Aspergillosis study day May 1st 2012 - Malcolm Richardson

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Professor Malcolm Richardson, Clinical Mycologist

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Aspergillosis study day May 1st 2012 - Malcolm Richardson

  1. 1. The life and times ofAspergillus in the homeProf Malcolm RichardsonMycology Reference CentreNational Aspergillosis CentreUHSM and University of Manchester
  2. 2. Our first encounter with Aspergillus
  3. 3. Aw < 0.80, ERH <80% Aw < 0.80-0.90, ERH <80-90% Aw >0.90, ERH >90% waterAw: Minimum water activity level at 25°CERH: Equilibrium relative humidity
  4. 4. WHO Dampness and Mould Occupants of damp or mouldy buildings are at increased risk of respiratory symptoms, respiratory infections and exacerbation of asthma Remediation of dampness can reduce adverse health outcomes There is clinical evidence that exposure to mould increases the risk of allergic alveolitis, chronic rhinosinusitis and allergic fungal sinusitis Allergic people are particularly susceptible to biological and chemical agents in damp building The increasing prevalence of asthma and allergies increases the number of people susceptible to the effects of dampness and mould.
  5. 5. Mouldy houses in the UKRICS Report : ‘ Mould in the Indoor Environment of Dwellings in England’.- Visible mould growth in 5.4% of properties tested (65/~1200).- Stachybotrys chartarum found in 12 homes.- Aspergillus fumigatus found in 2 homes. CONDENSATION/PENETRATING DAMPNESS.
  6. 6. Aspergillus fumigatus
  7. 7. Aspergillus fumigatus
  8. 8. Aspergillus fumigatus  Ubiquitous organism.  Most commonly reported opportunistic hyphomycete.  Important in compost cycle.  How did this grass eater become an opportunistic pathogen?
  9. 9. A. fumigatus: Compost to Man Life is very competitive in a compost pile. What are some of the growth characteristics that enable A. fumigatus to be successful in the environment that may also allow it to be an opportunistic pathogen?
  10. 10. Nutritional Versatility: Compost to Man  A. fumigatus plays a key role in recycling C and N in compost.  Carbon sensing and utilization: pkaR and sakA.  Nitrogen sensing and utilization: rhbA, areA, cpcA, & sakA.  Auxotrophies: pabaA, pyrG, lysF.
  11. 11. Sources of Aspergillus  Soil  Air; spores may be inhaled: (100-200 spores daily)  Water / storage tanks in hospitals  Food  Compost and decaying vegetation  Fire proofing materials  Bedding, pillows  Ventilation and air conditioning systems  Computer fans
  12. 12. Members of the family Genus of around 200 fungi (moulds) worlwide Filamentous fungus (opposed to single celled fungus), reproduction by spores A. fumigatus, A. flavus, A. terreus, A. niger, A. clavatus
  13. 13. People live in mouldy houses: exposure to Aspergillus and more
  14. 14. Mould and contents
  15. 15. Dust: a perfect home for Aspergillus!
  16. 16. More dust
  17. 17. Aspergillus is in the air!
  18. 18. What’s growing in the wall?
  19. 19. What’s growing in the wall?
  20. 20. In need of repair and clean up
  21. 21. Patient’s house
  22. 22. Patient’s house
  23. 23. How can we detect Aspergillus inthe home?
  24. 24. Aspergillus in dust
  25. 25. Air sampling
  26. 26. Air sampling: >1300 cfu/m3!
  27. 27. Aspergillus is found in A/C units
  28. 28. Patient’s house
  29. 29. Aspergillus is everywhere!
  30. 30. Aspergillus in the nursery
  31. 31. No home is spared!
  32. 32. Aspergillus in the garden

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