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Hyper-immunoglobulin E syndrome (HIES) is one of the primary immunodeficiencies characterized by recurrent staphylococcal skin and lung infections that result in lung destruction and critically diminished pulmonary function. Despite the lack of definitive treatment, there have been no reports of successful lung transplantation (LTx) for HIES patients. We report the case of a 42-year-old female HIES patient with progressive bronchiectasis whose pulmonary infection was controlled prior to transplantation and subsequent LTx was uneventful. LTx may be feasible in HIES if the patient is immunologically stable preoperatively, and peri-operative infections, especially Aspergillus infections, are well-controlled.

A 37-year-old male was admitted with an atypical presentation of central nervous system (CNS) aspergillosis while on ibrutinib therapy for a CNS relapse of mantle cell lymphoma. This case highlights the importance of a high clinical suspicion of opportunistic infections in patients receiving small-molecule kinase inhibitors. This report includes a review of reported cases of Aspergillus infections in patients receiving ibrutinib and the shared features of these cases.

We describe the chemical synthesis of the fungal naphthopyrones YWA1 and fonsecin B, as well as their functionalization with an amine-spacer arm and the conjugation of the resulting molecules to three different functional tags (i.e., biotin, Oregon green, 1-[3-(succinimidyloxycarbonyl)benzyl]-4-[5-(4-methoxyphenyl)-2-oxazolyl]pyridinium bromide (PyMPO)). The naphthopyrone-biotin and -PyMPO constructs maintained the ability to bind the C-type lectin receptor MelLec, whose interaction with immunologically active fungal metabolites (i.e., 1,8-dihydroxynaphthalene-(DHN)-melanin and YWA1) is a key step in host recognition and induction of protective immune responses against Aspergillus fumigatus. The fluorescent Fonsecin B-PyMPO construct 21 was used to selectively visualize MelLec-expressing cells, thus validating the potential of this strategy for studying the role and functions of MelLec in immunity.

Aspergillus-fumigatus (Asp)-Infektionen stellen eine der Hauptursachen für Morbidität und Mortalität bei Patienten nach einer allogenen hämatopoetischen Stammzelltransplantation (HSCT) dar. Im Zusammenhang mit unzureichender Immunität des Wirts zeigen Antimykotika nur eine begrenzte Wirksamkeit, wobei zellbasierte Therapien sich als wirksam erwiesen haben, um Pilzinfektionen zu beseitigen. Komplexe und kostenintensive Protokolle behinderten jedoch ihre Implementierung in klinische Anwendungen. Wir kombinierten zwei komplementäre Ansätze, um Aspergillus-spezifische T-Zellen (ATCs) durch direkte magnetische Selektion von Interferon-gamma (IFN-γ) positiven ATCs mit dem Cytokine Capture System (CSA) für den sofortigen Patienteneinsatz und die kurzfristige Zellkulturexpansion zu generieren (STE) für 12 Tage. Außerdem verglichen wir die Stimulation mit zwei standardisierten und kommerziell erhältlichen Produkten: kombinierten Peptid-Pools (PepMix) und Asp-Lysat. Bei der schnellen CSA-basierten Methode beobachteten wir nur IFN-γ+ ATCs in Lysat-stimulierten Zellen, während die Stimulation mit PepMix unbefriedigend war. Im Gegensatz dazu zeigte der STE-Ansatz hochspezifische ATCs sowohl für Lysat als auch für PepMix. Unabhängig vom Stimulus expandierten überwiegend CD4+ T-Zellen im Vergleich zu CD8+ T-Zellen. CD4+ T-Zellen waren hauptsächlich vom zentralen Gedächtnistyp wobei CD8+ T-Zellen hauptsächlich Effektor-Gedächtnis-Zellen beinhalteten. Expandierte T-Zellen waren hochfunktionell und zytotoxisch aktiv, wie durch die Sekretion von Granzym-B und IFN-γ gezeigt werden konnte. Wir bieten hier eine schnelle und zuverlässige Methode zur Generierung funktionell aktiver ATCs und eine GMP-konforme Methode zur sofortigen und nachhaltigen Behandlung von Patienten mit invasiver Aspergillose. Aspergillus-fumigatus (Asp) infections constitute a major cause of morbidity and mortality in patients following allogeneic hematopoietic stem cell transplantation (HSCT). In the context of insufficient host immunity antifungal drugs show only limited efficacy and cell-based therapies have proven essential to clear fungal infections. However, complex and cost intensive protocols hampered their implementation into clinical applications. We combined two complementary approaches to generate Aspergillus-specific T cells (ATCs) using direct magnetic selection of Interferon-gamma (IFN-γ) positive ATCs with the Cytokine Secretion Assay (CSA) for immediate patient use and short-term cell culture expansion (STE) for 12 days. We further compared stimulation with two standardized and commercially available products: combined peptide-pools (PepMix) and Asp-lysate. For the fast CSA-based method we only observed IFN-γ+ ATCs in lysate-stimulated cells while stimulation with PepMix was unsatisfactory. In contrast, the STE approach revealed highly specific ATCs for both lysate and PepMix. Independent of the stimulus, predominantly CD4+ T-cells expanded compared to CD8+ T-cells. CD4+ T-cells were mainly of central-memory type and CD8+ T-cells effector-memory cells. Target cells were highly functional and cytotoxic as determined by secretion of granzyme-B and IFN-γ. We here provide a fast and reliable method to generate functionally active ATCs and provide a GMP-compliant method for both immediate and sustained treatment of patients with invasive Aspergillosis.

