Risk of fungal infection from foods, particularly in immunocompromised patients

The aim of our study was the evaluation of fungal contamination of food distributed in hospitals to the immunocompromised patients. 97 samples of 10 sorts of fruit, 100 samples of 17 sorts of cheeses and 56 samples of 11 sorts of smoked meat products were investigated by cultivation on Sabourand's agar at 25 degrees C for 10 days. The yeasts (Candida, Trichosporon, Saccharomyces, Rhodotorula, Aureobasidium) were found in 82% of fruit, in 13% of cheeses and in 46% of smoked meat products. The filamentous fungi (Cladosporium, Alternaria, Penicillium, Aspergillus, Mucor and Helminthosporium) were found on all samples of fruit, in 44% of cheeses and in 3% of smoked foods. Our results show that the fungal contamination of the investigated food is not negligible. The isolated strains are agents of candidoses, phaeohyphomycoses, mucormycoses and aspergilloses and can kill immunocompromised patients.     

Comparisons of seasonal fungal prevalence in indoor and outdoor air and in house dusts of dwellings in one Northeast American county

Fungi cause allergies and many other adverse health effects. In this study, we characterized the nature and seasonal variation of fungi inside and outside homes in the Greater New Haven, Connecticut area. Three indoor air samples (in the living room, bedroom, and basement) and one outdoor sample were collected by the Burkard portable air sampler. House dust samples were collected in the living room by a vacuum cleaner. The mold concentrations varied widely from house to house in both indoor and outdoor air. No significant difference (p>0.05) in concentration and type of fungi between living room and bedroom or by season was observed. Both concentration and type of fungi were significantly higher (p<0.05) in the basement than other indoor areas and outdoor air in winter. The type of fungi in living room, bedroom, and outdoor air were found to have significant changes among seasons, but there was no significant difference for the basement among seasons. Cladosporium spp. was dominant in both indoor and outdoor air in summer. Penicillium and Aspergillus were dominant in indoor air in winter, but neither was dominant in any season in outdoor air. The type of fungi and their concentrations in house dust samples were not representative of those isolated in indoor air. In dust samples, more Mucor, Wallemia, and Alternaria species, but less Aspergillus, Cladosporium, and Penicillium species were found in all seasons. Air sampling in spring or fall in every suspected house is suggested for year-round fungal exposure assessment.     

The fungal profile of cotton lint from diverse sources and implications for occupational health

There is mounting evidence that inhalation of fungal spores and their fragments and toxins may cause respiratory illness, particularly in indoor environments and industrial settings. However, analysis of these organisms on cotton has not been carried out in detail and, hence, further examination may prove important in identifying sources of these organisms and assessing the risks posed to cotton workers. This study identified fungi from cotton lint samples originating in 12 world regions and revealed six different fungal genera, with the following rank order of sample isolation incidence: Aspergillus > Cladosporium > Fusarium > Rhizopus > Penicillium > Alternaria. Aspergillus was the most common genus and Aspergillus niger in particular was the pecies most frequently identified. Improved understanding of the variety of organisms that contaminate cotton may help to reduce prevalence of organic dust-related lung diseases.     

Correlation between the prevalence of certain fungi and sick building syndrome

OBJECTIVE: To examine the role of fungi in the production of sick building syndrome. METHODS: A 22 month study in the United States of 48 schools (in which there had been concerns about health and indoor air quality (IAQ). Building indoor air and surface samples, as well as outdoor air samples were taken at all sites to look for the presence of fungi or their viable propagules. RESULTS: Five fungal genera were consistently found in the outdoor air and comprised over 95% of the outdoor fungi. These genera were Cladosporium (81.5%), Penicillium (5.2%), Chrysosporium (4.9%), Alternaria (2.8%), and Aspergillus (1.1%). At 20 schools, there were significantly more colony forming units per cubic metre (CFU/m3) (p < 0.0001) of propagules of Penicillium species in the air samples from complaint areas when compared with the outdoor air samples and the indoor air samples from noncomplaint areas. At five schools, there were more, although not significant (p = 0.10), Penicillium propagules in the air samples from complaint areas when compared with the outdoor air samples and the indoor air samples from noncomplaint areas. In 11 schools, the indoor air (complaint areas) fungal ratios were similar to that in the outdoor air. In these 11 schools Stachybotrys atra was isolated from swab samples of visible growth under wetted carpets, on wetted walls, or behind vinyl wall coverings. In the remaining 11 schools, the fungal ratios and CFU/m3 of air were not significantly different in different areas. Many of the schools took remedial action that resulted in an indoor air fungal profile that was similar to that outdoors. CONCLUSIONS: Propagules of Penicillium and Stachybotrys species may be associated with sick building syndrome.

