Aspergillus and lung transplant recipients: a mycologic and molecular epidemiologic study.
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.
Brenier-Pinchart
M P
MP
Parasitologie-Mycologie Médicale et Moléculaire, Laboratoire Relation Hôte-Agents Pathogènes, Faculté de Médecine, Université Joseph Fourier, Grenoble, France.
Lebeau
B
B
Devouassoux
G
G
Mondon
P
P
Pison
C
C
Ambroise-Thomas
P
P
Grillot
R
R
D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000235:genetics*; D001980:Bronchi / Q000382:microbiology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D017931:DNA Primers / Q000235:genetics; D003937:Diagnosis, Differential; D005260:Female; D016041:Heart-Lung Transplantation / Q000276:immunology; D006801:Humans; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D011110:Polymorphism, Genetic / Q000235:genetics; D012189:Retrospective Studies; D017421:Sequence Analysis
D017931:DNA Primers