We report a case of primary cutaneous infection by the emerging fungus Aspergillus ustus in an immunosuppressed patient after a domestic accident. Aspergillus ustus is a mold that rarely infects humans; only 15 systemic cases have been reported. We report the first outbreak of invasive infection caused by A . Med Mycol. Jun;45(4) Clustering of invasive Aspergillus ustus eye infections in a tertiary care hospital: a molecular epidemiologic study of an.
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Sterigmatocystis usta Bainier Aspergillus minutus Abbott Aspergillus ustus var.
Thus, the source of A. Aspergillus ustus group colony on Modified Leonian’s agar. PCR products underwent sutus in 1. Recognition of invasive infections that occurred in 2 clusters of hematopoietic stem cell transplant HSCT recipients in our institution prompted us to perform a more thorough clinical investigation and environmental sampling to identify potential sources of acquisition.
Aspergillus ustus is a microfungus and member of the division Ascomycota. Journal of Clinical Microbiology. A spot map depicting case-patient location and timeline relating location to time of diagnosis was created.
Information on timing of construction activities and airflow information was obtained from hospital engineering and infection control personnel.
Aspergillus ustus is a group of filamentous hyalohyphomycetes consisting of 5 species: Fever, chest pain, nodular pulmonary opacity. The most common cause of IA is Aspergillus fumigatus 2.
These cases illustrate the potential for uncommon species like A. Curr Infect Dis Rep. An attack rate was estimated among the potentially exposed HSCT patients using as the denominator axpergillus number of patients who were admitted for HSCT from July through October and March through Septemberthe at-risk periods when cases occurred. Most of these infections were caused by A.
J Am Chem Soc. The relative pathogenicity of this Aspergillus species has not been well studied. The isolates recovered from the 5 HSCT were genetically similar. However, the environmental niche of this fungus is not known. At the time of his diagnosis and death, patient 2 resided in a room directly adjacent to and above the room of patient 5, albeit 2 years earlier Figure 1.
The pH of the medium is not modified by the species final pH 6. One of the first metabolites to be isolated and characterized from this fungus, ustic acid C 11 H 7 O 7reacts with Iron III chloride to form a deep purple-colored compound. Based on the clustering of cases in space and time and molecular data, common-source acquisition of this unusual drug-resistant species is possible.
Acknowledgments We thank Estella Whimbey and Nancy Whittington for their help with acquiring information on hospital airflow and construction activity, Robin Olsen for performing the environmental air sampling, Chris Davis for database support, David Madtes and Pat McDowell for obtaining bronchoscopic information, and S.
The results of molecular analyses suggest genetic similarity of isolates recovered from patients.
Environmental Sampling Based on the spot map, environmental air sampling of patient hospital rooms was performed, and environmental isolates were obtained. Since these patients resided in rooms within close proximity, common source acquisition e. Centralbureau voor schimmelcultures, Aspergjllus, Delft, Specifically, genomic rearrangement with recombination, which has been postulated to occur in several species of Aspergillusmay increase the variation observed between related strains All members of the A.
A phylogenetic study of Aspergillus section Usti using morphologysecondary metabolite chemistry and gene sequencing beta-tubulin and calmodulin revealed 21 distinct species and showed an affiliation of the section with two teleomorph genera, Emericella and Fennellia. Possible emission of a yellowish pigment.
Analyses of Isolates Eleven Asperbillus.
Aspergillus ustus – Wikipedia
Three isolates from patient 5 were genetically most similar to the isolate from patient 2. We report the first outbreak of disease caused by an unusual fungal pathogen, A. Spot map illustrating case-patient location on the northwestern aspergillud of the eighth floor 8NE and the seventh floor 7NE from the left panel and outbreaks right panel at the time of case diagnosis.
Nielsen KF Mycotoxin production by indoor molds. This species shows elevated resistance to antifungal drugs; however, four classes of drugs itraconazole a triazolevoriconazolecaspofungin and amphotericin B demonstrate fungicidal effectiveness that is most pronounced in combination.
Patients were in and out of the hospital after transplantation, so infection could have been acquired in the environment. CMV, parainfluenza pneumonia; BK virus hemorrhagic cystitis. Gel images A and composite dendrogram B are shown. Lippincott Williams and Wilkins; Antifungal drug susceptibility testing of A. We report here the first cluster of Aspergillus ustus endophthalmitis cases which occurred in a large tertiary care hospital during the period October to June Random amplification of polymorphic DNA may give valuable clues about the clonality of A.
Many reported cases have been either primary cutaneous disease or disseminated infection, however, we cannot draw firm conclusions regarding the types of infections this organism causes because of the high likelihood of reporting bias. RAPD and phylogenetic analysis showed genetic similarity between isolates from different patients. The conidia heads are columnar when mature with hemispherical or globose and generally pigmented vesicles.
Bilateral pulmonary consolidation, skin lesion.