A 56-year-old healthy man who was a current smoker died from fulminant tracheobronchial aspergillosis despite a month of treatment with a combination of intravenous anti-fungal agents that had been started immediately after the diagnosis. This case report is important for understanding and managing fulminant Aspergillus infections in healthy subjects, although the pathogenesis and underlying pathways are still unknown.

The authors have requested that this preprint be removed from Research Square.

This work presents a novel work for the early detection of Aspergillus infected wheat by using porous silica nanospheres (PSN) to fabricated nanocomposite colorimetric sensors and multivariable models. The volatile organic compounds (VOCs) of three Aspergillus (Aspergillus glaucus, Aspergillus candida, and Aspergillus flavus) were investigated at different mildew stages. The synthesized nano-porous silica was employed to modify the colorimetric sensor. And then, the nanocomposite colorimetric sensor was used to analyze the VOCs metabolized by the infected wheat with different mildew degrees. The result shows that the nanocomposite colorimetric sensor could improve the chemical response of Aspergillus infected wheat in the initial stage (3–4lgCFU/g colonies) and mild mildew (4–5lgCFU/g colonies), and these infected wheat samples could be accurately distinguished. Principal component analysis (PCA) and linear discriminant analysis (LDA) were used to establish the identification model of infected wheat samples, it shows that 100% of infected wheat samples were correctly identified. Based on the achieved results, this work demonstrated that nanocomposite colorimetric sensor modified by PSN was an effective way for early detection of different Aspergillus infections in wheat.

AW is supported by the Wellcome Trust Strategic Award (grant 097377) and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of Aberdeen.

Keratitis produced by Aspergillus tamarii has been previously described associated to an ocular injury. We report a case in a contact lens wearer with a history of previous bilateral myopic LASIK ablation, bilateral intracorneal rings and vitrectomy and scleral buckling in his left eye. The fungus could be quickly identified combining phenotype, microscopy and mass spectrometry. Treatment with intravenous amphotericin, oral voriconazole, and topical amphotericin and natamycin and voriconazole was needed for corneal preservation.

Aspergillus infections are increasingly recognized as a global health problem because of limited antifungal drugs and occurrence of azole resistance worldwide. More cyp51-mediated and non-cyp51-mediated mechanisms of azole resistance have been identified in clinical and laboratory studies in recent years with applications of molecular biotechnology including next-generation sequencing, reverse genetics and so on. In this review, current research on the molecular mechanisms of azole resistance in A. fumigatus were presented and summarized and meanwhile the putative clinical relevance of these findings from bench work were discussed. Important aims are to gain more insight to mechanism of azole resistance and provide some efficient lead for prevention strategy.

New guidelines for the diagnosis and treatment of infections due to Aspergillus species were published in August of 2016 by the Infectious Diseases Society of America (IDSA) (1), replacing those previously published in 2008 (2). These guidelines incorporate new data published between January 2008 and December 2014. The document provides guidance on non-culture-based diagnosis of Aspergillus infections, discourages the use of combination anti-fungal therapy for primary management, and begins to define the place in therapy for isavuconazole, a new anti-fungal drug of the azole class approved by the U.S. Food and Drug Administration (FDA) in March 2015 to treat aspergillosis and mucormycosis.

