, Volume 106, Issue 1, pp 13–22 | Cite as

Potted plants in hospitals as reservoirs of pathogenic fungi

  • Richard C. Summerbell
  • Sigmund Krajden
  • Julius Kane


The soils of five potted plants cultivated within a hospital were investigated for the presence of fungal opportunistic pathogens of humans. A total of 16 potentially pathogenic species were isolated, including Aspergillus fumigatus at up to 53.5 colony-forming units (CFU) per gram dry soil and Scedosporium apiospermum (Pseudallescheria boydii) at up to 97.0 CFU/g. Other common species included Phialophora verrucosa and Fusarium solani. Scedosporium inflatum, a recently described emerging pathogen, is reported for the first time from an environmental source. The results of this study, in combination with previous case reports linking mycoses to potted plants and available information on the establishment and dispersal of fungal opportunistic pathogens in indoor habitats, indicate that indoor plant soils constitute a serious mycotic hazard to the immunosuppressed patient.


Aspergillus Mycosis Fusarium Pathogenic Fungus Plant Soil 
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  1. 1.
    Aisner J, Schimpff SC, Bennett JE, Young VM, Wiernik PH. Aspergillus infections in cancer patients. Association with fireproofing materials in a new hospital. J Am Med Assoc 1976; 235: 411–12.Google Scholar
  2. 2.
    Ajello L. Hyalohyphomycosis and phaeohyphomycosis: two global disease entities of public health importance. Eur J Epidemiol 1986; 243–51.Google Scholar
  3. 3.
    Anaissie E, Kantarjian H, Jones P, Barlogie B, Luna M, Lopez-Berestein G, Bodey G. Fusarium. A newly recognized fungal pathogen in immunosuppressed patients. Cancer 1986; 57: 2141–5.Google Scholar
  4. 4.
    Arnow PM, Andersen RL, Mainous PD, Smith EJ. Pulmonary aspergillosis during hospital renovation. Am Rev Resp Dis 1978; 118: 49–53.Google Scholar
  5. 5.
    Bandoni RJ. Aquatic hyphomycetes from terrestrial litter. In: Wicklow DT, Carroll GC, eds. The fungal community. Its organization and role in the ecosystem. New York: Marcel Dekker Inc., 1981; 693–708.Google Scholar
  6. 6.
    Benham RW, Georg LK. Allescheria boydii, causative agent in a case of meningitis. J Invest Dermatol 1948; 10: 99–110.Google Scholar
  7. 7.
    Blazar BR, Hurd DD, Snover DC, Alexander JW, McGlave PB. Invasive Fusarium infections in bone marrow transplant recipients. Am J Med 1984; 77: 645–51.Google Scholar
  8. 8.
    Cho CT, Vats TS, Lowman JT, Brandsberg JW, Tosh FE. Fusarium solani infection during treatment for acute leukemia. J Pediatr 1973; 6: 1028–31.Google Scholar
  9. 9.
    Cho JJ, Schroth MN, Kominos SD, Green SK. Ornamental plants as carriers of Pseudomonas aeruginosa. Phytopathol 1975; 425–31.Google Scholar
  10. 10.
    De Hoog GS, Hermanides-Nijhof EJ. The black yeasts and allied Hyphomycetes. Stud Mycol 1977; 15: 1–222.Google Scholar
  11. 11.
    Domsch KH, Gams W, Anderson T-H. Compendium of soil fungi. New York: Academic Press, 1980.Google Scholar
  12. 12.
    Eisenberg ES, Alpert BE, Weiss RA, Mittman N, Soeiro R. Rhodotorula rubra peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. Am J Med 1983; 75: 349–52.Google Scholar
  13. 13.
    Enggano IL, Hugher WT, Kalwinsky DK, Pearson TA, Parham DM, Stass SA. Pseudallescheria boydii in a patient with acute lymphoblastic leukemia. Arch Pathol Lab Med 1984; 108: 619–22.Google Scholar
  14. 14.
    English MP. Nails and fungi. Brit J Dermatol 1976; 94: 697–701.Google Scholar
  15. 15.
    Feuilhade M, van der Meeren A, Bernaudin JF, Bignon J. 1986. Enquête d'hygiène hospitalière lors d'une épidémie nósocomiale d'aspergillose invasive en service d'hématologie, p. 67–76. In: Molina C, ed. Maladies des climatiseurs et des humidificateurs. INSERM, Paris, France.Google Scholar
  16. 16.