 

     

Frequencies of airborne moulds in Zagreb

Airborne fungi are sometimes associated with several respiratory diseases and allergies. This paper describes a study of qualitative and quantitative variations in the occurrence of airborne moulds in Zagreb area on three locations: centre of the city (C), Pharmaceutical Botanical Garden "Fran Kusan" (BG) and the mountain Medvednica (M) during autumn, winter, spring and summer 2002-03. Lower concentrations of airborne moulds were found in all three locations in autumn (up to 76.88 CFU/m3) and winter (31.46 CFU/m3), with significantly higher levels in C and BG than in M (P<0.001). In spring and summer, these concentrations were much higher in all sampling sites and were significantly higher in C (160.00 CFU/m3) and BG (134.00 CFU/m3) in spring than in M (90.07 CFU/m3) (P<0.001). In summer, significantly higher concentration was found in C (237.5 CFU/m3) than in BG (186.50 CFU/m3) (P<0.01), while concentrations in C and M (216.70 CFU/m3) were similar. Airspora belonging to 29 fungal genera were identified, and allergologicaly significant moulds, Cladosporium (up to 79.5%) and Alternaria (up to 59.4%) dominated in all sampling sites. Penicillium, Fusarium and Aspergillus were also constant fungal entities (43.0-70.5%), but in much lower concentrations than Cladosporium and Alternaria. Airsporas of Cladosporium and Alternaria were more frequent in spring and summer in all locations, with significantly higher concentrations in C and BG (P<0.05). The risk from allergies increases with higher airspora concentrations in spring and summer due to an increase in Cladosporium and Alternaria.     

室内常见气传真菌的分布及其培养提取物的免疫抑制作用研究

目的 了解室内常见气传真菌的分布及其影响因素,并分析其代谢提取物对呼吸道免疫功能的影响。方法 以平皿沉降法进行室内环境气传真菌的采样,并进行菌株鉴定及其分布影响因素的分析;同时以改良的混合淋巴细胞反应研究了室内常见气传真菌代谢提取物的非特异性免疫抑制作用。结果 室内环境中的主要真菌污染源为芽枝菌属、曲霉属、交链孢属、镰刀霉属、青霉属等,影响室内真菌分布的主要因素为温度、湿度及室外菌落数;青霉属、曲霉属的代谢提取物在无明显的细胞毒性浓度下,可抑制异型小鼠淋巴细胞混合刺激而产生的增生。结论 长期暴露于室内气传真菌对人体呼吸道防御功能构成了潜在的威胁。     

Exposure status of East and West German households with house dust mites and fungi

