Aspergillus Pulmonary Infections in Transplant Recipients

White, Dorothy A.

doi:10.1016/j.ccm.2005.06.007

Cited by 20 publications

(13 citation statements)

References 116 publications

(117 reference statements)

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“…Firstly, mold-contaminated water will probably be most important in hospitals and other health care institutions, where immunocompromised patients with, e.g., AIDS, cancer, or organ transplants undergo treatment. Because of the increasing frequencies of severely immunocompromised patients, hospitals are facing a greater challenge with respect to opportunistic fungal infections (40,64). Contaminated water may be a potential problem if the mold conidia or small hyphal fragments are aerosolized into the environment and subsequently inhaled.…”

Section: Discussionmentioning

confidence: 99%

“…Some of the mold species isolated from water samples are known to be strongly allergenic skin irritants or may cause infections in immunosuppressed individuals such as AIDS, cancer, and organ transplant patients and persons with asthma or various respiratory problems (12,14,64,67). Mold spores and hyphal fragments may be aerosolized in indoor air when contaminated water passes trough showerheads, taps, or toilet cisterns.…”

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confidence: 99%

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Diversity and Significance of Mold Species in Norwegian Drinking Water

Hageskal

Knutsen

Gaustad

et al. 2006

Appl Environ Microbiol

156

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In order to determine the occurrence, distribution, and significance of mold species in groundwater-and surface water-derived drinking water in Norway, molds isolated from 273 water samples were identified. Samples of raw water, treated water, and water from private homes and hospital installations were analyzed by incubation of 100-ml membrane-filtered samples on dichloran-18% glycerol agar. The total count (number of CFU per 100 ml) of fungal species and the species diversity within each sample were determined. The identification of mold species was based on morphological and molecular methods. In total, 94 mold species belonging to 30 genera were identified. The mycobiota was dominated by species of Penicillium, Trichoderma, and Aspergillus, with some of them occurring throughout the drinking water system. Several of the same species as isolated from water may have the potential to cause allergic reactions or disease in humans. Other species are common contaminants of food and beverages, and some may cause unwanted changes in the taste or smell of water. The present results indicate that the mycobiota of water should be considered when the microbiological safety and quality of drinking water are assessed. In fact, molds in drinking water should possibly be included in the Norwegian water supply and drinking water regulations.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Diversity and Significance of Mold Species in Norwegian Drinking Water

Hageskal

Knutsen

Gaustad

et al. 2006

Appl Environ Microbiol

156

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“…The halo sign corresponds to a low attenuation surrounding a mass or nodule [117,118], and the air-crescent sign is related to the contraction of infarcted lung tissue delineated by an air-filled space [118]. Although these signs are well described during neutropenia, it seems they are less frequently observed in COPD and solid organ-transplant patients [119,120], where nonspecific consolidations are seen more frequently than the specific features mentioned in table 3. The excessive host response (see Pathophysiology section), the lung parenchyma changes secondary to the underlying disease or the delay before the diagnosis, as reported in haematological patients [101], may explain why radiological findings are less specific in COPD patients.…”

Section: Radiologymentioning

confidence: 99%

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Bulpa¹,

Dive²,

Sibille³

2007

Eur Respir J

320

200

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Aspergillus spp. cultured in specimens from the airways of chronic obstructive pulmonary disease (COPD) patients are frequently considered as a contaminant. However, growing evidence suggests that severe COPD patients are at higher risk of developing invasive pulmonary aspergillosis (IPA), although IPA incidence in this population is poorly documented. Some data report that COPD is the underlying disease in 1% of patients with IPA.Definitive diagnosis of IPA in COPD patients is often difficult as tissue samples are rarely obtained before death. Diagnosis is therefore usually based on a combination of clinical features, radiological findings (mostly thoracic computed tomography scans), microbiological results and, sometimes, serological information.Of 56 patients with IPA reported in the literature, 43 (77%) were receiving corticosteroids on admission to hospital. Breathlessness was always a feature of disease and excess wheezing was present in 79% of patients. Fever (.38uC) was present in only 38.5%. Chest pain and haemoptysis were uncommon. Six out of 33 (18%) patients had tracheobronchitis observed during bronchoscopy. The median delay between symptoms and diagnosis was 8.5 days. The mortality rate was high: 53 out of 56 (95%) patients died despite invasive ventilation and antifungal treatment in 43 (77%) of them.In chronic obstructive pulmonary disease patients, invasive pulmonary aspergillosis currently carries a very poor prognosis. Outcome could perhaps be improved by more rapid diagnosis and prompt therapy with voriconazole.

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“…Invasive pulmonary aspergillosis (IPA) is a devastating disease characterized by extensive invasion of lung tissue in immunocompromised patients by hyphae of saprophytic molds in the genus Aspergillus (26,48,61). As the number of immunocompromised patients continues to rise with advances in medical technology, there has been a concomitant increase in the number of patients with IPA (29).…”

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confidence: 99%

Calcineurin Target CrzA Regulates Conidial Germination, Hyphal Growth, and Pathogenesis of Aspergillus fumigatus

et al. 2008

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The calcineurin pathway is a critical signal transduction pathway in fungi that mediates growth, morphology, stress responses, and pathogenicity. The importance of the calcineurin pathway in fungal physiology creates an opportunity for the development of new antifungal therapies that target this critical signaling pathway. In this study, we examined the role of the zinc finger transcription factor Crz1 homolog (CrzA) in the physiology and pathogenicity of the opportunistic human fungal pathogen Aspergillus fumigatus. Genetic replacement of the crzA locus in A. fumigatus resulted in a strain with significant defects in conidial germination, polarized hyphal growth, cell wall structure, and asexual development that are similar to but with differences from defects seen in the A. fumigatus ⌬cnaA (calcineurin A) strain. Like the ⌬cnaA strain, the ⌬crzA strain was incapable of causing disease in an experimental persistently neutropenic inhalational murine model of invasive pulmonary aspergillosis. Our results suggest that CrzA is an important downstream effector of calcineurin that controls morphology in A. fumigatus, but additional downstream effectors that mediate calcineurin signal transduction are likely present in this opportunistic fungal pathogen. In addition, the importance of CrzA to the production of disease is critical, and thus CrzA is an attractive fungus-specific antifungal target for the treatment of invasive aspergillosis.

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Aspergillus Pulmonary Infections in Transplant Recipients

Cited by 20 publications

References 116 publications

Diversity and Significance of Mold Species in Norwegian Drinking Water

Diversity and Significance of Mold Species in Norwegian Drinking Water

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Calcineurin Target CrzA Regulates Conidial Germination, Hyphal Growth, and Pathogenesis of Aspergillus fumigatus

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