A longitudinal study of lung transplant recipients infected with Aspergillus: genetic polymorphism of A fumigatus.
BACKGROUND
Aspergillus infection is a well-known complication of lung transplantation and remains associated with high mortality rates. Molecular typing methods are required to elucidate the complex epidemiology of Aspergillus disease in lung transplant recipients.


METHODS
Eight lung transplant recipients from one hospital were followed for A fumigatus colonization or infection. Forty-four sequential isolates from these patients were selected and typed by three molecular methods (random amplified polymorphic DNA, sequence-specific DNA primer and multi-locus enzyme electrophoresis).


RESULTS
Sixteen different types were identified of which 14 were specific to 1 patient. A factorial correspondence analysis showed that variability between sequential isolates from a single patient was as high as between isolates from the other patients. Lung transplant recipients presented many different genotypes, reflecting the environmental diversity of A fumigatus. Nevertheless, throughout their follow-up, 2 of the 8 lung transplant recipients harbored a common genotype that was not replaced by others.


CONCLUSIONS
These results confirm the important genetic polymorphism of the A fumigatus population. The observed genotypes were not related to the type of Aspergillus disease or anti-fungal treatment used nor to the outcome of the patient. These data confirm that all A fumigatus molecular types present the same pathogenic risk.
Symoens
F
F
Scientific Institute of Public Health-Louis Pasteur, Mycology Section, Brussels, Belgium. f.symoens@iph.fgov.be
Bertout
S
S
Piens
M A
MA
Burnod
J
J
Renaud
F
F
Nolard
N
N
Chapuis
F
F
Grillot
R
R
D000328:Adult; D001228:Aspergillosis / Q000209:etiology* / Q000235:genetics; D001232:Aspergillus fumigatus / Q000235:genetics; D004586:Electrophoresis / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005602:France; D005819:Genetic Markers / Q000235:genetics; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics; D019105:Random Amplified Polymorphic DNA Technique / Q000379:methods; D017422:Sequence Analysis, DNA / Q000379:methods
D005819:Genetic Markers