The interrelation between biological pollution of indoor spaces and health disorders, allergic symptoms and health issues in general is well known. Besides animal epithelia, the exposure to house dust mites and mould fungi is considered a serious risk factor. In the scope of a comparative study involving school beginners in East and West Germany (launched in 1991), dust was vacuumed from a total of 218 mattresses of children's beds and checked for their content of house dust mites and mould fungi. This investigation aimed at assessing the degree of exposure, to determine regional differences, if any, and to uncover the correlation between exposure and symptoms. Dust mite infestation was highest in the small town of Borken in Westphalia (in 86% of the specimens > 2 micrograms mite allergens/g of dust) and lowest in Magdeburg in Saxony-Anhalt (55.3%). Total concentrations of mould fungi varied from 1.4 x 10(3) CFU/g of dust and 300 x 10(3) CFU/g of dust with a geometric mean of 26.5 x 10(3) CFU/g of dust. A total of 41 different genera/species were identified. Most frequent were the following genera: Penicillium, Eurotium, Aspergillus, Alternaria, Epicoccum and Cladosporium. The importance of individual factors influencing was confirmed. Humidity decreases the higher the flat is situated in a building. This partly explains the differences in concentrations between Borken where children live mainly on the ground floor, and the other cities with taller buildings. Spores of mould fungi were discovered more frequently in mattresses from humid flats. An association between biological indoor space factors and some allergological parameters seemed obvious, however, due to the small size of the test group most of them were not significant.     

Fungal air-borne spores as health risk factors among workers in alimentary industries

A survey to evaluate the occurrence of air-borne fungal spores in two different food industries, dairies and bakeries, was conducted. Our data revealed considerable fungal pollution in the environments of both industries, as well as some differences in the distribution of the genera of fungi recovered.Noteworthy was the frequent finding of numerous fungi frequently responsible for allergic rhinitis, asthma and other diseases, or well-known for their production of mycotoxins in foods or characterized by their degradative activity against various substances. Aspergillus, Candida, Fusarium, Geotrichum, Mucor and Penicillium were the most common genera identified in dairies while Alternaria, Aspergillus, Botrytis, Candida, Cladosporium, Penicillium and Saccharomyces occurred more frequently in bakeries.The survey showed that fungi can play a significant role in allergic and non-allergic diseases in modern working environments.     

Hintergrundkonzentrationen von Schimmelpilzen in Hausstaub

Mold concentrations of house dust samples from dwellings reportedly free from mold infestations were analysed to obtain background values. Samples from carpet floors were taken from 80 dwellings in three parts of Germany in winter and summer. Samples were analysed with the cultivation method (using suspension). This resulted in the detection of 35 mold species or genera. Concentrations of the genera Alternaria, Cladosporium, Fusarium and yeast increased in summer. In contrast concentrations of Aspergillus and Penicillium in the summer samples were nearly equal to those in the winter samples. The majority of the various molds were only found in a number of samples too small for a reliable comparison of the winter and summer findings to be made. The results were compared with findings of other authors. The authors propose the concentrations of the 95th percentile of each species (when representing over 10,000 KBE/g of dust) as background values, while a threefold higher value is regarded as an indication of mold presence. An exception should be made for the concentrations of molds which increase sharply in the outdoor air in summer. Because of the difficulty in estimating the outdoor influence, no evaluation proposals can be given for these species for the summer season.     

Characteristics of indoor and outdoor bioaerosols at Korean high-rise apartment buildings

This study attempted to evaluate the bioaerosol exposure of apartment residents at high-rise apartment buildings in a Korean city. The characteristics associated with the bioaerosol exposure included the apartment floor, seasonal variation, summer survey period (seasonal rain-front period (SRFP) or no rain-front period (NRFP)), and room location inside an apartment. Four most prevalent fungal genera detected in both the indoor and the outdoor air were Cladosporium, Penicillium, Aspergillus, and Alternaria. The outdoor bacterial concentrations were significantly higher in the low-floor apartments than in the high-floor apartments. However, the bacterial and fungal concentrations in the interior air of the apartments were not significantly different between the low- and the high-floor apartments. The current bioaerosol concentrations were comparable to those in other reports, with geometric mean (GM) bacterial values between 10 and 10(3) CFU m(-3) and fungal aerosol concentrations in homes ranging also from 10 to 10(3) CFU m(-3). The indoor and outdoor fungal concentrations and the outdoor bacterial concentrations were usually higher in the summer than in the winter. The indoor and outdoor bioaerosol concentrations were both higher for the SRFP than for the NRFP. The difference in the total bacterial concentrations was not significant among the surveyed five rooms. The GM total fungal and Cladosporium concentrations, however, were significantly higher for the kitchen than for the other rooms.     

