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Address for correspondence: Kieren A. Abstract Aspergillus ustus is a mold that rarely infects humans; only 15 systemic cases have been reported. We report the first outbreak of invasive infection caused by A. Six patients with infections were identified; 3 infections each occurred in both and Molecular typing by using randomly amplified polymorphic DNA RAPD and antifungal drug susceptibility testing were performed on clinical and environmental isolates recovered from our hospital from to The highest overall attack rate in HSCT patients was 1.
Clinical isolates exhibited decreased susceptibility to antifungal drugs, especially azoles. RAPD and phylogenetic analysis showed genetic similarity between isolates from different patients. Based on the clustering of cases in space and time and molecular data, common-source acquisition of this unusual drug-resistant species is possible. The most common cause of IA is Aspergillus fumigatus 2.
However, in recent years, IA has been increasingly caused by non-fumigatus Aspergillus species. For example, at the Fred Hutchinson Cancer Research Center in Seattle, the proportion of infections caused by non-fumigatus Aspergillus species increased during the latter s. Most of these infections were caused by A.
Aspergillus ustus is a group of filamentous hyalohyphomycetes consisting of 5 species: A. Members of this group are rare human pathogens; only 15 cases of systemic infection have been reported in the literature since , and more than half of these occurred in the past 10 years Table A1 4 - Infections caused by A. Recognition of invasive infections that occurred in 2 clusters of hematopoietic stem cell transplant HSCT recipients in our institution prompted us to perform a more thorough clinical investigation and environmental sampling to identify potential sources of acquisition.
Methods Case Identification and Environmental Surveillance Recognition of time-clustered cases in prompted us to do this retrospective study and epidemiologic investigation. Cases of infection caused by A. Charts were reviewed for clinical data demographics, underlying disease, transplantation characteristics, antifungal therapies, radiographic and laboratory studies, and outcome. The hospital is a large tertiary care facility that houses patients with HSCT on the top 2 floors the northeast wings of the seventh and eighth floors.
A spot map depicting case-patient location and timeline relating location to time of diagnosis was created. Information on timing of construction activities and airflow information was obtained from hospital engineering and infection control personnel. An attack rate was estimated among the potentially exposed HSCT patients using as the denominator the number of patients who were admitted for HSCT from July through October and March through September , the at-risk periods when cases occurred.
Environmental Sampling Based on the spot map, environmental air sampling of patient hospital rooms was performed, and environmental isolates were obtained. Samples 0. Organisms were identified to the species level by using standard morphologic criteria for A. Molecular Typing Molecular typing of A. Mixtures were subjected to 3 cycles of freeze-thaw in liquid nitrogen, alternating with vortexing with 0. PCR products underwent electrophoresis in 1. The band patterns from each gel with each primer were analyzed by using tools for population genetics analysis TFPGA unpub.
Cluster analysis was performed by the unweighted pair group mean with arithmetic average UPGMA method
Address for correspondence: Kieren A. Abstract Aspergillus ustus is a mold that rarely infects humans; only 15 systemic cases have been reported. We report the first outbreak of invasive infection caused by A. Six patients with infections were identified; 3 infections each occurred in both and
Aspergillus versicolor Aspergillus Niger Aspergillus niger is the most abundant species of Aspergillus in nature as it can grow on a large variety of substances. Aspergillus niger can even grow in environments with very little nutrients available. In houses it is often found growing on damp walls. Of the Aspergillus species, Aspergillus niger infects humans the third most often. The health effects of Aspergillus niger include hearing problems and even hearing loss. Aspergillus niger is black on the surface and white or yellow underneath.
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Sources of Aspergillosis