Airborne Aspergillus fumigatus conidia: a risk factor for aspergillosis

Aspergillus fumigatus is an opportunistic fungal pathogen that causes invasive aspergillosis, a usually fatal infection. The disease has risen in prominence in recent years due to the increasing numbers of severely immunocompromised patients becoming infected. The fungus is ubiquitous in the environment, producing large numbers of conidia that are dispersed in the air. Humans inhale numerous conidia everyday, but infections are not seen in healthy individuals. As inhalation of conidia is the main route of infection, considerable efforts are required to prevent infection in susceptible patients. This review summarises the current knowledge on airborne concentrations of A. fumigatus conidia, their background levels in outdoor air and seasonal distribution patterns. New and established methods of air sampling for airborne A. fumigatus conidia are discussed. Common environmental sources of the fungus are reviewed, including its presence in compost heaps. Finally, the lack of stringent guidelines on the monitoring and control of airborne A. fumigatus concentrations in hospitals is discussed.