Germ of the Month - August 2005

This month we would like to introduce you to Gus (Aspergillus fumigatus). Gus is really hitting his stride as the summer, with the heat and humidity, is in full swing. Aspergillus is a group of molds, which is found world-wide--especially in the autumn and winter in the Northern hemisphere. Only a few of these molds can cause illness in humans and animals. Most people are naturally immune and do not develop diseases caused by Aspergillus. The types of diseases caused by Aspergillus are varied, ranging from an allergy-related illness to life-threatening, generalized infections. Diseases caused by Aspergillus are called aspergillosis. The severity of aspergillosis is determined by various factors but one of the most important is the state of the immune system of the person.

Allergic bronchopulmonary aspergillosis (ABPA) is a condition which produces an allergy to the spores of Aspergillus molds. Aspergilloma, or chronic pulmonary aspergillosis, are caused when fungus grows within a cavity of the lung, which was previously damaged during an illness such as tuberculosis or sarcoidosis. Aspergillus sinusitis is associated with allergic disease and long-standing symptoms of a runny, blocked nose.

Many people with damaged or impaired immune systems die from invasive aspergillosis. Their chances of living are improved the earlier the diagnosis is made, but, unfortunately there is no good, single diagnostic test. Often, treatment has to be started when the condition is only suspected.¹ This condition is usually clinically diagnosed in a person with low defenses such as bone marrow transplant, low white cells after cancer treatment, AIDS or major burns. There is also a rare, inherited condition that gives people low immunity (chronic granulomatous disease), which puts affected people at moderate risk. In people with particularly poor immune systems, the fungus can transfer from the lung via the blood stream to the brain² or to other organs, including the eye, the heart (infective endocarditis³), the kidneys, the skin and implanted devices.⁴ As always, a key component to the reduction of transmission is good hand hygiene using an antiseptic soap with good persistence.

We hope you will enjoy introducing your staff to Gus as you continue your own efforts to educate and maintain awareness
about infectious disease in your facility. This information is brought to you by Mölnlycke Health Care, maker of Hibiclens®
antiseptic and Hibistat ®, convenient antimicrobial towelettes with the persistence of CHG.⁵ Our reason for all that we do is to provide you with the very best in products and support, to help you control infections. We look forward to hearing from you about our Hibigeebie® campaign. Please feel free to contact us at 1-800-843-8497.

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1 Maurya V, Gugnani HC, Sarma PU, Madan T, Shah A.. Sensitization to Aspergillus antigens and occurrence of allergic bronchopulmonary aspergillosis in patients with asthma Chest. 2005 Apr;127(4):1252-9.
2 Dubey A, Patwardhan RV, Sampth S, Santosh V, Kolluri S, Nanda A. Intracranial fungal granuloma: analysis of 40 patientsand review of the literature. Surgical Neurology 63 (2005) 254–260.
3 Sherman-Weber S, Axelrod P, Suh B, Rubin S, Beltramo D, Manacchio J, Furukawa S, Weber T, Eisen H, Samuel R.Infective endocarditis following orthotopic heart transplantation: 10 cases and a review of the literature.
Transpl Infect Dis. 2004 Dec;6(4):165-70.
4 Izquierdo R, Llorente C, Mayo J, Garcia-Porrua C, Gonzalez-Juanatey C, Gonzalez-Gay MA. Pacemaker infection due to Aspergillus: report of two cases and literature review.Clin Cardiol. 2005 Jan;28(1):36-8.
5 Mölnlycke Health Care urges all users to read the product leaflet closely and use Hibi products only as directed.