    Gage AA, Dean DC, Schimert G, Minsley N. Aspergillus infection after cardiac surgery. Arch Surg 1970; 101: 384–7.Google Scholar
  17. 17.
    Gemeinhardt H, Eckert H, Fischer P. Lokalisierte Lungen-Aspergillose durch Aspergillus niger. Z Erkr Atmungsorgane 1982; 159: 289–94.Google Scholar
  18. 18.
    Glassman MI, Henkind P, Alture-Werber E. Monosporium apiospermum endophthalmitis. Am J Ophthalmol 1973; 76: 821–4.Google Scholar
  19. 19.
    Gordon G, Axelrod JL. Case report: prosthetic valve endocarditis caused by Pseudallescheria boydii and Clostridium limosum. Mycopathologia 1985; 89: 12–134.Google Scholar
  20. 20.
    Grosse G, L'Age M, Staib F. Perakute disseminiert verlaufene, tödliche Aspergillus fumigatus-Infektion bei Leberversagen und Kortikoidtherapie. Klin Wochenschr 1985; 63: 523–8.Google Scholar
  21. 21.
    Howard DH. 1983. Fungi pathogenic for humans and animals. Part A. Biology. Marcel Dekker, Inc., New York & Basel.Google Scholar
  22. 22.
    Junghannss, U, Korbl G, Ruthard P, Streb D, Breitenbach B, Wille H. Topfblumen im Krankenzimmer — eine Quelle für nosokomiale Infektionen? Krankenhaus 1985; 77: 179–81.Google Scholar
  23. 23.
    Kaitzis G. Zierpflanzen-Hydrokulturen im Krankenhaus als mögliches Reservoir für Hospitalismus-Nasskeime. Mitt Österr Sanitätsverwaltung 1977; 78: 193–7.Google Scholar
  24. 24.
    Kauffman CA, Wilson KH, Schwartz DB. Necrotizing pulmonary aspergillosis with oxalosis. Mykosen 1984; 27: 535–8.Google Scholar
  25. 25.
    Kerr CM, Perfect JR, Craven PC, Jorgensen JH, Drutz DJ, Shelburne JD, Gallis HA, Gutman RA. Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis. Ann Intern Med 1983; 99: 334–7.Google Scholar
  26. 26.
    Kiehn TE, Nelson PE, Bernard EM, Edwards FF, Koziner B, Armstrong D. Catheter-associated fungemia caused by Fusarium chlamydosporum in a patient with lymphocytic lymphoma. J Clin Microbiol 1985; 21: 501–4.Google Scholar
  27. 27.
    Kiehn TE, Polsky B, Punithalingam E, Edwards F, Brown AE, Armstrong D. Liver infection caused by Coniothyrium fuckelii in a patient with acute myelogenous leukemia. J Clin Microbiol 1987; 25: 2410–2.Google Scholar
  28. 28.
    Kominos SD, Copeland DE, Grosiak B, Postic B. Introduction of Pseudomonas aeruginosa into a hospital via vegetables. Appl Microbiol 1972; 24: 567–70.Google Scholar
  29. 29.
    Kreger-van Rij NJW. 1984. The yeasts, a taxonomic study. Elsevier Sci Publ, Amsterdam.Google Scholar
  30. 30.
    Lazarus HS, Myers JP, Brocker PJ. Post-craniotomy wound infection caused by Pseudallescheria boydii. J Neurosurg 1986; 64: 153–4.Google Scholar
  31. 31.
    Lentino JR, Rosenkranz MA, Michaels JA, Kurup VP, Rose HD, Rytel MW. Nosocomial aspergillosis. A retrospective review of airborne disease secondary to road construction and contaminated air conditioners. Am J Epidemiol 1982; 116: 430–7.Google Scholar
  32. 32.
    Levenson JE, Gardner SK, Duffin RM, Pettit TH. Dematiaceous fungal keratitis following penetrating keratoplasty. Ophthalm Surg 1984; 15: 578–82.Google Scholar
  33. 33.
    Lie TS, Höfer M, Höhnke C, Krizek L, Kühnen E, Iwantscheff A, Köster O, Overlack A, Vogel J, Rommelsheim K. Aspergillose nach Lebertransplantation als Hospitalismusinfektion. Deutsche Med Wochenschr 1987; 112: 297–301.Google Scholar
  34. 34.
