Major articleHospital environment and invasive aspergillosis in patients with hematologic malignancy
Section snippets
Methods
All patients who occupied any of the 74 study rooms for at least 7 days were clinically and radiographically evaluated. The patient needed to have occupied the room 30 days before environmental sampling or 60 days after sampling. All patients housed in the study rooms were followed for 2 additional months to determine whether invasive aspergillosis (IA) developed.
Nosocomial Aspergillus infection was defined as an infection that developed within 2 weeks following hospitalization. Patients were
Patient information
A total of 458 patients was evaluated: 203 patients were evaluated in culture positive rooms and 255 evaluated in culture negative rooms.
Study population
Compared with patients in Aspergillus-negative rooms, patients in Aspergillus-positive rooms were more likely to have hematologic malignancy (93% vs 81%, respectively, P < .001). The 2 groups were comparable for age, gender, neutropenia status, and bone marrow transplant (Table 1).
Only 2 patients who were housed in the study rooms developed nosocomial IA.
Discussion
Our results confirmed the lack of relationship between environmental cultures and the strains of Aspergillus species causing IA in our patients. The results illustrate predominantly mismatched speciation. Similarly, Hospenthal et al reported that there was no association between the environmental samples and the types of aspergillosis species recovered from the patients’ areas when samples were collected on a weekly basis in patient care areas and in the hallways.10 In addition, several other
Conclusion
Our data showed no correlation between A niger found in the environmental sample of the room and the 2 patients who tested positive for A fumigatus. In HEPA-filtered rooms, the contribution of bioaerosol contamination could be minimal. Incidence of nosocomial IA appears to be related to prior community-acquired colonization or nosocomial acquisition transport of the patients outside the room with the infection manifesting in the hospital setting following immunosuppression. The water did not
References (14)
Hospital infection from contaminated ice
Lancet
(1968)- et al.
Value of environmental sampling and molecular typing aspergilli to assess nosocomial sources of aspergillosis
J Hosp Infect
(1997) - et al.
Epidemiology of nosocomial fungal infections: Invasive aspergillosis and the environment
Diagn Microbiol Infect Dis
(1999) - et al.
Invasive aspergillosis in 2002: An update
Eur J Clin Microbiol
(2002) - et al.
Invasive aspergillosis following hematopoietic cell transplantation: Outcomes and prognostic factors associated with mortality
Clin Infect Dis
(2007) - et al.
Pathogenic Aspergillus species recovered from a hospital water system: A 3-year prospective study
Clin Infect Dis
(2002) - et al.
Contamination of hospital water with Aspergillus fumigatus and other molds
Clin Infect Dis
(2002)
Cited by (27)
Invasive fungal infections in hemato-oncology
2023, Indian Journal of Medical MicrobiologyFungal contamination assessment in healthcare environments-A bibliographic review
2021, Viruses, Bacteria and Fungi in the Built Environment: Designing Healthy Indoor EnvironmentsDiagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline
2018, Clinical Microbiology and InfectionRapid quantification of viable fungi in hospital environments: Analysis of air and surface samples using solid-phase cytometry
2013, Journal of Hospital InfectionCitation Excerpt :Monitoring of environmental fungal contamination is strongly recommended, especially for outbreak investigation in epidemic situations and during building construction and renovation work.3,4 Moreover, environmental surveillance programmes are also useful to assess air control efficiency in wards with high-risk patients.5,6 Culture-based analysis is the conventional approach used for fungal quantification in air and surface samples.
Technical note: The effect of different incubation temperatures on the recovery of Aspergillus species from hospital air
2012, American Journal of Infection ControlCitation Excerpt :Those studies reported a predominance of fungi belonging to the genera Penicillium and Cladosporium, with a low frequency of Aspergillus species.2-5 In some previous studies, incubation temperature was not even mentioned.6 An earlier study from Italy used 2 different incubation temperatures.7
Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital
2012, Journal of InfectionCitation Excerpt :In this study, NIA was defined according to the time lapse between admission in the hospital and onset of the IA first signs: minimum 10 days. Another study in haematological patients used a definition based on time lapse (2 weeks), but concluded that in this context, incidence of NIA appeared to be related to prior community-acquired colonization or nosocomial acquisition.8 Recently, Graf et al. defined nosocomial acquisition of IA as the apparition of clinical symptoms more than seven days after admission with at least one negative respiratory culture before the first positive GM result.28
L.D.L.’s current institution is Waste Management Healthcare Solutions, Houston, TX.
Conflicts of interest: None to report.