Molecular epidemiology of airway colonisation by Aspergillus fumigatus in cystic fibrosis patients

Cimon, Bernard; Symoens, Françoise; Zouhair, Rachid; Chabasse, Dominique; Nolard, N.; Defontaine, Alain; Bouchara, Jean‐Philippe

doi:10.1099/0022-1317-50-4-367

Cited by 49 publications

(43 citation statements)

References 16 publications

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“…Several previous studies have demonstrated that patients with invasive aspergillosis might be infected by more than one strain (7,8,18). Colonization with multiple A. fumigatus genotypes in the CGD patient has also been shown in patients with cystic fibrosis (11,25).…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Aspergillus fumigatus Isolates Recovered from Water, Air, and Patients Shows Two Clusters of Genetically Distinct Strains

et al. 2003

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There has been an increase in data suggesting that besides air, hospital water is a potential source of transmission of filamentous fungi, and in particular Aspergillus fumigatus. Molecular characterization of environmental and clinical A. fumigatus isolates, collected prospectively during an 18-month period, was performed to establish if waterborne fungi play a role in the pathogenesis of invasive aspergillosis. Isolates recovered from water (n ‫؍‬ 54) and air (n ‫؍‬ 21) at various locations inside and outside the hospital and from 15 patients (n ‫؍‬ 21) with proven, probable, or possible invasive aspergillosis were genotyped by amplified fragment length polymorphism analysis. Based on genomic fingerprints, the environmental A. fumigatus isolates could be grouped into two major clusters primarily containing isolates recovered from either air or water. The genotypic relatedness between clinical and environmental isolates suggests that patients with invasive aspergillosis can be infected by strains originating from water or from air. In addition, 12 clusters with genetically indistinguishable or highly related strains were differentiated, each containing two to three isolates. In two clusters, clinical isolates recovered from patients matched those recovered from water sources, while in another cluster the clinical isolate was indistinguishable from one cultured from air. This observation might open new perspectives in the development of infection control measures to prevent invasive aspergillosis in high-risk patients. The genetic variability found between airborne and waterborne A. fumigatus strains might prove to be a powerful tool in understanding the transmission of invasive aspergillosis and in outbreak control.With the continuing increase in the number of severely immunocompromised patients, hospitals are faced with the growing problem of invasive aspergillosis and other opportunistic fungal infections (17). Since treatment of these infections is difficult and the outcome is often fatal, preventive measures are of major importance in the control of invasive filamentous fungal infections. Nosocomial invasive aspergillosis is thought to be primarily airborne; however, despite the use of appropriate hospital air filtration systems, the incidence of this infection continues to increase. Together with the lack of genetic relatedness between airborne strains and those causing invasive disease (10, 12), it is tempting to speculate about the existence of other routes of transmission.As early as 1985, Aspergillus species and other filamentous fungi were shown to inhabit water distribution systems that deliver water to hospitals in Europe and the United States (13). Recently, there has been an increase in data supporting water as a potential source of filamentous fungi and, in particular, Aspergillus fumigatus (1, 2, 4, 28). However, direct evidence that waterborne A. fumigatus strains are involved in human infection is lacking. To test the hypothesis that a wet route of transmission might exist, we performed molecu...

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Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Aspergillus fumigatus Isolates Recovered from Water, Air, and Patients Shows Two Clusters of Genetically Distinct Strains

et al. 2003

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“…The many clinical forms of aspergillosis result from inhalation of A. fumigatus from environmental sources, yet research attempting to make positive associations between environmental isolates and isolates infecting patients has not easily made such links, regardless of the typing method used. While some investigators have found examples of indistinguishable A. fumigatus isolates in some individual patients and their hospital environments (10,19,33), others have reported multiple strain types in the same patient and even the same sample (10,11,33). The best evidence for common types in infecting and environmental isolates comes more from statistical clustering of strain types (10,17,19,53) than from unequivocal evidence of an indistinguishable strain type in a clinical sample and a sample, say, from the patient's ward.…”

Section: Discussionmentioning

confidence: 99%

Multilocus Sequence Typing of the Pathogenic Fungus Aspergillus fumigatus

et al. 2007

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A multilocus sequence typing (MLST) scheme was devised for Aspergillus fumigatus. The system involved sequencing seven gene fragments and was applied to a panel of 100 isolates of A. fumigatus from diverse sources. Thirty different sequence types were found among the 100 isolates, and 93% of the isolates differed from the other isolates by only one allele sequence, forming a single clonal cluster as indicated by the eBURST algorithm. The discriminatory power of the MLST method was only 0.93. These results strongly indicate that A. fumigatus is a species of a relatively recent origin, with low levels of sequence dissimilarity. Typing methods based on variable numbers of tandem repeats offer higher levels of strain discrimination. Mating type data for the 100 isolates showed that 71 isolates were type MAT1-2 and 29 isolates were MAT1-1.

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“…Thus, when employing AFLP analysis for epidemiological analysis, it is important that pure cultures be obtained and analyzed. Assuming that individuals are, in fact, likely to be colonized by more than one genotype, it is important to subculture and analyze each colony separately when several are obtained from a respiratory sample in order to prevent false conclusions from being drawn (4,6).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Highly Discriminatory Molecular Fingerprinting Assays for Analysis of Multiple Aspergillus fumigatus Isolates from Patients with Invasive Aspergillosis

et al. 2007

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Two highly discriminatory fingerprinting assays, short tandem repeat typing and amplified fragment length polymorphism (AFLP), were compared to determine the genetic relatedness between 55 isolates of Aspergillus fumigatus obtained from 15 different patients suffering from proven invasive aspergillosis. Both techniques showed that interpatient isolates belonged to different genotypes and that intrapatient isolates from deep sites were all of the same genotype. By contrast, multiple genotypes were found among isolates originating from respiratory samples. Both techniques have specific advantages and disadvantages. AFLP is more universally applicable, but short tandem repeat analysis offers better discriminatory power and should be the preferred method for standardizing typing of clinical isolates of Aspergillus fumigatus.

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Molecular epidemiology of airway colonisation by Aspergillus fumigatus in cystic fibrosis patients

Cited by 49 publications

References 16 publications

Molecular Epidemiology of Aspergillus fumigatus Isolates Recovered from Water, Air, and Patients Shows Two Clusters of Genetically Distinct Strains

Molecular Epidemiology of Aspergillus fumigatus Isolates Recovered from Water, Air, and Patients Shows Two Clusters of Genetically Distinct Strains

Multilocus Sequence Typing of the Pathogenic Fungus Aspergillus fumigatus

Comparison of Two Highly Discriminatory Molecular Fingerprinting Assays for Analysis of Multiple Aspergillus fumigatus Isolates from Patients with Invasive Aspergillosis

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