Environmental variables associated with an increased risk of invasive aspergillosis

Abstract

Information on the environmental variables that may affect the incidence of invasive aspergillosis (IA) is scarce. We sought to determine the relationship between airborne spore counts, climatic conditions and IA. We also examined whether circulating respiratory viruses predispose patients to IA in a multicentre cohort study of hospitalized adults with IA. Data on environmental mould spores, climatic conditions and circulating respiratory viruses were obtained from the Environmental Department of the Autonomous University of Barcelona, the Meteorological Service of Catalonia and the Acute Respiratory Infection Surveillance Project in Catalonia, respectively. Between 2008 and 2011, 165 patients with IA were identified. Diagnosis was based on one or more of the following: culture (125 cases), galactomannan antigen (98) and histology (34). One hundred and twenty-seven cases (77%) had criteria for probable IA and the remainder for proven IA. Environmental mould spore counts from the period 28-42 days preceding infection presented significant associations with admissions due to IA. None of the climatic conditions were associated with an increased risk of IA, but the presence of circulating respiratory viruses was associated with a higher risk of infection: the most strongly associated viruses were respiratory syncytial virus, influenza A(H1N1)pdm09 and adenovirus. In conclusion, the presence of high numbers of spores in the air increases the risk of admission due to IA. Circulating respiratory viruses appear to be associated with a higher risk of developing IA. Physicians should be aware of this association in order to optimize prevention and diagnosis strategies for IA during viral epidemic periods.

10 years of prophylaxis with nebulized liposomal amphotericin B and the changing epidemiology ofAspergillusspp. infection in lung transplantation

“…colonization and infection rates have decreased in the last 5 years in our center. In contrast to the findings from a recent epidemiologic study on Aspergillus species in Spain and previous series in LTR , significant increases have occurred in colonization and infection by Aspergillus species with reduced susceptibility or resistance to AB. However, these species did not seem to be associated with lower successful outcome or higher mortality in our series.…”

Epidemiology and Immediate Indirect Effects of Respiratory Viruses in Lung Transplant Recipients: A 5-Year Prospective Study

“…Previous studies have suggested that an RV infection may be a risk factor for subsequent Aspergillus spp. infection (25). In our study, no statistical association was found, probably because of a statistical limitation related to a low incidence of aspergillosis secondary to an effective antifungal prophylaxis regimen (26).…”

Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study

“…Although respiratory viral infections, including influenza, respiratory‐syncytial virus (RSV) and parainfluenza, have been identified as risk factors for IA in allogeneic hematopoietic cell transplant recipients, there have been no prior reports to implicate these infections in the pathogenesis of IA in SOTr . More recently, an association between IA and infections due to influenza H1N1 virus, adenovirus and RSV was reported in a cohort of variable immunocompromised hosts, including SOTr, with the vast majority being patients with hematologic malignancies . In contrast, another recent study failed to identify any possible association between respiratory viral infections and IA in a cohort of asymptomatic lung transplant recipients with positive nasopharyngeal swabs for a respiratory virus .…”