Aspergillus spp.

Characteristics
Morphology	Aspergillus species are filamentous fungi that are commonly found in soil, decaying vegetation, and seeds and grains, where they thrive as saprophytes. In humans, Aspergillus fumigatus (A. fumigatus) is the most common and life-threatening airborne opportunistic fungal pathogen. Notably, other causative Aspergillus spp. include A. flavus, A. terreus, and A. niger, and A. lentulus. Spores, called conidia, are released by Aspergillus species and lead to further propagation of the fungus. In addition, numerous secondary metabolites known as mycotoxins are excreted by Aspergillus species
Growth Conditions	Most Aspergillus species are found in a wide variety of environments and substrates on the Earth throughout the year.

Characteristics

Morphology

Aspergillus species are filamentous fungi that are commonly found in soil, decaying vegetation, and seeds and grains, where they thrive as saprophytes. In humans, Aspergillus fumigatus (A. fumigatus) is the most common and life-threatening airborne opportunistic fungal pathogen. Notably, other causative Aspergillus spp. include A. flavus, A. terreus, and A. niger, and A. lentulus. Spores, called conidia, are released by Aspergillus species and lead to further propagation of the fungus. In addition, numerous secondary metabolites known as mycotoxins are excreted by Aspergillus species

Growth
Conditions

Most Aspergillus species are found in a wide variety of environments and substrates on the Earth throughout the year.

Health Hazards
Host Range	Humans, Animals (wild, domestic, livestock)
Modes of Transmission	Transmission occurs through inhalation of airborne conidia. Hospital-acquired infections may be sporadic or may be associated with dust exposure during building renovation or construction. Occasional outbreaks of cutaneous infection have been traced to contaminated biomedical devices.
Signs and Symptoms	Aspergillus causes disease called aspergillosis and can cause different symptoms. The symptoms of allergic bronchopulmonary aspergillosis (ABPA) are similar to asthma symptoms, including: wheezing, shortness of breath, cough, and fever. Symptoms of allergic Aspergillus sinusitis include: runny nose, headache, and reduced ability to smell. Symptoms of chronic pulmonary aspergillosis include: weight loss, cough (often with blood), fatigue, shortness of breath.
Infectious Dose	Unknown
Incubation Period	The incubation period for aspergillosis is unclear and likely varies depending on the dose of Aspergillus and the host immune response.

Medical Precautions/Treatment
Prophylaxis	Antifungal medication can be used, prophylaxis against aspergillosis is recommended during prolonged neutropenia for patients who are at high risk for aspergillosis
Vaccines	None publically available
Treatment	Antifungal therapy
Surveillance	Monitor for symptoms. Diagnosis of aspergillosis typically requires a positive culture from a normally sterile site and histopathological evidence of infection. Other diagnostic tools include radiology, galactomannan antigen detection, Beta-D-glucan detection, and polymerase chain reaction (PCR).
GWU Requirements	Report all incidents to the Office of Risk Management as well as the Office of Research Safety (ORS) IMMEDIATELY FOLLOWING THE OCCURRENCE.

Containment
BSL-2	Risk Group 2 classification is applied to Aspergillus species. BSL-2 practices and procedures, containment equipment, and facilities are recommended for manipulations of clinical specimens.
ABSL-2	Animal studies using infected specimens should be performed in ABSL-2 settings.

Spill Procedures
Small Spills (<1 liter)	If the spill occurred inside a biological safety cabinet, close the sash and allow the cabinet to operate for 15 minutes before continuing with the spill cleanup. Aspergillus species can be aerosolized and contaminate surrounding surfaces, caution should be taken during a spill outside of a BSC. Leave the room immediately and allow the aerosols to dissipate for 15 minutes. Notify others working in the lab. Don appropriate PPE. Cover area of the spill with paper towels or any absorbent material and apply an EPA registered disinfectant effective against the fungus (chlorexidine-cetrimine, benzalconium chloride and ammonium quaternary derivative), working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials.
Large Spills	Alert lab personnel in the laboratory to the spill and keep people out of the area to prevent spread of the contamination. Check if you have been contaminated or if any of your PPE has been breached. If so follow exposure procedures. Remove any contaminated clothing and place it the biohazard waste. Wash your hands and post a sign on the door. Notify your supervisor of the incident and call ORS (4-8258) for assistance. If the situation involves an imminently life-threatening injury or has catastrophic potential, call 911.