Introduction: The incidence of Aspergillus lung infections is increasing in patients with structural lung disease & immune-suppressive conditions for the last few decades. Favourable environmental factors such as temperature and humidity exhibit an influence on the atmospheric concentration of aerosolized fungal spores. Material & Method: Patients with a diagnosis of lower respiratory tract infection growing Aspergillus in their respiratory samples were recruited from the inpatient and the outpatient department of a tertiary care hospital in the study over a period of two years. Results were retrospectively analyzed to find out if any correlation existed between the monsoon season & surge of Aspergillus lung infections. Results: Of the 31 patients recruited in the study, 16 patients had structural lung disease with a majority suffering from bullous lung disease. A higher incidence was observed in patients with multiple comorbidities. Most patients got admitted (n=22) and the predominant symptom was severe refractory cough (n=16). 20% patients had a co-existing bacterial infection. 10 out of 17 patients in 2016 and similarly 10 out of 14 patients in 2017 had positive aspergillus growths during the months of June to August implying that almost 74% patients recruited in the study had aspergillus growths in the monsoon season. Conclusion: Our study suggests that there is a definite surge of Aspergillus lung infections especially in patients with pre-existing lung diseases and multiple comorbidities during the monsoon season. Our study aims at increasing awareness in physicians about pulmonary Aspergillus infections especially in the monsoon season, although a larger study is however warranted to validate the findings.

© 2018 Taylor & Francis, The frequency and importance of Aspergillus infections is increasing worldwide. This study aimed to assess the occupational exposure of forklifts and taxi drivers to Aspergillus spp. Nineteen filters from air conditioning system of taxis, 17 from forklifts and 37 from personal vehicles were assessed. Filters extract were streaked onto MEA, DG18 and in azole-supplemented media. Real-time quantitative PCR amplification of selected Aspergillus species-complex was also performed. Forklifts filter samples presented higher median values. Aspergillus section Nigri was the most observed in forklifts filters in MEA (28.2%) and in azole-supplemented media. DNA from Aspergillus sections Fumigati and Versicolores was successfully amplified by qPCR. This study enlightens the added value of using filters from the air conditioning system to assess Aspergillus spp. occupational exposure. Aspergillus azole resistance screening should be included in future occupational exposure assessments., Project “Waste Workers’ Exposure to Bioburden in the Truck Cab during Waste Management – W2E Bioburden” (IPL/2016/W2E_ ESTeSL).

Background. Fungal infections of the central nervous system (FICNS) are important causes of morbidity and mortalityamong immunocompromised pediatric patients. Standard diagnostic modalities lack the sensitivity for detecting and therapeutically monitoring these life-threatening diseases. Current molecular methods remain investigational. (1!3)-β-D-glucan (BDG) is a cell wall component found in several fungal pathogens, including Candida and Aspergillus spp. Detecting BDG in cerebrospinal fluid (CSF) may be an important approach for detecting and therapeutically monitoring FICNS. To date, there has been no study that has investigated the effectiveness of CSF BDG as a diagnostic and therapeutic marker of FICNS in children. Methods. Serial BDG levels were measured in serum and CSF samples obtained from pediatric patients (aged 0–18 years) with a diagnosis of probable or proven Candida or Aspergillus CNS infection. Results. Nine cases of FICNS were identified in patients aged 1 month to 18 years. Two patients were infected with an Aspergillus species, and 7 patients were infected with a Candida species. All the patients at baseline had detectable BDG in their CSF. Among 7 patients who completed therapy for an FICNS, all elevated CSF BDG levels decreased to

Immunocompromised individuals are susceptible to pulmonary Aspergillus infections, whereas invasive Aspergillus infection is extremely rare in the presence of normal immunity. A case of larynx-tracheobronchial-pulmonary aspergillosis in an immunocompetent 57-year-old female host who was successfully treated with amphotericin-B and voriconazole is reported here.

