title: Pathogenic Aspergillus species recovered from a hospital water system: a 3-year prospective study.
abstract: Nosocomial aspergillosis, a life-threatening infection in immunocompromised patients, is thought to be caused primarily by Aspergillus organisms in the air. A 3-year prospective study of the air, environmental surfaces, and water distribution system of a hospital in which there were known cases of aspergillosis was conducted to determine other possible sources of infection. Aspergillus species were found in the hospital water system. Significantly higher concentrations of airborne aspergillus propagules were found in bathrooms, where water use was highest (2.95 colony-forming units [cfu]/m(3)) than in patient rooms (0.78 cfu/m(3); P=.05) and in hallways (0.61 cfu/m(3); P=.03). A correlation was found between the rank orders of Aspergillus species recovered from hospital water and air. Water from tanks yielded higher counts of colony-forming units than did municipal water. An isolate of Aspergillus fumigatus recovered from a patient with aspergillosis was genotypically identical to an isolate recovered from the shower wall in the patient's room. In addition to the air, hospital water systems may be a source of nosocomial aspergillosis.
authors.affiliation: Myeloma and Transplantation Research Center, Arkansas Cancer Research Center, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA. anaissieeliasj@uams.edu
authors.forename: Elias J
authors.initials: EJ
authors.lastname: Anaissie
authors.forename: Shawna L
authors.initials: SL
authors.lastname: Stratton
authors.forename: M Cecilia
authors.initials: MC
authors.lastname: Dignani
authors.forename: Richard C
authors.initials: RC
authors.lastname: Summerbell
authors.forename: John H
authors.initials: JH
authors.lastname: Rex
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Monson
authors.forename: Trey
authors.initials: T
authors.lastname: Spencer
authors.forename: Miki
authors.initials: M
authors.lastname: Kasai
authors.forename: Andrea
authors.initials: A
authors.lastname: Francesconi
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000397:Air Pollution; D001228:Aspergillosis / Q000453:epidemiology / Q000382:microbiology; D001230:Aspergillus / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014871:Water Microbiology; D014876:Water Pollution