ASPERGILLUS AND LUNG-TRANSPLANT RECIPIENTS - A MYCOLOGICAL AND MOLECULAR EPIDEMIOLOGIC-STUDY

Background: After lung transplantation, filamentous fungi and mon part icularly Aspergillus fumigatus are commonly isolated, although the ori gin of contamination is unclear. Methods: To investigate the fungal fl ora in bronchoscopic fluids, we retrospectively reviewed 20 cases of l ung transplant recipients. Using sequence-specific DNA primers analysi s, we typed the clinical strains of A. fumigatus isolated from 6 lung transplant recipients. For 4 of them, the strains of this species were isolated from their environment. Results: At least once 90% of patien ts had filamentous fungi, and A. fumigatus was the most frequently iso lated. Bronchial colonization was detected in 14 patients, invasive br onchial mycosis was diagnosed in 4 others, and no case of invasive pul monary fungal infection was detected. Genome typing of the 47 clinical strains revealed that a given patient could be affected by several di fferent strains. A very extensive polymorphism existed among the 38 en vironmental strains. Origin of contamination at home was possible in 1 case and in the hospital in 3 cases. Conclusions: Bronchial colonizat ion is frequent after lung transplantation. Although the clinical stra ins show a polymorphism, it is less widespread than the polymorphism o f environmental strains. The origin of acquisition may be in the patie nt's community.