Emerging fungal infections are an important component of infectious disease diagnosis and public health assessment. These infections cause significant morbidity and mortality and can be difficult to diagnose. Recent episodes of fungal infections are presented, including the ongoing Cryptococcus gattii outbreak in British Columbia, Canada, and the northwestern United States; the Apophysomyces trapeziformis infections associated with the Joplin, Missouri, tornado in 2011; the emerging unusual Aspergillus infections associated with antifungal prophylaxis; and the ongoing fungal meningitis outbreak associated with contaminated steroids. Lessons learned from these episodes are discussed in order to provide a platform for illustrating dilemmas in mycology. Useful tools to help the microbiology laboratory stay informed about emerging fungal infections are also discussed.

Invasive fungal infections are a major cause of morbidity and mortality in immunosuppressed patients with fatality rates ranging from 30 % to 80 % in neutropenic patients. This results at least partly in difficulties obtaining a reliable and early diagnosis, followed by the fact that clinical symptoms are unspecific and of very limited use. Conventional methods may be difficult and are often delayed. Serological tests like the galactomannan enzyme immunoassay are presently most promising for diagnosing invasive aspergillosis, however, sensitivity and specificity vary within the studies. This review reflects the current situation of diagnosing invasive fungal infections with a special focus on how to best diagnose Aspergillus-related infections (e.g., culture, microscopy, imaging techniques, CT-guided biopsies). Promising molecular techniques under development will be discussed and their potential for routine diagnostic applications (e.g. lateral flow device, polymerase chain reaction [PCR]-based assays, rolling circle amplification [RCA], loop-mediated amplification [LAMP], nucleic acid sequence-based amplification [NASBA]). A summary is given on commercial assays (e.g., Platelia Aspergillus®, Fungitell®, in situ hybridization, immunohistochemisty) and their purposes as screening tools and/or diagnostic tools. This review gives a future outlook on how to best diagnose Aspergillus infections.

The permanent contact with cork may lead to constant exposure to fungi, raising awareness as a potential occupational hazard in the cork industry.The presence of fungi belonging to the Penicillium glabrum complex has been associated with the development of respiratory diseases such as suberosis, one of the most prevalent diseases among workers from cork industries, besides occupational asthma. Azoles are used as pesticides but also the first line therapy in the treatment of Aspergillus infections; azole-resistance as been described as to have also an environmental source and is considered an emerging public health problem.The aim of this work was to characterize fungal distribution and to evaluate the presence of azole-resistant Aspergillus isolates in nose swab samples from the cork industry workers.

Amphotericin B (AMB) has been used for nearly five decades in the treatment of life-threatening mycoses. While triazoles and echinocandins have largely supplanted the routine use of AMB for common Candida and Aspergillus infections, this prototypical broad-spectrum agent or its lipid formulations are still preferred by many clinicians as the initial empiric antifungal therapy for severely immunosuppressed patients, and remain the preferred treatment in combination with 5-fluorocytosine for cryptococcal meningioencephalitis. This article reviews progress over the last decade in understanding the pharmacology and clinical dosing of AMB formulations for common systemic mycoses, including invasive candidiasis, cryptococcosis, aspergillosis and mucormycosis.

Human lungs are constantly exposed to a large number ofAspergillusspores which are present in ambient air. These spores are usually harmless to immunocompetent subjects but can produce a symptomatic disease in patients with impaired antifungal defense. In a small percentage of patients, the trachea and bronchi may be the main or even the sole site ofAspergillusinfection. The clinical entities that may develop in tracheobronchial location include saprophytic, allergic and invasive diseases. Although this review is focused on invasiveAspergillustracheobronchial infections, some aspects of allergic and saprophytic tracheobronchial diseases are also discussed in order to present the whole spectrum of tracheobronchial aspergillosis. To be consistent with clinical practice, an approach basing on specific conditions predisposing to invasiveAspergillustracheobronchial infections is used to present the differences in the clinical course and prognosis of these infections. Thus, invasive or potentially invasiveAspergillusairway diseases are discussed separately in three groups of patients: (1) lung transplant recipients, (2) highly immunocompromised patients with hematologic malignancies and/or patients undergoing hematopoietic stem cell transplantation, and (3) the remaining, less severely immunocompromised patients or even immunocompetent subjects.

Fungal infections remain a serious clinical problem with a high disease and financial burden, especially among immunocompromised and critically ill patients. Numerous efforts have not fully identified clinical and laboratory risk factors for increased susceptibility to fungal infections. The recent acquisition of knowledge about innate immune responses to fungi and genetic alterations in immunologic mechanisms has revealed additional genetic risk factors and has shed more light on the predisposition of individuals to fungal infections. The aim of this review is to address the findings of recent studies associating genetic factors with susceptibility to fungal infections, focusing on the most common opportunistic fungi, Candida and Aspergillus species.