    Lutwick LI, Rytel MW, Yanez JP, Galgiani JN, Stevens DA. Deep infections from Petriellidium boydii treated with miconazole. J Am Med Assoc 1979; 241: 272–3.Google Scholar
  35. 35.
    Mahoney DH, Jr, Steuber CP, Starling KA, Barrett FF, Goldberg J, Fernbach DJ. An outbreak of aspergillosis in children with acute leukemia. J Pediatrics 1979; 95: 70–72.Google Scholar
  36. 36.
    Malloch D. 1981. Moulds. Their isolation, cultivation, and identification. University of Toronto Press, Toronto.Google Scholar
  37. 37.
    Malloch D, Salkin IF. A new species of Scedosporium associated with osteomyelitis in humans. Mycotaxon 1984; 21: 247–55.Google Scholar
  38. 38.
    Mariat F. 1968. The epidemiology of sporotrichosis. p. 144–59. In: Wolstenholme GEW, Porter R, ed. Systemic mycoses. Churchill Publ, London.Google Scholar
  39. 39.
    Matsumoto T, Matsuda T. Critical review of hyalohyphomycosis caused by Fusarium species, in: Torres-Rodrigues JM, ed. Proceedings of the X Congress of the International Society for Human and Animal Mycology. Prous JR Science, Barcelona, Spain.Google Scholar
  40. 40.
    McGinnis MR. Laboratory handbook of medical mycology. New York: Academic Press, Inc, 1980.Google Scholar
  41. 41.
    McNeely DJ, Vas SI, Dombros N, Oreopoulos DG. Fusarium peritonitis: an uncommon complication of continuous ambulatory peritoneal dialysis. Peritoneal Dial Bull 1981; 1: 94–6.Google Scholar
  42. 42.
    Metzger, JB, Garagusi VF, Kerwin DM. Pulmonary oxalosis caused by Aspergillus niger. Am Rev Resp Dis 1984; 129: 501–2.Google Scholar
  43. 43.
    Moore RS, Hasleton PS, Lawson R, Stanbridge TN. Aspergillus niger endocarditis complicating aortic tissue valve replacement. Thorax 1984; 39: 76–7.Google Scholar
  44. 44.
    Muckelmann R, Kunkel G, Staib F, Blohm B, Rudolph R, Mishra SK, Müller JA, Mast H, Sladek M. Respirationsallergien verursacht durch Aspergillus-Arten aus der Topferde von Zimmerpflanzen. Prax Pneumol 1981; 35: 363–6.Google Scholar
  45. 45.
    Nishimura K, Miyaji M, Taguchi H, Tanaka R. Fungi in bathwater and sludge of bathroom drainpipes. 1. Frequent isolation of Exophiala species. Mycopathol 1987; 97: 17–23.Google Scholar
  46. 46.
    Opal SM, Asp AA, Cannady Jr PB, Morse PL, Burton LJ, Hammer II PG. Efficacy of infection control measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction. J Infect Dis 1986; 153: 634–7.Google Scholar
  47. 47.
    Perraud M, Piens MA, Nicoloyannis N, Garin JP, Sepetjan M. Travaux de démolition et risque d'aspergillose pulmonaire invasive. Presse Medicale 1985; 14: 2195.Google Scholar
  48. 48.
    Petheram IS, Seal RME. Aspergillus prosthetic valve endocarditis. Thorax 1976; 31: 380–90.Google Scholar
  49. 49.
    Pitt J. The genus Penicillium and its teleomorphic states Eupenicillium and Talaromyces. New York, Academic Press, 1979.Google Scholar
  50. 50.
    Potel J, Rhode G, Seeliger H, Werry H. Exophiala jeanselmei (Phialophora jeanselmei). Nachweis im Glaskörperinhalt des Auges. Mykosen 1984; 27: 380–4.Google Scholar
  51. 51.
    Rhame FS, Streifel AJ, Kersey JH, McGlave PB. Extrinsic risk factors for pneumonia in the patient at high risk of infection. Am J Med 1984; 76: 42–52.Google Scholar
  52. 52.
    Richardson SE, Bannatyne RM, Milliken J, Gold R, Weitzman SS. 1988. Disseminated Fusarium infection in the immunocompromised host. Rev Infect Dis (in press)Google Scholar
  53. 53.
