Fungal contamination of medical masks among forensic healthcare workers in the COVID19 era

Merad, Yassine; Belmokhtar, Zoubir; Hadjazi, Omar; Belkacemi, Malika; Matmour, Derouicha; Merad, Zakaria; Bassaid, Adila; Megherbi, Ouziane

doi:10.1016/j.nmni.2023.101134

Cited by 3 publications

(5 citation statements)

References 22 publications

(30 reference statements)

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“…Both our experimental study and the published literature show that face masks accumulate microorganisms, including pathobionts (Table 1 and 2) [39,42,43,45,47,[60][61][62][63][64][65][66][67][68], with a microbial load up to several hundred times higher than the German standard VDI 6022 limit for ventilation systems surfaces [69] and the EN 14683 requirements for unused masks. Contamination increases with extended wearing time (Figure 5) [39,42,47,[62][63][64]67,68] and is greater for N95 than surgical masks [65]. Most contamination was with staphylococci, occasionally including the pathogen S. aureus.…”

Section: Discussionmentioning

confidence: 52%

“…Our literature review showed that all relevant mask types (surgical, N95, cloth) become increasingly contaminated with microorganisms during wear (Table 2, Figure 5) [39,41,42,47,62,64,68]. The literature reports contamination by bacteria of the genera Acinetobacter, Bacillus, Escherichia (specifically, E. coli, a faecal organism), Enterobacter, Enterococcus (another faecal organism), Klebsiella (including K. pneumoniae), Micrococcus, Pseudomonas, Staphylococcus (including S. aureus) and Streptococcus and by fungi of the genera Aspergillus, Alternaria, Candida, Cadosporium, Microsporum and Mucor (Table 2).…”

Section: Literature Review On Mask Contaminationmentioning

confidence: 99%

“…Eleven studies considered bacteria, five fungi, and three both (Table 2). Four studies were for the general population whereas 10 were for healthcare workers (HCWs) [39,42,43,45,47,[60][61][62][63][64][65][66][67][68]. Six were for surgical units (one specifically performing orthopaedic surgery) and five for dental practices [45,[61][62][63][64].…”

Section: Systematic Literature Searchmentioning

confidence: 99%

“…Fungal contamination is seen up to 70-88% of used masks [67,68], and can be also higher inside than outside the mask [67]. This is surprising, given that fungi must come from outside the mask [60].…”

Section: Literature Review On Mask Contaminationmentioning

confidence: 99%

“…Sukul et al changes in the gut microbiome (metabolic alterations) [20] whilst Xiang et al found change of the nasal microbial communities after prolonged mask wearing [107]. Lastly, face masks are mentioned as possible factors behind an increase in mucormycosis cases during the COVID-19 pandemic particularly in immunocompromised or otherwise vulnerable individuals [67,68,140].…”

Section: Face Mask Contaminationpotential Clinical Implicationsmentioning

confidence: 99%

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The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

Kisielinski,

Wojtasik,

Zalewska

et al. 2023

Preprint

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We investigated and quantified bacterial accumulation in facemasks used by the general population, using 16S rRNA (Sanger Sequencing), culture and biochemical analysis along with Rose Bengal staining. Additionally, a systematic overview of the literature on face mask contamination was undertaken. We found an average bacterial load of 4.24 × 104 CFU recovered/mask, with a maximum load of 2.85 × 105 CFU. This maximum is 310 times higher than the limit value for contamination of ventilation system outlet surfaces specified by the German standard VDI 6022. Biochemical and molecular identification predominantly found Staphylococcus species (80%), including Staphylococcus aureus, along with endospore-forming Bacillus spp. Literature reports also indicate contamination of masks by bacterial and fungal opportunists of the genera Acinetobacter, Aspergillus, Alternaria, Bacillus, Cadosporium, Candida, Escherichia, Enterobacter, Enterococcus, Klebsiella (including K. pneumoniae), Micrococcus, Microsporum, Mucor, Pseudomonas, Staphylococcus and Streptococcus. Bacterial counts increase linearly with wearing duration, and prolonged use may affect the skin and respiratory microbiomes, promoting consequential eye, skin, oral and airway conditions. These aspects underscore the urgent need for further research and a risk-benefit analysis in respect of mask use, particularly given their unproven efficacy in disrupting the transmission of respiratory viruses and their adverse social consequences.

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Section: Discussionmentioning

confidence: 52%

Section: Literature Review On Mask Contaminationmentioning

confidence: 99%

Section: Systematic Literature Searchmentioning

confidence: 99%

Section: Literature Review On Mask Contaminationmentioning

confidence: 99%

Section: Face Mask Contaminationpotential Clinical Implicationsmentioning

confidence: 99%

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The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

Kisielinski,

Wojtasik,

Zalewska

et al. 2023

Preprint

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Uncontrolled Asthma and Laryngeal Candidiasis in Primary Care

Johnston,

Shanahan

2023

The Journal for Nurse Practitioners

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Impact of COVID-19 Disease on the Development of Osteomyelitis of Jaws: A Systematic Review

Vardas,

Adamo,

Canfora

et al. 2024

JCM

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Background/Objectives: Osteomyelitis is characterized by an inflammatory process affecting both bone and bone marrow, leading to cell death and the formation of bone sequestrum. Recent literature from the past five years has documented instances of osteomyelitis following infections of SARS-CoV-2. This systematic review explores the link between osteomyelitis of the jaw (OMJ) and COVID-19 infections. Methods: This review adhered to the PRISMA guidelines, systematically analyzing literature from 2020 to 2024 sourced from databases including Medline, Embase, Scopus, and Web of Science. PROSPERO ID: CRD42024526257. Results: The review selected 42 articles, detailing 201 cases of osteomyelitis of the jaw related to COVID-19 (COMJ). The demographic breakdown included 195 male (74.4%) and 67 female patients (25.6%), with a median age of 52.7 years, ranging from 24 to 71 years. A significant portion of COMJ patients (41.5%) were hospitalized due to COVID-19, and 58.5% received corticosteroid therapy. Diabetes mellitus was a common comorbidity among COMJ patients (65.1%). Most cases involved maxilla (182 cases; 90.5%), with nearly half showing sinus involvement (49.4%). The mandible was affected in 19 cases (9.5%). Mucormycosis and aspergillosis emerged as the predominant fungal infections, identified in 103 (51.2%) and 50 (24.9%) cases, respectively. Conclusions: Individuals with pre-existing health conditions such as diabetes mellitus who have been treated for COVID-19 are at an increased risk of developing OMJ, particularly maxillary fungal osteomyelitis. COMJ poses a significant diagnostic and therapeutic challenge for dental and maxillofacial professionals, who are often the first to encounter these cases.

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Fungal contamination of medical masks among forensic healthcare workers in the COVID19 era

Cited by 3 publications

References 22 publications

The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

Uncontrolled Asthma and Laryngeal Candidiasis in Primary Care

Impact of COVID-19 Disease on the Development of Osteomyelitis of Jaws: A Systematic Review

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