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Environmental investigations and molecular typing of Aspergillus in a Chinese hospital
Jun-hong Ao1, Zhen-feng Hao, He Zhu
1Institute of Skin Damage and Repair, General Hospital of Beijing Military Command of PLA, Beijing, 100700, China.
Abstract:
Invasive fungal infections due to Aspergillus species have become a major cause of morbidity and mortality among immunocompromised patients. In order to determine the possible relationship between environmental contamination by Aspergillus and the occurrence of invasive aspergillosis, a 1-year prospective study was carried out in a tertiary hospital in China. Air, surface, and tap water sampling was performed twice monthly at the bone marrow transplant (BMT) department, intensive care unit (ICU), neurosurgery intensive care unit (NICU), and outdoors. Nose, pharynx, and sputum samples were collected from high-risk patients. Isolates of Aspergillus from the environment and patients were genotyped by random amplification of polymorphic DNA (RAPD) assay to investigate the origin of infection. Mean total Aspergillus count was 7.73, 8.94, 13.19, and 17.32 cfu/m(3) in the BMT department, ICU, NICU, and outdoors, respectively. RAPD analysis by R108 primer demonstrated that strains isolated from patients in NICU were identical to the environmental strain. Strains isolated from patients in ICU differed from the environmental strain. Aspergillus contamination was found in the BTM department, NICU, and ICU. Clinical and environmental strains from NICU had identical genotypes. These findings suggest that Aspergillus is found in the hospital environment including the air, surface, and tap water. The genotypes of Aspergillus were identical from patients and the environment, suggesting that clinical infection may originate from the hospital environment.
Insights
Environmental Aspergillus contamination is linked to invasive aspergillosis in immunocompromised patients. Genotyping revealed identical Aspergillus strains in the neurosurgery intensive care unit (NICU) environment and patients, suggesting a common origin.
Area of Science:
- Medical Mycology
- Hospital Epidemiology
- Infectious Diseases
Background:
- Invasive aspergillosis poses significant risks to immunocompromised individuals.
- Understanding the link between environmental Aspergillus and patient infections is crucial for prevention.
Purpose of the Study:
- To investigate the relationship between environmental Aspergillus contamination and invasive aspergillosis in a tertiary hospital.
- To determine the origin of Aspergillus infections in high-risk patients.
Main Methods:
- A 1-year prospective study involving environmental sampling (air, surface, water) and patient specimen collection.
- Genotyping of Aspergillus isolates using random amplification of polymorphic DNA (RAPD) assay.
- Sampling conducted in bone marrow transplant (BMT), intensive care unit (ICU), and neurosurgery intensive care unit (NICU) departments.
Main Results:
- Significant Aspergillus contamination detected across BMT, ICU, and NICU environments.
- Mean Aspergillus counts varied by location, with the highest outdoors.
- Genotyping confirmed identical Aspergillus strains between NICU patients and the environment, but not in the ICU.
Conclusions:
- Aspergillus species are prevalent in various hospital environments, including air, surfaces, and water.
- Identical genotypes of clinical and environmental Aspergillus strains in the NICU strongly suggest the hospital environment as the source of infection.
- Further research is needed to elucidate the transmission dynamics in other units like the ICU.
