Aspergillus fumigatus and other thermotolerant fungi generated by hospital building demolition

Streifel, Andrew J.; Lauer, J. L.; Vesley, Donald; Juni, Billie A.; Rhame, Frank S.

doi:10.1128/aem.46.2.375-378.1983

Cited by 65 publications

(30 citation statements)

References 11 publications

(9 reference statements)

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“…26,27 Concerning the pathogenesis of IPA, Aspergillus has a sporulating capacity ranging from 1 to 100 spores/mm 3 in the normal air. 28,29 The conidia released from the spores are small enough (2-3 m of diameter) to reach the alveoli by inhalation, thus the respiratory tract is the main source of entry. The impaired immunologic response of the host may lead to Aspergillus colonization of the respiratory system and subsequently to invasive aspergillosis.…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Invasive aspergillosis in the intensive care unit

Dimοpoulos¹,

Frantzeskaki²,

Poulakou

et al. 2012

Annals of the New York Academy of Sciences

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Invasive aspergillosis is a devastating infection affecting severely immunocompromised patients, most frequently with hematologic malignancies. In recent years, a surge in the incidence of invasive aspergillosis has been reported in critically ill patients without the classical risk factors. The mortality of the disease is equally high in the group of intensive care unit (ICU) patients, while the clinical signs and symptoms are nonspecific and the diagnosis remains a challenge. New noninvasive diagnostic methods in combination with better tolerated antifungal drugs aim for early diagnosis and improved prognosis of invasive aspergillosis. In this review, we discuss the epidemiology, the diagnostic strategy and algorithms, and the therapeutic choices of this severe infection in critically ill patients.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Invasive aspergillosis in the intensive care unit

Dimοpoulos¹,

Frantzeskaki²,

Poulakou

et al. 2012

Annals of the New York Academy of Sciences

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“…In particular, their aerosolisation may be associated with demolition or renovation/construction work. 42,43 They can also originate inside the hospital but this requires prolonged damp conditions in the patient's proximity or renovation/construction work. 44 In addition to the prevention of infection by direct and indirect contact, it has to be ensured that all the air available for these patients to breath has had the fungal spores filtered from it.…”

Section: Protective Isolationmentioning

confidence: 99%

Hospital and community acquired infection and the built environment – design and testing of infection control rooms

Walker¹,

Hoffman²,

Bennett³

et al. 2007

Journal of Hospital Infection

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Negative-pressure isolation rooms are required to house patients infected with agents transmissible by the aerosol route in order to minimise exposure of healthcare workers and other patients. Housing patients in a separate room provides a barrier which minimises any physical contact with other patients. An isolation room held at negative pressure to reduce aerosol escape and a high air-change rate to allow rapid removal of aerosols can eliminate transmission of infectious aerosols to those outside the room. However, badly designed and/or incorrectly operating isolation rooms have been shown to place healthcare workers and other patients at risk from airborne diseases such as tuberculosis. Few standards are available for the design of isolation rooms and no pressure differential or air-change rates are specified. Techniques such as aerosol particle tracer sampling and computational fluid dynamics can be applied to study the performance of negative-pressure rooms and to assess how design variables can affect their performance. This should allow cost-effective designs for isolation rooms to be developed. Healthcare staff should be trained to understand how these rooms operate and there should be systems in place to ensure they are functioning correctly.

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“…Streifel et al . also observed an increase in the concentration of Aspergillus and other thermo‐tolerant fungi after the implosion of a hospital building, with high concentrations of A . fumigatus and A .…”

Section: Discussionmentioning

confidence: 80%

“…The concentration of fungi in the air in periods of building constructions and renovations has been evaluated in various studies . Bouza et al .…”

Section: Discussionmentioning

confidence: 99%

Effect of the implosion and demolition of a hospital building on the concentration of fungi in the air

Barreiros

Akiti

Magalhães

et al. 2015

Mycoses

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Building renovations increase the concentration of Aspergillus conidia in the air. In 2010, one wing of the hospital building was imploded due to structural problems. To evaluate the impact of building implosion on the concentration of fungi in the air, the demolition was performed in two phases: mechanical demolition of 30 m of the building, followed by implosion of the wing. Patients at high risk for aspergillosis were placed in protected wards. Air sampling was performed during mechanical demolition, on the day of implosion and after implosion. Total and specific fungal concentrations were compared in the different areas and periods of sampling, using the anova test. The incidence of IA in the year before and after implosion was calculated. The mean concentration of Aspergillus increased during mechanical demolition and on the day of implosion. However, in the most protected areas, there was no significant difference in the concentration of fungi. The incidence of invasive aspergillosis (cases per 1000 admissions) was 0.9 in the 12 months before, 0.4 during, and 0.5 in the 12 months after mechanical demolition (P > 0.05). Continuous monitoring of the quality of air and effective infection control measures are important to minimize the impact of building demolition.

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Aspergillus fumigatus and other thermotolerant fungi generated by hospital building demolition

Cited by 65 publications

References 11 publications

Invasive aspergillosis in the intensive care unit

Invasive aspergillosis in the intensive care unit

Hospital and community acquired infection and the built environment – design and testing of infection control rooms

Effect of the implosion and demolition of a hospital building on the concentration of fungi in the air

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