Airborne Aspergillus contamination during hospital construction works: Efficacy of protective measures

Fournel, Isabelle; Sautour, Marc; Lafon, Ingrid; Sixt, Nathalie; l'Ollivier, Coralie; Dalle, Frédéric; Chavanet, P.; Couillaud, Gérard; Caillot, Denis; Astruc, K.; Bonnin, Alain; Aho-Glélé, Ludwid-Serge

doi:10.1016/j.ajic.2009.07.011

Cited by 36 publications

(18 citation statements)

References 20 publications

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“…28 As several previously reported NIA episodes were related to the occurrence of hospital construction or renovation works, implementation of specific effective protective measures against Aspergillus contamination in case of building construction was recommended and established in the GUH. 13,18,19,22,29,30 Despite application of these recommendations, most NIA cases (68.4%) still occurred while construction works were taking place in the patient's environment, albeit no cluster of NIA cases was identified in our study. Our results suggest the need for a reinforcement of these preventive measures, especially in the case of minor or intermediate renovation or construction works.…”

Section: Discussionmentioning

confidence: 54%

Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital

Garnaud¹,

Brenier-Pinchart²,

Thiébaut-Bertrand³

et al. 2012

Journal of Infection

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Section: Discussionmentioning

confidence: 54%

Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital

Garnaud¹,

Brenier-Pinchart²,

Thiébaut-Bertrand³

et al. 2012

Journal of Infection

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“…Facilities maintenance programs can be undermined by the presence of microenvironments that serve as havens for contaminant strains, particularly those that are adept at biofilm formation. Aspergillus contamination of hospitals is a well-documented problem, and many methods have been developed to reduce the introduction of this potential pathogen [5,8]. In contrast, cases of Aspergillus contamination in industrial facilities are not well documented.…”

Section: Discussionmentioning

confidence: 99%

“…This was a significant finding because members of the Aspergillus genus have proven to be adept at colonizing human tissues; mortality rates associated with A. fumigatus-caused invasive aspergillosis approach 90% and pose a threat to transplant recipients [6,11]. Additionally, Aspergilli are well-documented contaminants in hospitals, and significant efforts have been made to control their dissemination in these sensitive environments [5,8]. Even with the development of novel control mechanisms, Aspergillus contamination is still a significant problem for industrial biomedical research and production facilities, with significant regulatory and financial implications.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Aspergillus contamination in a biomedical research facility: a case study

Cornelison

Stubblefield

Gilbert

et al. 2012

Journal of Industrial Microbiology and Biotechnology

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Fungal contamination of biomedical processes and facilities can result in major revenue loss and product delay. A biomedical research facility (BRF) culturing human cell lines experienced recurring fungal contamination of clean room incubators over a 3-year period. In 2010, as part of the plan to mitigate contamination, 20 fungal specimens were isolated by air and swab samples at various locations within the BRF. Aspergillus niger and Aspergillus fumigatus were isolated from several clean-room incubators. A. niger and A. fumigatus were identified using sequence comparison of the 18S rRNA gene. To determine whether the contaminant strains isolated in 2010 were the same as or different from strains isolated between 2007 and 2009, a novel forensic approach to random amplified polymorphic DNA (RAPD) PCR was used. The phylogenetic relationship among isolates showed two main genotypic clusters, and indicated the continual presence of the same A. fumigatus strain in the clean room since 2007. Biofilms can serve as chronic sources of contamination; visual inspection of plugs within the incubators revealed fungal biofilms. Moreover, confocal microscopy imaging of flow cell-grown biofilms demonstrated that the strains isolated from the incubators formed dense biofilms relative to other environmental isolates from the BRF. Lastly, the efficacies of various disinfectants employed at the BRF were examined for their ability to prevent spore germination. Overall, the investigation found that the use of rubber plugs around thermometers in the tissue culture incubators provided a microenvironment where A. fumigatus could survive regular surface disinfection. A general lesson from this case study is that the presence of microenvironments harboring contaminants can undermine decontamination procedures and serve as a source of recurrent contamination.

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“…44 In addition, this emerging problem highlights the importance of following standardized infection control practices to reduce the risk of nosocomial aspergillosis in high-risk patients and the urgent need to develop tests to rapidly identify azole-resistant Aspergillus species. 45 …”

Section: Emerging Antifungal Resistancementioning

confidence: 99%

Antifungal stewardship considerations for adults and pediatrics

2016

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Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via postprescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

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Airborne Aspergillus contamination during hospital construction works: Efficacy of protective measures

Cited by 36 publications

References 20 publications

Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital

Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital

Recurrent Aspergillus contamination in a biomedical research facility: a case study

Antifungal stewardship considerations for adults and pediatrics

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