Control of Construction-Associated Nosocomial Aspergillosis in an Antiquated Hematology Unit

Abstract

An environmental control strategy incorporating widely available technology may have played an important role in controlling this outbreak of construction-associated invasive aspergillosis.

Nosocomial aspergillosis in outbreak settings

“…In 24 outbreaks, volumetric air samples in the hospital and outdoors were taken during the environmental investigation (Table III). The concentration of airborne fungi in patient care areas 44 1.1e>90 Humphreys 48 0.0 Richet et al 50 0.0 0.0 Flynn et al 82 >71.0 Buffington et al 24 Took volumetric air samples but did not describe exact results of environmental investigation Leenders et al 26,84 0.0e<0.1 0.0e<0.1 0.9e1.3 Loo et al 85 6.8 Singer et al 22 0.0 Gaspar et al 87 48.0 5.0e35.0 Thio et al 28 0.8e18.0 Lai 88 0.0e5.9 0.0 Oren et al 89 15.0 15.0 0.2 Hahn et al 90 <4.0e>150.0 Pegues et al 23 1.1e106.8 Heinemann et al 33,91,92 <5.0e115.0 HEPA, high-efficiency particulate air. during outbreak investigations ranged from 0 to more than 100 spores/m 3 .…”

Hospital-wide prospective mandatory surveillance of invasive aspergillosis in a French teaching hospital (2000–2002)

“…Thus, outbreaks of nosocomial infection are recognized and have been attributed to factors such as ongoing construction and fire-proofing material. [3][4][5] The Centers for Disease Control and Prevention (CDC) have established the need for epidemiological surveillance of pulmonary IA in hospitals. 6 In France, two official guidelines concerning IA prevention recently recommended epidemiological surveillance of IA in hospitals.…”

Aspergillus surveillance project at a large tertiary-care hospital

“…11, 23 -27 Some of these studies also employed additional controls for aspergillus such as intranasal amphotericin B, 24 or use of sealed rooms, replacement of perforated ceiling tiles and dust-accumulating blinds, and use of anti-fungal copper-8-quionolate paint. 23 This year-long aspergillus study was conducted at the request of a major tertiary-care hospital, which had about 200 bone marrow and organ transplant patients per year. The hospital was concerned about possible aspergillus infections due to renovation work inside the hospital and several large demolition and building projects being undertaken within 1 km of the hospital.…”