Moulds and mycotoxins in herb tea and medicinal plants

The level of toxigenic moulds and mycotoxins were analyzed in 62 samples of medicinal plant material and 11 herbal tea samples. The most predominant fungi detected were: Aspergillus, Penicillium, Mucor, Rhizopus, Absidia, Alternaria, Cladosporium and Trichoderma. Aspergillus flavus, a known producer of the aflatoxin mycotoxin, was present in 11 or 18% of the 62 medicinal plant samples and in 1 or 9% of the herbal tea samples. The medicinal plant samples, contaminated with A. flavus were also analyzed for the mycotoxins aflatoxin, ochratoxin and zearalenone; ochratoxin was found in one of the 7 samples analyzed. This study suggests that medicinal plant material and possibly herbal teas, if stored improperly allowing for mould growth, should be analyzed for mould and mycotoxin prior to use.     

饮用天然矿泉水水源霉菌菌相分析

目的 掌握饮用天然矿泉水水源霉菌污染现状。方法 对69个灌装厂有的73处饮用天然矿泉水水源采样调查。结果 在73件水源样品中45份（61.64%）检出霉菌982株。半知菌类发现频率最高，藻状菌纲，子囊菌纲、担子菌纲较少见。检出的18个霉菌属中，曲霉（50.41%) 、枝孢霉（33.81%）占较大优势，青霉、木霉、镰刀菌等属也较常见。霉菌检出与水源菌落总数、大肠菌群、亚硝酸盐等指标的相关性无显著意义。结论 饮用天然矿泉水水源的霉菌主要来源于开采后的外界污染。     

Exposure assessment of indoor allergens, endotoxin, and airborne fungi for homes in southern Taiwan

This study was undertaken to examine the seasonal variations of domestic Der p 1, Der p 2, and endotoxin on mattress and airborne fungal concentrations in homes of asthmatic and nonasthmatic children in southern Taiwan, where temperature and relative humidity are usually high throughout the year. A group of asthmatic children (10-12 years old) were selected randomly based on a citywide questionnaire survey. The nonasthmatic children were chosen to be in the comparison group by matching in age, gender, and proximity of residence. Environmental sampling of domestic microbes was conducted once a month for a year. Twelve calendar months were grouped into spring, summer, fall, and winter according to weather data (mainly average temperature and humidity) from the Central Weather Bureau. Dust samples from a child's mattress and airborne samples from a child's bedroom were collected and analyzed for allergens of Der p 1 and Der p 2, endotoxin, and fungi respectively. Results show that about 65% of children's mattresses in our region have Der p 1 levels greater than 2 microg/g. It is also apparent that most airborne fungal concentrations found in homes of either asthmatic or nonasthmatic children are higher than the recommended levels of concern. The predominant genera are Cladosporium, Aspergillus, Penicillium, Alternaria, and yeast. In addition, seasonal effects seem to be a critical factor for the concentrations and distributions of domestic endotoxin in these study homes. The implication of long-term exposure to these high levels of environmental microbes and how their effects vary with seasons remain to be further characterized.     

眼部丝状真菌感染的诊断与致病菌分离鉴定

目的 分析眼部丝状真菌感染致病菌的种类和致病特征。方法 对13例眼部丝关真菌感染患者的临床资料进行分析和致病菌分离鉴定，对眼部丝状真菌感染的致病菌、发病原因、早期诊断方法、丝状真菌与酵母菌眼部感染特征进行分析。结果 13例患者中11例为真菌性角膜溃疡，2例为真菌性眼内炎；13例15眼标本真菌培养均为丝状真菌，其中痂病镰刀菌2例、烟曲霉2例、谢瓦曲霉1例、黄曲霉1例、链格孢霉1例、尖端单孢子菌1例、总关毛霉1例、链霉菌1例。结论 眼部丝状真菌感染仍以镨刀菌、曲霉为主，但有明显的多样化趋势；确定诊断须真菌检查，早期是预后良好的关键。     

