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<p>Filamentous fungi are common airborne contaminants in hospitals, posing significant risks to immunocompromised patients. This study assessed the diversity, seasonal distribution, and antifungal susceptibility of airborne filamentous fungi, with a focus on <i>Aspergillus</i> spp., in two inpatient wards of a tertiary hospital in southeastern Brazil. Air samples were collected seasonally from November 2022 to September 2023 using a six-stage Andersen sampler. Fungal isolates were identified based on macro- and micromorphological characteristics, and <i>Aspergillus</i> spp. were further characterised by β-tubulin gene sequencing. In vitro susceptibility to amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and anidulafungin (AFG) was evaluated following CLSI guidelines. A total of 583 filamentous fungi were isolated, with <i>Penicillium</i>, <i>Cladosporium</i> and <i>Aspergillus</i> as the most prevalent genera. Fungal concentrations were higher in humidified air and decreased after installation and maintenance of the air-conditioning system. Fourteen <i>Aspergillus</i> species were identified across eight sections, including emerging and cryptic taxa such as <i>A</i>. <i>subramanianii</i>, <i>A</i>. <i>sclerotiorum</i> and <i>A</i>. <i>alboviridis</i>. Resistance to ITR was detected in one isolate of <i>A</i>. <i>fumigatus</i> and one of <i>A</i>. <i>flavus</i>, while isolates from emerging species of the section <i>Circumdati</i> exhibited elevated MICs for AMB and triazoles. All isolates demonstrated low AFG MECs. The study highlights the importance of routine environmental surveillance and antifungal susceptibility testing in hospital settings. The detection of potentially resistant <i>Aspergillus</i> species in hospital air emphasises the need to enhance ventilation, monitoring, and diagnostic capabilities to mitigate the risks of healthcare-associated fungal infections.</p>

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Hospital Indoor Air as a Reservoir of Opportunistic Filamentous Fungi: Species Diversity and Antifungal Susceptibility

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月7日

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  • Jhully Pimentel,
  • Glaucia Queiroz dos Santos,
  • Thiago Oliveira Condé,
  • Simone Bravim Maifrede,
  • Thaís Oliveira Scardua,
  • Rubia Miossi,
  • Tatiana Alves dos Reis,
  • Kelly Ishida,
  • Creuza Rachel Vicente,
  • Sarah Santos Gonçalves

摘要

Filamentous fungi are common airborne contaminants in hospitals, posing significant risks to immunocompromised patients. This study assessed the diversity, seasonal distribution, and antifungal susceptibility of airborne filamentous fungi, with a focus on Aspergillus spp., in two inpatient wards of a tertiary hospital in southeastern Brazil. Air samples were collected seasonally from November 2022 to September 2023 using a six-stage Andersen sampler. Fungal isolates were identified based on macro- and micromorphological characteristics, and Aspergillus spp. were further characterised by β-tubulin gene sequencing. In vitro susceptibility to amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and anidulafungin (AFG) was evaluated following CLSI guidelines. A total of 583 filamentous fungi were isolated, with Penicillium, Cladosporium and Aspergillus as the most prevalent genera. Fungal concentrations were higher in humidified air and decreased after installation and maintenance of the air-conditioning system. Fourteen Aspergillus species were identified across eight sections, including emerging and cryptic taxa such as A. subramanianii, A. sclerotiorum and A. alboviridis. Resistance to ITR was detected in one isolate of A. fumigatus and one of A. flavus, while isolates from emerging species of the section Circumdati exhibited elevated MICs for AMB and triazoles. All isolates demonstrated low AFG MECs. The study highlights the importance of routine environmental surveillance and antifungal susceptibility testing in hospital settings. The detection of potentially resistant Aspergillus species in hospital air emphasises the need to enhance ventilation, monitoring, and diagnostic capabilities to mitigate the risks of healthcare-associated fungal infections.