Invasive fungal infections (IFIs) are important causes of morbidity and mortality in immunocompromised children. The increased incidence and high mortality rates associated with IFIs has led to development of novel antifungal agents to expand the breadth and effectiveness of treatment options available to clinicians. Since its initial approval in 1958, conventional amphotericin B deoxycholate had been considered the standard in treatment for IFIs. However, because of the dose-limiting toxicity of conventional amphotericin B deoxycholate, lipid formulations of amphotericin have been developed to potentially improve outcomes and mitigate the adverse effects associated with antifungal therapy. While less frequently employed today as prophylaxis (given the expanded availability of safer alternatives), amphotericin B is still considered a treatment option in select cases of severe or life-threatening IFIs. This article reviews the clinical use of amphotericin B for the prevention and treatment of IFIs.

Many ophthalmic units in the UK are housed in old buildings that may be in the process of being renovated. Outbreaks of nosocomial aspergillus infections have been reported among immunocompromised ophthalmic patients, which have been associated with hospital renovation and construction. Infection with aspergillus poses a serious threat to the vulnerable patient group, therefore, it is important to ensure that preventative measures are taken to decrease the risk of exposure to aspergillus spores during construction work. Early involvement of the infection control team in the planning stages and prior to commencement of any work is important to ensure that correct guidance is adhered to in order to minimize the risk of aspergillus infection in the vulnerable patient population.

Summary. The broad-spectrum oral triazole antifungal, itraconazole, has been shown to be effective in the treatment of superficial and systemic infections with fungi including Candida albicans, C. krusei and C. glabrata, Cryptococcus, Aspergillus, Histoplasma, Blastomyces and others. Its broad spectrum of activity, high and persistent tissue levels and favourable safety profile suggest that it may be appropriate for the prevention of opportunistic fungal infections in at-risk patients. In this study, itraconazole's prophylactic efficacy was tested against experimental models of Candida and Aspergillus infection. A single dose of 1.25 mg kg-1 or 2.5 mg kg-1, given 1 h before vaginal infection with C. albicans, protected 50% of treated rats. In systemic and disseminated candidosis, prophylaxis with itraconazole reduced both folliculitis and organ Candida content in guinea pigs. Amphotericin B was also used in this study and was found to be less efficacious than itraconazole. Itraconazole prolonged survival when administered to guinea pigs before experimental induction of systemic and invasive aspergillosis. In all cases, increasing the itraconazole dosage increased its prophylactic efficacy. Therefore, as the clinical efficacy of itraconazole is accurately reflected by the results of animal models, this study shows itraconazole to be a potential prophylactic therapy for patients at risk of opportunistic fungal infection. Zusammenfassung. Itraconazol, ein orales Breitspektrumantimykotikum aus der Gruppe der Triazole, hat sich bei der Behandlung von oberflachlichen und systemischen Pilzinfektionen als wirksam erwiesen, und zwar unter anderem bei Infektionen mit Candida albicans, C. krusei und C. glabrata, Cryptococcus, Aspergillus, Histoplasma und Blastomyces. Mit seinem breiten Wirkungsspektrum, den hohen und lange bestehenden Gewebskonzentrationen und der guten Vertraglichkeit konnte sich Itraconazol zur Prophylaxe von Infektionen mit opportunistischen Pilzen bei Risikopatienten eignen. In dieser Studie wurde die prophylaktische Wirksamkeit von Itraconazol mithilfe von experimentellen Modellen einer Candida- und Aspergillus-Infektion untersucht. Eine einzige Dosis von 1,25 mg oder 2,5 mg kg-1, die eine Stunde vor einer vaginalen Infektion mit C. albicans verabreicht wurde, schutzte 50% der behandelten Ratten vor dem Ausbruch der Krankheit. Im Fall einer systemischen und disseminierten Candidose bei Meerschweinchen wirkte sich die Prophylaxe mit Itraconazol sowohl gunstig auf die Follikulitis als auch auf das Ausmas des Organbefalls mit Candida aus. Das in dieser Untersuchung ebenfalls verwendete Amphotericin B stellte sich gegenuber Itraconazol als weniger wirksam heraus. Wurde Itraconazol Meerschweinchen vor einer experimentell verursachten, systemischen, invasiven Aspergillose verabreicht, wirkte es lebensverlangernd. In allen Fallen erhohte sich bei einer groseren Dosis auch die prophylaktische Wirkung des Itraconazols. Da die klinische Wirksamkeit von Itraconazol durch Ergebnisse von Tiermodellen genau untersucht ist, zeigt diese Studie, das Itraconazol moglicherweise bei der prophylaktischen Therapie von Patienten eingesetzt werden kann, bei denen die Gefahr einer Infektion mit opportunistischen Pilzen besteht.

