Author:

A Warris, A Voss & PE Verweij

Date: 4 April 2004

Abstract:

With the continuing increase in the number of severely immunocompromisedpatients, hospitals are faced with the growing problem of invasive aspergillosisand other opportunistic fungal infections. Since treatment of these infections aredifficult and outcome is often fatal, preventive measures are of major importancein the control of invasive filamentous fungal infections. Until recently, inhalation ofairborne conidia was believed to be the primary route of acquiring Aspergillusinfection. Despite the fact, that efforts to filter the hospital air has led to a reductionof airborne conidia paralleled by a decrease in the frequency of invasiveinfections, the correlation between the concentration of Aspergillusconidia inhospital air and the risk of invasive infections remains unclear. Furthermore,alternative modes of transmission may exist and should be recognized andinvestigated. The discovery of hospital water as a potential source of Aspergillusfumigatus and other filamentous fungi may suggest a new route for the transmissionof invasive filamentous fungal infections. Epidemiological studies, based onmolecular characterization and comparisons of fungal isolates recovered frompatients and environment, are needed to expand our understanding of thesealternative routes of transmission.

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