title: Domestic mould exposure and invasive aspergillosis-air sampling of Aspergillus spp. spores in homes of hematological patients, a pilot study.
abstract: Aspergillus spp.-related morbidity and mortality remains a major challenge in the management of neutropenic patients. Little is known about the impact of domestic Aspergillus spp.
  
  
  METHODS
  In this controlled prospective study, fungal spores were collected from homes of neutropenic patients. Cases were defined as patients with probable or proven controls as patients with no invasive pulmonary aspergillosis, while patients with possible disease were evaluated as a third group. Forty patients were enrolled and returned questionnaires on high-risk activities and mould exposure. A. fumigatus was detected in concentrations of 0 to 76 cfu/m(3) in every home. A. terreus was detected in nine (18%) homes. Mean Aspergillus spp. cfu/m(3) according to EORTC criteria were: proven/probable IA (15 patients) - 36; possible IA (12 patients) - 42; no IA (13 patients) - 42. Of the seven patients with self-reported moulded walls at home, four had probable and three had possible aspergillosis; the risk ratio of developing IA was 1.65 (95% CI: 1.25-2.17). In conclusion self-reported domestic mould exposure was associated with a high incidence of IA and may be a feasible tool for identifying high-risk patients. There was no correlation between domestic ambient-air spore counts and IA.
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: K E
authors.initials: KE
authors.lastname: Schweer
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Jakob
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Liss
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Christ
authors.affiliation: Landesgesundheitsamt Baden-Württemberg (local health authority Baden-Württemberg), Germany.
authors.forename: G
authors.initials: G
authors.lastname: Fischer
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany.
authors.forename: Mjgt
authors.initials: M
authors.lastname: Vehreschild
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany Clinical Trials Centre Cologne, ZKS Köln, Medical Faculty, University of Cologne, Cologne, Germany Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Medical Faculty, University of Cologne, Cologne, Germany.
authors.forename: O A
authors.initials: OA
authors.lastname: Cornely
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany Center for Integrated Oncology CIO KölnBonn, Medical Faculty, University of Cologne, Cologne, Germany German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany joerg-janne.vehreschild@uk-koeln.de.
authors.forename: J J
authors.initials: JJ
authors.lastname: Vehreschild
mesh_terms: D000328:Adult; D000368:Aged; D000391:Air Microbiology; D001230:Aspergillus / Q000302:isolation & purification*; D016022:Case-Control Studies; D015169:Colony Count, Microbial; D004781:Environmental Exposure; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D015994:Incidence; D055744:Invasive Pulmonary Aspergillosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013172:Spores, Fungal / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: domestic exposure; hygiene; pathogenesis; risk factors; spores