Zusammenfassung: Virchow (1856) beschrieb die Aspergillose des Menschen als Inhalationsmykose der Lunge auf dem Boden vorbestehender Lungenkavernen. Obwohl diese atiologie nach wie vor voll gultig ist, erweiterte sich die Anzahl bekannter pradisponierender Faktoren fur die Entste-hung einer solchen Aspergillose erheblich: Bakterielle, virale und parasitare Lungenerkrankungen und deren antibiorische Behandlung, Corticoid- und Zytostatika-The-rapie im Rahmen generalisierender Erkrankungen, Immunsuppression nach Organtrans-plantation, alimentare StoffwechselstOrungen, wie bei Diabetes mellitus und Alkoholismus, sind im Zusammenhang zu nennen. Damit stieg auch die Erkrankungsrate sekundarer Infektionen durch Aspergillus-Arten. Neuere Beobachtungen belegen aber auch das Vorkommen primarer Aspergillus-Mykosen. Das nahezu ubiquitare Vorkommen von Schimmelpilzen fuhrt leider dazu, das sich Gefahrdete der Inhalation von Sporen kaum entziehen kOnnen. Auf der Suche nach Streuquellen fur Aspergillus-Arten wiesen Staib und Mitarbeiter wiederholt auf die Gefahrdung immun-supprimierter Personen durch kontaminierte Topfpflanzenerde hin. Umgebungsuntersuchungen nach wiederholtem Auftreten von Aspergillosen. in Krankenhausern stellten einen direkten Zusammenhang defekter Klimaanlagen, z.B. kontaminiert durch Taubenexkremente, mit diesen Hospitalinfektionen her. Neue Aspekte zur atiologie nosokomialer Aspergillosen lieferten retrospektive Fallberichte aus den Vereinigten Staaten uber gehauft auftretende Inhalationsmykosen im Bereich von Baumasnahmen in unmittelbarer und mittelbarer Umgebung von Kranken. Dabei waren Staubentwicklungen bei Abris- und Umbaumasnahmen im Umgang mit Feuerschutzmaterial und Kunststoffen eingezogener Zimmerdecken und Leitungen innerhalb von Kliniken ebenso mutmasliche Quellen hoher Konzentrationen an Pilzsporen wie Konstruktionsarbeiten beim Strasenbau nahe dem Klinikgebaude. Auch der Mensch und seine Kleidung sind bei der ubertragung von Aspergillus-Sporen auf Gefahrdete in Betracht zu ziehen, desgleichen Nahrungsbestandteile wie z.B. mit Pilzsporen behaftete Gewurze. Summary: Virchow (1856) has described human aspergillosis as inhalation mycosis on the basis of pre-existing pulmonary cavities. Although this etiology is still valid, the number of known predisposing factors for this mycosis is growing rapidly. Pulmonary infections due to bacteria, viruses and parasites and their resulting antibiotic treatment as well as concomitant therapy with corticosteroids and cytostatic drugs are to be mentioned in this connection as a result of generalized diseases, immunosuppression or organ transplantation, alimentary metabolic disorders such as diabetes mellitus and severe alcoholism. Consequently the frequency of secondary Aspergillus infections have increased markedly. Recent observations are furthermore connected with primary aspergillosis. Obviously the ubiquitous occurrence of mold spores makes it almost impossible for individuals at risk to avoid their inhalation. In their search for primary foci of aspergilli, Staib and coworkers pointed out repeatedly the danger of susceptible individuals being contaminated by soil from flower pots. Environmental studies after the observation of aspergillosis in hospitals demonstrated direct connections between damaged air conditioning systems contaminated by pigeon faeces and such hospital infections. Retrospective case reports on frequent pulmonary aspergillosis in the USA pointed to construction work in the immediate vicinity and the environment of such patients as the origin. The development of spore-loaded dusts during demolition or repair work was incriminated, and likewise the handling of fireprotective materials, plastic wall boards and connection lines within the hospitals were suspected to be sources of high concentrations of fungal spores. Construction and road work near the hospital areas may have played a similar role. Human carriers and their clothing must also be considered in the process of transmission as well as food ingredients such as spices which are frequently heavily contaminated with fungal spores.

