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Aspergillus and lung transplant recipients: a mycologic and molecular epidemiologic study
M P Brenier-Pinchart1, B Lebeau, G Devouassoux
1Parasitologie-Mycologie Médicale et Moléculaire, Laboratoire Relation Hôte-Agents Pathogènes, Faculté de Médecine, Université Joseph Fourier, Grenoble, France.
Background:
After lung transplantation, filamentous fungi and more particularly Aspergillus fumigatus are commonly isolated, although the origin of contamination is unclear.
Methods:
To investigate the fungal flora in bronchoscopic fluids, we retrospectively reviewed 20 cases of lung transplant recipients. Using sequence-specific DNA primers analysis, we typed the clinical strains of A. fumigatus isolated from 6 lung transplant recipients. For 4 of them, the strains of this species were isolated from their environment.
Results:
At least once 90% of patients had filamentous fungi, and A. fumigatus was the most frequently isolated. Bronchial colonization was detected in 14 patients, invasive bronchial mycosis was diagnosed in 4 others, and no case of invasive pulmonary fungal infection was detected. Genome typing of the 47 clinical strains revealed that a given patient could be affected by several different strains. A very extensive polymorphism existed among the 38 environmental strains. Origin of contamination at home was possible in 1 case and in the hospital in 3 cases.
Conclusions:
Bronchial colonization is frequent after lung transplantation. Although the clinical strains show a polymorphism, it is less widespread than the polymorphism of environmental strains. The origin of acquisition may be in the patient's community.