    Rippon JW. Medical mycology: the pathogenic fungi and the pathogenic actinomycetes, 3d ed. Philadelphia: The WB Saunders Co., 1988.Google Scholar
  54. 54.
    Rippon JW, Larson RA, Rosenthal DM, Clayman J. Disseminated cutaneous and peritoneal hyalohyphomycosis caused by Fusarium species: three cases and a review of the literature. Mycopathologia 1988; 101: 105–11.Google Scholar
  55. 55.
    Rose HD. Mechanical control of hospital ventilation and Aspergillus infections. Am Rev Resp Dis 1972; 105: 306–7.Google Scholar
  56. 56.
    Rose HD, Hirsch SR. Filtering hospital air decreases Aspergillus spore counts. Am Rev Resp Dis 1979; 119: 511–3.Google Scholar
  57. 57.
    Rose HD, Varkey B. Deep mycotic infection in the hospitalized adult: a study of 123 patients. Medicine 1975; 54: 499–507.Google Scholar
  58. 58.
    Rosen PP, Sternberg SS. Decreased frequency of aspergillosis and mucormycosis. New Engl J Med 1976; 295: 1319–20.Google Scholar
  59. 59.
    Rusthoven JJ, Feld R, Tuffnell PG. Systemic infection by Rhodotorula spp in the immunocompromised host. J Infect 1984; 8: 241–6.Google Scholar
  60. 60.
    Ruutu P, Valtonen V, Tiitanen L, Elonen E, Volin L, Veijalainen P, Ruutu T. An outbreak of invasive aspergillosis in a haematologic unit. Scand J Infect Dis 1987; 19: 347–51.Google Scholar
  61. 61.
    Salkin IF, McGinnis MR, Dykstra MJ, Rinaldi MG. Scedosporium inflatum, an emerging pathogen. J Clin Microbiol 1988; 26: 498–503.Google Scholar
  62. 62.
    Samson RA. Occurrence of moulds in modern living and working environments. Eur J Epidemiol 1985; 1: 54–61.Google Scholar
  63. 63.
    Sarubbi FA, Kopf HB, Wilson MB, McGinnis MR, Rutala WA. Increased recovery of Aspergillus flavus from respiratory specimens during hospital construction. Am Rev Resp Dis 1982; 125: 33–8.Google Scholar
  64. 64.
    Schipper MAA, Stalpers JA. A revision of the genus Rhizopus II. The Rhizopus microsporus group. Stud Mycol 1984; 25: 20–34.Google Scholar
  65. 65.
    Schlichting HE. Ejection of microalgae into the air via bursting bubbles. J Allergy Clin Immunol 1974; 53: 185–8.Google Scholar
  66. 66.
    Schmidt U, Knopf B, Wätzig V. Persistierende umschriebene Hyperkeratosen durch Rhodotorula rubra. Dermatol Monatsschr 1982; 168: 111–5.Google Scholar
  67. 67.
    Smith AG, Crain SM, Dejongh C, Thomas GM, Vigorito RD. Systemic pseudallescheriasis in a patient with acute myelocytic leukemia. Mycopathol 1985; 90: 85–9.Google Scholar
  68. 68.
    Smith V, Streifel A, Rhame FS, Juni B. Potted plant fungal spore shedding (abstract). Abs Ann Meeting Am Soc Microbiol 1988: 414.Google Scholar
  69. 69.
    Staib F. Raumluftuntersuchung auf Aspergillus-Arten in der Wohnung eines chronisch Lungenkranken. Ein Beitrag zum Thema Topfpflanzenerde als Reservoir und Streuherd pathogener Aspergillus-Arten. Bundesgesundheitsbl 1978; 21: 471–4.Google Scholar
  70. 70.
    Staib F. Mykosen durch Pilzsporen in der Raumluft. Zbl Bakt Hyg, I Abt, Orig B, 1982; 176: 142–54.Google Scholar
  71. 71.
    Staib F, Abel Th, Mishra SK, Müller JA. Aspergillus-fumigatus-Infektion der Lunge bei Mucoviscidose. Deutsche Med Wochenschr 1980; 105: 442–5.Google Scholar
  72. 72.
    Staib F, Bennhold I, Voigt H-W, Bangel C, Blisse A. Amphotericin B und Flucytosin-Therapie bei Aspergillus-Pneumonie und akutem Nierenversagen. Klin. Wochenschr 1987; 65: 40–7.Google Scholar
  73. 73.