Summary. Prophylactic treatment with human granulocyte colony-stimulating factor (hG-CSF) affords significant protection against systemic aspergillosis or pulmonary aspergillosis in neutropenic (cyclophosphamid-treated) mice but not in cortisone-treated animals. Cryptococcosis does not respond to hG-CSF therapy. Our data show that granulocytes play an important role in the immune defense against aspergillosis, but not against cryptococcosis. Combined treatment using hG-CSF and conventional antimycotics shows a significant beneficial effect in systemic or pulmonary aspergillosis. Zusammenfassung. Die prophylaktische Be-handlung mit dem granulozytenstimulierenden Faktor des Menschen (hG-CSF) gewahrt signifi-kanten Schutz gegen die tieflokalisierte Aspergillose und die Lungen-Aspergillose an neutropenischen, Cyclophosphamid-behandelten Mausen, nicht je-doch an Cortison-behandelten Tieren. Die Cryp-tococcose spricht auf hG-CSF-Therapie nicht an. Unsere Ergebnisse zeigen, das Granulozyten eine wichtige Rolle in der Immunabwehr der Aspergil-lose, nicht jedoch der Cryptococcose spielen. Die Kombinationsbehandlung mit hG-CSF und kon-ventionellen Antimykotika zeigte eine signifikante gunstige Wirkung auf die sytemische wie auf die Lungen-Aspergillose.

Aspergillus spp. are ubiquitous environmental fungi that are increasingly recognized as a cause of severe illness and mortality in immunocompromised patients. More than 60 outbreaks of healthcare-associated invasive aspergillosis have been described in the English literature. Information gained from outbreak investigations, especially control measures, form the basis for current guidelines to prevent healthcare-associated aspergillosis. Guidelines from the Centers for Disease Control and Prevention (CDC) and Healthcare Infection Control Practices Advisory Committee (HICPAC) provide evidence-based recommendations for preventing healthcare-associated aspergillosis and should be adopted by healthcare facilities.

This study was undertaken to determine the prevalence of female genital Aspergillus infections. Additionally, the study explored whether genital Aspergillus infections were associated with Aspergil...

An increasing incidence of invasive fungal infections is observed in most immunocompromised patients, and especially leukaemia patients. In order to decrease the mortality due to these infections, the clinicians need to optimise their treatment choices for the most common fungal infections observed in this population: invasive aspergillosis and candidiasis. These recommendations have been developed by an expert panel following an evidence-based search of the literature assessing the role of antifungal therapies in the treatment of patients with acute leukaemia or bone marrow transplantation and invasive candidiasis – including candidaemia – and aspergillosis. We present results from a questionnaire on the current practice among experts in Europe, show results of the literature search and provide the panel’s recommendations.

The prevention and management of bacterial, fungal, and viral infections are important components in the care of the liver transplant recipient. Although much progress has been made, challenges still remain. This article provides updates on the management of bilomas and peritonitis, the prevention and management of invasive Candida and Aspergillus infections, the prevention and management of cytomegalovirus disease, and the current status of liver transplantation in HIV-infected patients.

The aim of this study was to determine the prevalence of Aspergillus infections among the patients attending at tertiary care hospital and Hospital environment in Navi Mumbai, India, from January 2014 to December 2014. Total 1785 samples were included in this study for prevalence of Aspergillus species. Out of which 251(14.06%) were positive for Aspergillus infection. Species wise distribution of Aspergillus, maximum numbers were A. niger 142 (56.57%), followed by A. fumigatus 62 (24.70%), A. flavus 35 (13.94%), A. brasiliensis 9 (3.59%) and A. terrus 3 (1.20%). Aspergillus infection prevalence in male patients was 3-fold higher than in female patients. Most infection occurred in age group 51 and above years.