Abstract：
BACKGROUND: Patients with hematological malignancies are at a high risk of developing invasive fungal infections (IFI) because they undergo several cycles of treatment leading to episodes of neutropenia. In addition, they alternate between hospital stays and periods spent at home. Thus, when an IFI is diagnosed during their hospital stays, it is highly challenging to identify the origin of the fungal contamination. The objective of this study was to analyze at home fungal exposure of 20 patients with leukemia by taking air and water samples in their living residence.
METHODS: Air was sampled in 3 rooms of each home with a portable air system impactor. Tap water was collected at 3 water distribution points of each home. For positive samples, fungi were identified by mass spectrometry or on the basis of their morphological features.
RESULTS: 85 % of homes revealed the presence in air of Aspergillus spp. and those belonging to the section Fumigati presented the highest concentrations and the greatest frequency of isolation. Concerning mucorales, Rhizopus spp. and Mucor spp. were isolated in air of 20 % and 5 % of dwellings, respectively. In 4 homes, more than 70 % of the fungal species identified in air were potential opportunists; these were mainly Aspergillus spp. with concentrations greater than 20 cfu/m3. The water samples revealed the presence of Fusarium in 3 dwellings, with concentrations up to 80 cfu/L. Finally, for one patient, fungal species isolated during a period of hospitalization were phenotypically similar to those isolated in samples taken at home. For a second patient, a PCR Mucorale was positive on a sample of bronchoalveolar fluid while air samples taken at his home also revealed also the presence of mucorales.
CONCLUSIONS: The presence of opportunistic fungal species in the air of all the explored homes suggests the need for strengthened preventive measures in the home of immunocompromised patients. It would be interesting to compare the fungi isolated (from patients and from their environment) by genotyping studies aimed at specifying the correspondence existing between fungal species present in the patients\' homes and those responsible for IFI in the same patients.
METHODS: Air was sampled in 3 rooms of each home with a portable air system impactor. Tap water was collected at 3 water distribution points of each home. For positive samples, fungi were identified by mass spectrometry or on the basis of their morphological features.
RESULTS: 85 % of homes revealed the presence in air of Aspergillus spp. and those belonging to the section Fumigati presented the highest concentrations and the greatest frequency of isolation. Concerning mucorales, Rhizopus spp. and Mucor spp. were isolated in air of 20 % and 5 % of dwellings, respectively. In 4 homes, more than 70 % of the fungal species identified in air were potential opportunists; these were mainly Aspergillus spp. with concentrations greater than 20 cfu/m3. The water samples revealed the presence of Fusarium in 3 dwellings, with concentrations up to 80 cfu/L. Finally, for one patient, fungal species isolated during a period of hospitalization were phenotypically similar to those isolated in samples taken at home. For a second patient, a PCR Mucorale was positive on a sample of bronchoalveolar fluid while air samples taken at his home also revealed also the presence of mucorales.
CONCLUSIONS: The presence of opportunistic fungal species in the air of all the explored homes suggests the need for strengthened preventive measures in the home of immunocompromised patients. It would be interesting to compare the fungi isolated (from patients and from their environment) by genotyping studies aimed at specifying the correspondence existing between fungal species present in the patients\' homes and those responsible for IFI in the same patients.
摘要：
背景：血液系统恶性肿瘤患者发生侵袭性真菌感染（FI）的风险很高，因为他们经历了几个周期的治疗，导致中性粒细胞减少症发作。此外,他们在住院和在家期间交替。因此，当他们在住院期间被诊断出有助于预防感染时,确定真菌污染的来源非常具有挑战性。这项研究的目的是通过在其住所中采集空气和水样本来分析20名白血病患者在家中的真菌暴露情况。
方法：使用便携式空气系统冲击器在每个家庭的3个房间中采样空气。在每个家庭的3个水分配点收集自来水。对于阳性样本，真菌通过质谱或根据其形态特征进行鉴定。
结果：85%的家庭显示空气中存在曲霉属。属于Fumigati部分的那些人表现出最高的浓度和最大的隔离频率。关于粘膜，根霉属。和Mucorspp。被隔离在20%和5%住宅的空气中，分别。在4家，在空气中鉴定出的真菌物种中有70％以上是潜在的机会主义者；这些主要是曲霉属。浓度大于20cfu/m3。水样显示3所住宅中存在镰刀菌，浓度高达80cfu/L最后,一个病人,住院期间分离出的真菌种类在表型上与在家中采集的样本中分离出的真菌种类相似.对于第二个病人来说，PCRMucorale对支气管肺泡液样本呈阳性，而在其家中采集的空气样本也显示存在粘膜。
结论：所有探索家庭的空气中都存在机会性真菌物种，这表明需要在免疫功能低下患者的家中加强预防措施。通过基因分型研究比较（从患者和他们的环境中）分离的真菌将是有趣的，该研究旨在指定患者家中存在的真菌物种与同一患者中负责FI的真菌物种之间存在的对应关系。
方法：使用便携式空气系统冲击器在每个家庭的3个房间中采样空气。在每个家庭的3个水分配点收集自来水。对于阳性样本，真菌通过质谱或根据其形态特征进行鉴定。
结果：85%的家庭显示空气中存在曲霉属。属于Fumigati部分的那些人表现出最高的浓度和最大的隔离频率。关于粘膜，根霉属。和Mucorspp。被隔离在20%和5%住宅的空气中，分别。在4家，在空气中鉴定出的真菌物种中有70％以上是潜在的机会主义者；这些主要是曲霉属。浓度大于20cfu/m3。水样显示3所住宅中存在镰刀菌，浓度高达80cfu/L最后,一个病人,住院期间分离出的真菌种类在表型上与在家中采集的样本中分离出的真菌种类相似.对于第二个病人来说，PCRMucorale对支气管肺泡液样本呈阳性，而在其家中采集的空气样本也显示存在粘膜。
结论：所有探索家庭的空气中都存在机会性真菌物种，这表明需要在免疫功能低下患者的家中加强预防措施。通过基因分型研究比较（从患者和他们的环境中）分离的真菌将是有趣的，该研究旨在指定患者家中存在的真菌物种与同一患者中负责FI的真菌物种之间存在的对应关系。
