That means the collapse of farming as an industry, so nobody will ever agree to it.
The situation is a stalemate. Farmers cannot stop spraying, because the harvest would vanish within three seasons. Hospitals cannot stop the spores, because the spores are already in the air. In Vishnevsky's view the number of human victims will keep growing.