    Staib F, Bohl D, Foth B, Mishra SK, Rajendran C, Mueller JA. Tödliche Aspergillose nach Infarktpneumonie. Prax. Pneumol 1980; 34: 732–8.Google Scholar
  74. 74.
    Staib F, Folkens U, Tompak B, Abel Th, Thiel D. A comparative study of antigens of Aspergillus fumigatus isolates from patients and soil of ornamental plants in the immunodiffusion test. Zbl Bakt Hyg, I Abt Orig 1978; A 242: 93–9.Google Scholar
  75. 75.
    Staib F, Steffen J, Krumhaar D, Kapetanakis G, Minck C, Grosse G. Lokalisierte Aspergillose und Oxalose der Lunge durch Aspergillus niger. Deutsche Med Wochenschr 1979; 104: 1176–9.Google Scholar
  76. 76.
    Staib F, Tompak B, Thiel D, Abel Th. Aspergillus fumigatus in der Topferde von Zimmerpflanzen. Ein Beitrag zur Epidemiologie der Aspergillose des Menschen. Bundesgesundheitsbl 1978; 21: 209–13.Google Scholar
  77. 77.
    Staib F, Tompak B, Thiel D, Blisse A. Aspergillus fumigatus and Aspergillus niger in two potted ornamental plants, cactus (Epiphyllum truncatum) and clivia (Clivia miniata). Biological and epidemiological aspects. Mycopathol 1978; 66: 27–30.Google Scholar
  78. 78.
    Stern RM, Zakov ZN, Meisler DM, Hall GS, Martin A. Endogenous Pseudallescheria boydii endophthalmitis. A clinicopathologic report. Cleveland Clin Quart 1986; 53: 197–203.Google Scholar
  79. 79.
    Stone HH, Cuzzell JZ, Kolb LB, Moskowitz MS, McGowan Jr JE. Aspergillus infection of the burn wound. J Trauma 1979; 19: 765–7.Google Scholar
  80. 80.
    Streifel AJ, Stevens PP, Rhame FS. In hospital source of airborne Penicillium species spores. J Clin Microbiol 1987; 25: 1–4.Google Scholar
  81. 81.
    Summerbell RC. The heterobasidiomycetous yeast genus Leucosporidium in an area of temporate climate. Can J Bot 1983; 61: 1402–10.Google Scholar
  82. 82.
    Summerbell RC. Microfungal populations and interactions in the mycorrhizosphere of black spruce. Ph D thesis, University of Toronto, Toronto, Canada, 1985.Google Scholar
  83. 83.
    Taplin D, Mertz PM. Flower vases in hospitals as reservoirs of pathogens. The Lancet 1973 II: 1279–81.Google Scholar
  84. 84.
    Velcovsky H-G, Graubner M. Allergische Alveolitis durch Inhalation von Schimmelpilzsporen aus Blumenerde. Deutsche Med Wochenschr 1981; 106: 115–20.Google Scholar
  85. 85.
    Vidotto V, Caramello S, Lucchini A. Sources of fungal contamination in a burn-care unit. Mycopathol 1986; 95: 77–80.Google Scholar
  86. 86.
    Walshe MM, English MP. Fungi in nails. Brit J Dermatol 1966; 78: 198–207.Google Scholar
  87. 87.
    Weitzman I. Saprophytic molds as agents of cutaneous and subcutaneous infection in the immunocompromised host Arch Dermatol 1986; 122: 1161–8.Google Scholar
  88. 88.
    Yoo D, Lee WHS, Kwon-Chung KJ. Brain abscesses due to Pseudallescheria boydii associated with primary non-Hodgkins lymphoma of the central nervous system: a case report and literature review. Rev Infect Dis 1985; 7: 272–7.Google Scholar
  89. 89.
    Young RC, Bennett JE, Vogel CL, Carbone PP, DeVita VT. Aspergillosis. The spectrum of the disease in 98 patients. Medicine 1970; 49: 147–73.Google Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Richard C. Summerbell
    • 1
  • Sigmund Krajden
    • 2
  • Julius Kane
    • 1
  1. 1.Mycology LaboratoryOntario Ministry of Health Laboratory Services BranchTorontoCanada
  2. 2.Department of MicrobiologySt. Joseph's Health CentreTorontoCanada

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