Spill Procedures

Small Spills (<1 liter)

If the spill occurred inside a biological safety cabinet, close the sash and allow the cabinet to operate for 15 minutes before continuing with the spill cleanup.

Aspergillus species can be aerosolized and contaminate surrounding surfaces, caution should be taken during a spill outside of a BSC. Leave the room immediately and allow the aerosols to dissipate for 15 minutes. Notify others working in the lab. Don appropriate PPE. Cover area of the spill with paper towels or any absorbent material and apply an EPA registered disinfectant effective against the fungus (chlorexidine-cetrimine, benzalconium chloride and ammonium quaternary derivative), working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials.

Large Spills

Alert lab personnel in the laboratory to the spill and keep people out of the area to prevent spread of the contamination. Check if you have been contaminated or if any of your PPE has been breached. If so follow exposure procedures. Remove any contaminated clothing and place it the biohazard waste. Wash your hands and post a sign on the door. Notify your supervisor of the incident and call ORS (4-8258) for assistance. If the situation involves an imminently life-threatening injury or has catastrophic potential, call 911.

Exposure Procedures
Mucus Membrane	Flush eyes, mouth or nose for 15 minutes at eyewash station.
Other Exposure	Wash with soap and water for 15 minutes (open wounds, sores, etc.)
Reporting	Report ALL injuries to the PI immediately and reported to the Office of Risk Management at [email protected] IMMEDIATELY FOLLOWING THE OCCURRENCE. Exposures that involve a bloodborne-pathogen or recombinant DNA also need to be reported to the Office of Research Safety at [email protected]. If the injury requires immediate medical attention, call GWPD at 202-994-6111 or call 911.
Medical Monitoring	Seek immediate medical evaluation, treatment, and post exposure follow-up at the Employee Health Office at GWU Hospital (900 23rd St., NW, Suite G-1090, Phone: 202-715-4275). Students should go to the Students Health Office at Marvin Center. After hours treatment can be received at the GWU hospital emergency room.

Stability
Disinfection	Sensitive to 200μg/mL chlorhexidine, 100–200 μg/mL benzalconium chloride, and 2.5 μL/mL ammonium quaternary derivative
Inactivation	Inactivated by UV irradiation and autoclaving
Survival Outside Host	Very stable in most environments

Personal Protective Equipment (PPE)
Minimum PPE Requirements	At minimum, personnel are required to don gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with Aspergillus species. Additional PPE may be required depending on lab specific SOPs.
Additional Precautions	Additional protection may be worn over laboratory clothing when infectious materials are directly handled, such as solid-front gowns with tight fitting wrists, gloves, and respiratory protection. Wash hands with soap and water after removing gloves.

References
CDC (https://www.cdc.gov/fungal/diseases/aspergillosis/index.html) BMBL 6th Edition (https://www.cdc.gov/labs/BMBL.html) Aspergillus species in indoor environments (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490296/) In vitro activity of disinfectants against Aspergillus spp (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833149/) Ultraviolet irradiation: An effective inactivation method of Aspergillus spp (https://pubmed.ncbi.nlm.nih.gov/22985523/) Clinical and Microbiological Characterization of Invasive Pulmonary Aspergillosis Caused by Aspergillus lentulus (https://www.frontiersin.org/articles/10.3389/fmicb.2020.01672/full)

References

CDC (https://www.cdc.gov/fungal/diseases/aspergillosis/index.html)

BMBL 6th Edition (https://www.cdc.gov/labs/BMBL.html)

Aspergillus species in indoor environments (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490296/)

In vitro activity of disinfectants against Aspergillus spp (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833149/)

Ultraviolet irradiation: An effective inactivation method of Aspergillus spp (https://pubmed.ncbi.nlm.nih.gov/22985523/)

Clinical and Microbiological Characterization of Invasive Pulmonary Aspergillosis Caused by Aspergillus lentulus (https://www.frontiersin.org/articles/10.3389/fmicb.2020.01672/full)