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Hospital sources of Aspergillus: New routes of transmission?
A Warris1, A Voss, P E Verweij
1Department of Pediatrics, University Medical Centre St. Radboud, 435, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. A.Warris@ckskg.azn.nl
Abstract:
With the continuing increase in the number of severely immunocompromised patients, hospitals are faced with the growing problem of invasive aspergillosis and other opportunistic fungal infections. Since treatment of these infections are difficult and outcome is often fatal, preventive measures are of major importance in the control of invasive filamentous fungal infections. Until recently, inhalation of airborne conidia was believed to be the primary route of acquiring Aspergillus infection. Despite the fact, that efforts to filter the hospital air has led to a reduction of airborne conidia paralleled by a decrease in the frequency of invasive infections, the correlation between the concentration of Aspergillus conidia in hospital air and the risk of invasive infections remains unclear. Furthermore, alternative modes of transmission may exist and should be recognized and investigated. The discovery of hospital water as a potential source of Aspergillus fumigatus and other filamentous fungi may suggest a new route for the transmission of invasive filamentous fungal infections. Epidemiological studies, based on molecular characterization and comparisons of fungal isolates recovered from patients and environment, are needed to expand our understanding of these alternative routes of transmission.
Insights
Invasive aspergillosis is a growing concern in immunocompromised patients. Hospital water may be a new transmission source for Aspergillus, necessitating further research into alternative infection routes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Rising incidence of invasive fungal infections in immunocompromised patients.
- Difficulty in treating invasive aspergillosis and high fatality rates.
- Importance of preventive measures in controlling filamentous fungal infections.
Purpose of the Study:
- To investigate potential alternative transmission routes of invasive filamentous fungal infections.
- To explore hospital water as a potential source of Aspergillus fumigatus.
- To highlight the need for epidemiological studies on fungal transmission.
Main Methods:
- Review of current understanding of Aspergillus transmission routes.
- Discussion of the potential role of hospital water in fungal infections.
- Emphasis on molecular characterization and epidemiological studies.
Main Results:
- Inhalation of airborne conidia was previously considered the primary transmission route.
- Hospital water identified as a potential source of Aspergillus fumigatus.
- Correlation between airborne conidia concentration and infection risk remains unclear.
Conclusions:
- Alternative transmission routes for invasive filamentous fungal infections may exist.
- Hospital water represents a potential, under-recognized source of infection.
- Further epidemiological research is crucial to understand and control these infections.
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