Aspergillus flavus: Identifying the Root Causes of a Hospital Outbreak through Source Investigation, Molecular Epidemiology and Microbiological Phenotyping

PhD defence by Alexander Jacob Kongstad Gewecke

Assessment Committee

Professor Ditte Marie Lindhardt Saunte, Department of Clinical Medicine, University of Copenhagen (Chairperson)
Professor Christian Borbjerg Laursen, University of Southern Denmark
Professor David Denning, The University of Manchester

Supervisors

Clinical Professor Maiken Cavling Arendrup
Clinical Associate Professor Marie Helleberg
Dr Med Jannik Helweg-Larsen

Department

Department of Clinical Medicine

Graduate Programme

Veterinary, Animal Health and Microbiological Sciences

Place

Jernesalen, (Statens Serum Institut), Room: Common hall, Artillerivej 5, 2300 Copenhagen S

Email address to gain access to the thesis: ajkg@ssi.dk.
You will either receive a copy of the thesis or be informed where you can read a physical copy.
Recipients of copies of the thesis are not allowed to share or distribute it due to copyright compliance.

Short description of the thesis

Unravelling a prolonged hospital outbreak of Aspergillus flavus
For almost a decade, infections by A. flavus occurred among patients at the Copenhagen University Hospital. What initially appeared to be an insufficient antifungal prophylaxis strategy, that selected for this species, turned out to be part of a much longer and more complex story.
Through molecular epidemiology, extensive environmental investigations, whole genome sequencing, and phenotypic characterisation, we traced a genetically distinct lineage of A. flavus that had persisted in the hospital environment for years. The investigations uncovered unexpected environmental reservoirs inside the hospital, potential links to contaminated building materials, and distinctive biological characteristics.
This PhD defence presents how the outbreak was investigated, what we discovered, and which questions remain unanswered.