Neosartorya hiratsukae: Environmental isolation from intensive care units in an Italian hospital

Neosartorya hiratsukae, teleomorph of the Aspergillus section Fumigati, is a rare fungus isolated for the first time in Japan from indoor air and from pasteurized aloe juice.1 Neosartorya hiratsukae is an opportunistic pathogen and only few cases of human infections have been reported worldwide.2–6 N. hiratsukae is often misidentified because it cannot be distinguished from A. fumigatus sensu stricto by conventional morphological macroscopic and microscopic analyses or by the extensively used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). No break points (BPs) have been specified for N. hiratsukae; however, the MIC values of our isolate are low and under the EUCAST BPs established for A. fumigatus.8 No cases of aspergillosis were diagnosed in the 2 ICUs in a 5-month period, 3 before the isolation of N. hiratsukae from the environment and 2 thereafter (Dr R. Grande, personal communication). In the literature, N. hiratsukae has been reported in the indoor air1 and on drywall, where the small white colonies are hardly visible, so the spores can easily spread in the environment causing a health risk.9 In the 2 ICUs examined, no renovations had been made in the period prior to the sampling, and there is no drywall in these wards.