title: Relationship between Fungal Colonisation of the Respiratory Tract in Lung Transplant Recipients and Fungal Contamination of the Hospital Environment.
abstract: BACKGROUND
  Aspergillus colonisation is frequently reported after lung transplantation. The question of whether aspergillus colonisation is related to the hospital environment is crucial to prevention.
  
  
  METHODS
  To elucidate this question, a prospective study of aspergillus colonisation after lung transplantation, along with a mycological survey of the patient environment, was performed.
  
  
  RESULTS
  Forty-four consecutive patients were included from the day of lung transplantation and then examined weekly for aspergillus colonisation until hospital discharge. Environmental fungal contamination of each patient was followed weekly via air and surface sampling. Twelve patients (27%) had transient aspergillus colonisation, occurring 1-13 weeks after lung transplantation, without associated manifestation of aspergillosis. Responsible Aspergillus species were A. fumigatus (6), A. niger (3), A. sydowii (1), A. calidoustus (1) and Aspergillus sp. (1). In the environment, contamination by Penicillium and Aspergillus was predominant. Multivariate analysis showed a significant association between occurrence of aspergillus colonisation and fungal contamination of the patient's room, either by Aspergillus spp. in the air or by A.fumigatus on the floor. Related clinical and environmental isolates were genotyped in 9 cases of aspergillus colonisation. For A. fumigatus (4 cases), two identical microsatellite profiles were found between clinical and environmental isolates collected on distant dates or locations. For other Aspergillus species, isolates were different in 2 cases; in 3 cases of aspergillus colonisation by A. sydowii, A. niger and A. calidoustus, similarity between clinical and environmental internal transcribed spacer and tubulin sequences was >99%.
  
  
  CONCLUSIONS
  Taken together, these results support the hypothesis of environmental risk of hospital acquisition of aspergillus colonisation in lung transplant recipients.
authors.affiliation: AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, F-75018, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Bonnal
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France.|University Pierre et Marie Curie-Paris 6, Paris, France.
authors.forename: Christopher
authors.initials: C
authors.lastname: Leleu
authors.affiliation: AP-HP, Service de Pneumologie B, Unité de Transplantation Pulmonaire, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Brugière
authors.affiliation: AP-HP, Laboratory of Parasitology and Mycology, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Chochillon
authors.affiliation: Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, UMR 1153, Inserm, Université Paris Descartes, Paris, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Porcher
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France.|INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique-U1136, Paris, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boelle
authors.affiliation: AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, F-75018, Paris, France.|AP-HP, Laboratory of Parasitology and Mycology, Saint-Louis University Hospital, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Menotti
authors.affiliation: AP-HP, Laboratory of Parasitology and Mycology, Bichat-Claude Bernard University Hospital, Paris, France.|UMR 216, Mère et enfants face aux infections tropicales, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Houze
authors.affiliation: University Pierre et Marie Curie-Paris 6, Paris, France.|Paris Diderot University, IAME, UMR 1137, F-75018 Paris, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lucet
authors.affiliation: AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, F-75018, Paris, France.|AP-HP, Laboratory of Parasitology and Mycology, Saint-Louis University Hospital, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Derouin
mesh_terms: D000328:Adult; D000368:Aged; D001230:Aspergillus / Q000145:classification / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010297:Paris; D011446:Prospective Studies; D012137:Respiratory System / Q000382:microbiology*