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Journal of Clinical Microbiology, June 1999, p. 1752-1757, Vol. 37, No. 6
Department of Medical Microbiology and
Infectious Diseases, Erasmus University Medical Center of
Rotterdam, 3015 GD Rotterdam, The Netherlands
Received 1 October 1998/Returned for modification 3 November
1998/Accepted 6 February 1999
After five patients were diagnosed with nosocomial
invasive aspergillosis caused by Aspergillus fumigatus and
A. flavus, a 14-month surveillance program for
pathogenic and nonpathogenic fungal conidia in the air within and
outside the University Hospital in Rotterdam (The Netherlands) was
begun. A. fumigatus isolates obtained from the
Department of Hematology were studied for genetic relatedness by
randomly amplified polymorphic DNA (RAPD) analysis. This was repeated
with A. fumigatus isolates contaminating culture media
in the microbiology laboratory. The density of the conidia of
nonpathogenic fungi in the outside air showed a seasonal
variation: higher densities were measured during the summer, while
lower densities were determined during the fall and winter. Hardly any variation was found in the numbers of Aspergillus conidia.
We found decreasing numbers of conidia when comparing air from
outside the hospital to that inside the hospital and when comparing
open areas within the hospital to the closed department of hematology. The increase in the number of patients with invasive aspergillosis could not be explained by an increase in the number of
Aspergillus conidia in the outside air. The short-term
presence of A. flavus can only be explained by the
presence of a point source, which was probably patient related.
Genotyping A. fumigatus isolates from the department
of hematology showed that clonally related isolates were persistently
present for more than 1 year. Clinical isolates of A. fumigatus obtained during the outbreak period were different
from these persistent clones. A. fumigatus isolates contaminating culture media were all genotypically identical, indicating a causative point source. Knowledge of the
epidemiology of Aspergillus species is necessary
for the development of strategies to prevent invasive aspergillosis.
RAPD fingerprinting of Aspergillus isolates can help
to determine the cause of an outbreak of invasive aspergillosis.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Density and Molecular Epidemiology of
Aspergillus in Air and Relationship to Outbreaks of
Aspergillus Infection
*
Corresponding author. Present address: Department of
Medical Microbiology, Bosch Medicentrum, P.O. Box 90153, 5200 ME's-Hertogenbosch, The Netherlands. Phone: 31-73-6162872. Fax: 31-73-6162872. E-mail: med_microbiologie{at}boschmedicentrum.nl.
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