Monitoring of airborne fungus and yeast species in a hospital unit

OBJECTIVE: To monitor and characterize airborne filamentous fungi and yeasts from abiotic and biotic sources within a hospital unit. METHODS: Collections were carried out on a monthly basis, at two different time periods, from the adult and pediatric intensive care units and surgical center of a hospital in Araraquara, Southeastern Brazil. Collection of airborne fungi was carried out using a simple-stage Andersen sample. The presence of yeasts was investigated in samples taken from the hands and oropharynx of staff members as well as from the surface of beds and doorknobs inside the critical areas. RESULTS: Thirty-two genera of airborne fungi and were recovered from the surgical center and 31 from the intensive care units. Genera most frequently isolated were Cladophialophora spp., Fusarium spp., Penicillium spp., Chrysosporium spp. e Aspergillus spp. During the study period, a new unit was built in the hospital, which coincided with an increase in Cladophialophora spp., Aspergillus spp., and Fusarium spp. colony counts. Yeasts were found in 39.4% of samples obtained from healthcare staff (16.7% from interdigital spaces, 12.1% from nailbeds, and 10.6% from oropharynx) and in 44% of furniture samples, with a predominance of the Candida genus ((C. albicans, C. guilliermondii, C. parapsilosis e C. lusitaniae), followed by Trichosporon spp. CONCLUSIONS: We found a relatively high number of airborne fungi (potentially pathological) in special areas and expressive levels of yeasts in both biotic and abiotic samples. Microbiological and environmental monitoring should be conducted, especially in special areas which include immunocompromised patients, who are more susceptible to the exposure to environmental and staff-derived pathogens.     

Evaluating fungal populations by genera/species on wide body commercial passenger aircraft and in airport terminals

Given the potential health effects of fungi and the amount of time aircrew and passengers spend inside aircraft, it is important to study fungal populations in the aircraft environment. Research objectives included documenting the genera/species of airborne culturable fungal concentrations and total spore concentrations on a twin-aisle wide body commercial passenger aircraft. Twelve flights between 4.5 and 6.5 h in duration on Boeing 767 (B-767) aircraft were evaluated. Two air cooling packs and 50% recirculation rate (i.e. 50:50 mix of outside air and filtered inside air) were utilized during flight operations. Passenger occupancy rates varied from 67 to 100%. N-6 impactors and total spore traps were used to collect sequential, triplicate air samples in the front and rear of coach class during six sampling intervals throughout each flight: boarding, mid-climb, early cruise, mid-cruise, late cruise and deplaning. Comparison air samples were also collected inside and outside the airport terminals at the origin and destination cities resulting in a total of 522 culturable and 517 total spore samples. A total of 45 surface wipe samples were collected using swabs onboard the aircraft and inside the airport terminals. A variety of taxa were observed in the culturable and total spore samples. A frequency analysis of the fungal data indicated that Cladosporium, Aspergillus and Penicillium were predominant genera in the culturable samples whereas Cladosporium, Basidiospores and Penicillium/Aspergillus were predominant in the total spore samples. Fungal populations observed inside the aircraft were comprised of similar genera, detected significantly less frequently and with lower mean concentrations than those observed in typical office buildings. Although sources internal to the aircraft could not be ruled out, our data demonstrate the importance of passenger activity as the source of the fungi observed on aircraft. Isolated fungal peak events occurred occasionally when concentrations of a particular genus or species rose sharply inside the cabin for a limited period. Overall, our research demonstrates that on the sampled flights the B-767 filtration system operated efficiently to remove fungal spores when two air cooling packs and 50% recirculation rate were utilized during flight operations.     

