A research team in France have undertaken a screen on indoor air, soil and dust in and around hospitals to look for azole resistant Aspergillus in the environment of the University Hospital of Besançon.

The authors noted that the numbers of azole resistant Aspergillus fumigatus strains that were being isolated from patients, especially cystic fibrosis patients, was increasing. The study was designed to test the air in the hospital to discover if azole resistant A. fumigatus was brought to the hospital from rural environments by prevailing winds. They also wanted to see if plants, trees and flowerbeds around the hospital played a role.

The researchers found 83 azole resistant A. fumigatus isolates.

• 1 from the air of the intensive care unit
• 16 from the main corridors
• 59 from pots of tulips imported from the Netherlands
• 5 from the soil of trees grown in pots.

No samples of azole resistant A. fumigatus were found from an external sensor, suggesting that the resistant strains collected were not carried into the hospital on prevailing winds.

The tulips may be the main source but the authors are careful to note that to confirm this, genetic analysis would be needed to link isolates found in flower beds to isolates found in the hospital or strains isolated from patients.

In the University Hospital of Besançon, the decision has been made to stop planting bulbs. The results demonstrate a need for increasing vigilance on the surveillance of resistant strains.

The full paper is available here.