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Invasive aspergillosis: clusters and sources?
K W Loudon1, A P Coke, J P Burnie
1Department of Medical Microbiology, University of Manchester Medical School, UK.
Abstract:
Clusters of invasive infection with Aspergillus fumigatus are known to be associated with building works but studying the epidemiology has been hampered by the lack of a reliable typing system. A combination of three typing systems; silver staining of sodium dodecyl sulphate-polyacrylamide gels, immunoblot fingerprinting, and random amplification of polymorphic DNA (RAPD) was applied to seven cases on a haematology unit. The results show three of the patients to have indistinguishable isolates, suggesting a common source. Detection and removal of such sources, although difficult, would be an effective way of controlling the infection.
Insights
Clusters of invasive Aspergillus fumigatus infections linked to building work were studied using three typing methods. Three patients shared an indistinguishable fungal strain, indicating a common source that should be identified and removed to control outbreaks.
Area of Science:
- Medical Mycology
- Infectious Disease Epidemiology
- Molecular Typing
Background:
- Invasive infections caused by Aspergillus fumigatus are a significant concern, particularly in immunocompromised patients.
- Outbreaks of Aspergillus fumigatus have been associated with construction or renovation activities within healthcare facilities.
- Studying the epidemiology of these infections has been challenging due to the absence of a robust typing system.
Purpose of the Study:
- To investigate the epidemiological links between building works and invasive Aspergillus fumigatus infections.
- To evaluate the utility of a combination of molecular typing techniques for identifying the source of infection.
- To assess the feasibility of controlling Aspergillus fumigatus outbreaks through source detection and removal.
Main Methods:
- A combination of three typing systems was employed: silver staining of sodium dodecyl sulphate-polyacrylamide gels (SDS-PAGE), immunoblot fingerprinting, and random amplification of polymorphic DNA (RAPD).
- These methods were applied to Aspergillus fumigatus isolates from seven cases admitted to a haematology unit.
- The typing results were analyzed to determine the relatedness of the isolates.
Main Results:
- The study identified three patients with indistinguishable Aspergillus fumigatus isolates.
- This finding strongly suggests a common source of infection among these three individuals.
- The applied typing methods proved effective in differentiating and linking fungal isolates.
Conclusions:
- A common source of Aspergillus fumigatus infection was identified in a cluster of cases on a haematology unit.
- Effective control of invasive Aspergillus fumigatus infections associated with building works requires diligent source detection and removal.
- Despite the challenges, identifying and eliminating sources is a crucial strategy for preventing and managing these infections.