Fungal levels in the home and allergic rhinitis by 5 years of age

Studies have repeatedly demonstrated that sensitization to fungi, such as Alternaria, is strongly associated with allergic rhinitis and asthma in children. However, the role of exposure to fungi in the development of childhood allergic rhinitis is poorly understood. In a prospective birth cohort of 405 children of asthmatic/allergic parents from metropolitan Boston, Massachusetts, we examined in-home high fungal concentrations (> 90th percentile) measured once within the first 3 months of life as predictors of doctor-diagnosed allergic rhinitis in the first 5 years of life. In multivariate Cox regression analyses, predictors of allergic rhinitis included high levels of dust-borne Aspergillus [hazard ratio (HR) = 3.27; 95% confidence interval (CI), 1.50-7.14], Aureobasidium (HR = 3.04; 95% CI, 1.33-6.93), and yeasts (HR = 2.67; 95% CI, 1.26-5.66). The factors controlled for in these analyses included water damage or mild or mildew in the building during the first year of the child's life, any lower respiratory tract infection in the first year, male sex, African-American race, fall date of birth, and maternal IgE to Alternaria > 0.35 U/mL. Dust-borne Alternaria and nonsporulating and total fungi were also predictors of allergic rhinitis in models excluding other fungi but adjusting for all of the potential confounders listed above. High measured fungal concentrations and reports of water damage, mold, or mildew in homes may predispose children with a family history of asthma or allergy to the development of allergic rhinitis.     

上海市气传真菌污染的调查研究

采用平皿沉降法于１９９７年对上海市６个功能区的大气真菌进行了为期１年的监测,并进行了菌株鉴定和影响因素的研究分析。结果表明,上海市全年气传真菌数量变化曲线呈双峰型。上海市空气中常年飘散着多种真菌,芽枝菌属、交链孢属、红酵母属、酵母菌属和青霉属等为优势菌群。红酵母及酵母属所占比例较高。垃圾中转站、火车站、南京路地区的气传真菌数量位居前列,大气中真菌污染较为严重。     

镇江市区气传真菌调查结果与哮喘关系的研究

目的 为了探明本地区空气中飘乳真菌种类、数量和季节消长,以及真菌与过敏性哮喘的关系。方法 采用曝皿法对气传真菌进行了全年调查,同时采用过敏原皮内试验对已筛选过的交链孢霉、枝孢芽枝菌等八种常邮真菌进行致敏性研究。结果 曝皿法收集到真菌菌落571个,18个种属。真菌菌落飘散的高峰期是4－11月。曝片法收集到各类真菌孢子7045个,共27个种属。5－11月是真菌孢子飘散的高峰。在376例支气管哮喘病人中,有150人至少对八种真菌中的一种皮试结果呈阳性反应,阳性率为39.9%。从150例皮试阳性的真菌过敏性哮喘病人的发病季节中可以发现：季节性发病的病人最多（101例）占67.3%,其中以秋季发病最多点50％,其闪为夏季发病者占27.2%;常年性发病伴季节性加剧的病人其病情加剧的月份大从在6月－11月间占87％。结论 镇江市城区大气中普遍存在真菌,一年四季均存在,但以秋季最高,优势真菌为交链孢霉、枝孢霉等,真菌过敏性哮喘的发病率为39.8%,其好发季节为秋季。     

Fungi genus and concentration in the air of onion fields and their opportunistic action related to mycotic keratitis

The authors determined fungi concentrations and genera from onion fields located in monsoon and nonmonsoon areas of Taiwan, as well as concentrations from a county housing location, which served as the comparison site. The authors explored the relationship(s) among onion harvesting, monsoon characteristics, airborne fungal levels, and mycotic eye infection. Airborne fungal levels in the onion field in the nonmonsoon area were the highest, followed by decreasing levels in the monsoon area and control sites, regardless of the sampling periods. The geometric mean of airborne fungal concentrations was the highest during onion harvesting. Cladosporium was the most dominant fungus during pre- and postharvest seasons, whereas Aspergillus, Fusraium, Acremonium, Alternaria, Penicillium, Monilia, Mycelia, and Rhizopus were increased significantly during harvesting. Although fungal concentrations in monsoon onion fields were lower than concentrations measured in the nonmonsoon area, the invasion of dangerous fungal pathogens following eye trauma by airborne sharp exotics (e.g., onion flakes) dispersed in high wind may account for the increase in corneal ulcer cases that occur in the monsoon area.