Role of Non-O157:H7 Escherichia coli in hemolytic uremic syndrome.

RA. Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. and prognostic factors of invasive aspergillosis after allogeneic bone marrow transplantation. Reply Sir—Gangneux et al. [1] agree with us that alternative hospital sources of Asper-gillus conidia should be investigated and that air-quality precautions need to be strictly implemented to prevent airborne nosocomial aspergillosis. We agree with the sampling sites recommended by Gangneux et al. [1], but we emphasize the importance of sampling water-related areas and structures, such as sinks and showers. We also agree that variation in ecological niches may account for potential differences among institutions with regard to the rate and type of fungal colonization in water. These differences could also be explained by other factors, such as the methods of collection and the timing of sampling (e.g., sampling the first liter of water from a source vs. sampling subsequent liters) [2]. As stated by Gang-neux and colleagues, humidity may indeed favor fungal growth in water-related structures , such as bathrooms. As we have recently shown, cleaning the surfaces of such structures may decrease the risk of aero-solization of fungal conidia [3]. Gangneux et al. [1] also mention that we consider hospital water to be a major source of infection, a statement that we did not make. In the original article [4], we were asked to make the case for our hypothesis that hospital water was a potential source of Aspergillus conidia. We did so; however, we reiterated that this hypothesis needs to be considered in hospitals in which cases of nosocomial as-pergillosis continue to occur despite the strict implementation of air-quality precautions. Gangneux and colleagues mention a study [5] that showed a correlation between airborne mold concentration and the incidence of invasive aspergillosis, which does not conflict with our hypothesis about waterborne mold. As discussed in our editorial, fungal conidia could have been " secondarily airborne " from a water source. We thank Gangneux et al. [1] for raising these important questions, and we reiterate the need for continued implementation of air-quality precautions in high-risk hospital wards and for additional studies to determine the exact contribution of alternative sources (i.e., water and other sources) to nosocomial and community acquired aspergillosis. Cleaning patient shower facilities: a novel approach to reducing patient exposure to aero-solized Aspergillus species and other opportun-istic molds. et al. Relationship between environmental fungal contamination and the incidence of invasive as-pergillosis in …