ICU environmental surfaces are a reservoir of fungi: species distribution in northern Italy

Prigitano, Anna; Perrone, Pier Mario; Esposto, Maria Carmela; Carnevali, Davide; Nard, F. De; Grimoldi, Ludovico; Principi, Niccolò; Cogliati, Massimo; Castaldi, Silvana; Romanò, Luisa

doi:10.1016/j.jhin.2022.02.006

Cited by 10 publications

(9 citation statements)

References 22 publications

(20 reference statements)

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“…Fungi are abundant in our surroundings but few are capable of causing infection in humans. There have been reports on the presence of fungi in public places and hospitals ( 18 – 20 ). Exposure to environmental fungi in immunocompromised patients can cause subclinical to severe fungal infections ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Risks of mortality were more than twice as high in patients infected with fungi as in those without fungal infections ( 5 ). Prigitano et al reported that fungi were isolated from 12% of ICU environmental surfaces sampled, with molds isolated from 70.8%, mainly Aspergillus fumigatus , and yeasts, mainly C. parapsilosis and Candida glabrata , were isolated from 27.1% of positive samples ( 20 ). The fungal species reported in the present study are comparable to those recorded in hospital environments in other studies conducted.…”

Section: Discussionmentioning

confidence: 99%

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Environmental surveillance of fungi and susceptibility to antifungal agents in tertiary care hospitals

Badiee,

Ghadimi-Moghadam,

Bayatmanesh

et al. 2024

Microbiol Spectr

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This study aimed to evaluate the epidemiology of fungi in environment of tertiary care hospitals and their susceptibility patterns to seven antifungal agents for controlling and preventing fungal infections in patients. Environmental samplings on the surfaces of different parts of hospitals were collected from four university-affiliated teaching hospitals in Iran. Routine and molecular procedures identified isolated fungi, and antifungal susceptibility tests were performed in vitro . Of the 400 samples, 152 presented positive culture results, and 193 fungal species were isolated. Mold fungi accounted for 59.1% (115 species) of isolates. Most isolated fungal species in descending order were 22 Aspergillus flavus (11.4%), 21 Candida albicans (10.9%), 17 Mucor species (8.8%), 16 Penicillium species (8.3%), 16 Candida famata (8.3%), 15 Alternaria species (7.8%), 13 Fusarium species (6.7%), 11 Candida parapsilosis (5.7%), and 10 Aspergillus niger sensu stricto (5.2%). The isolated Aspergillus species revealed relatively low susceptibility to itraconazole and posaconazole with MIC90 values of 8 µg/mL. The MIC90 values of amphotericin and luliconazole in Candida species were 0.5 and 0.064 µg/mL, respectively. In this study, different species of filamentous and yeast fungi with varying susceptibility to antifungal agents were reported from the environment of the studied hospitals. IMPORTANCE Saprophytic fungi can cause nosocomial infections in high-risk patients. These infections are related to high mortality and cost. In the current study, different species of filamentous fungi and yeast were isolated from the environment of the studied hospitals. Some species were resistant to antifungal drugs. We suggest that the future work concentrates on the relationship between the level/quantification of saprophytic contamination in the environment of hospitals and fungal infections in patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Environmental surveillance of fungi and susceptibility to antifungal agents in tertiary care hospitals

Badiee,

Ghadimi-Moghadam,

Bayatmanesh

et al. 2024

Microbiol Spectr

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“…In recent years, the research on microorganisms in the ICU medical environment has not stopped. Recent studies have found that the surface of the ICU environment is a repository for fungi, 19 and Durán-ManuelEM has found that Acinetobacter baumannii can be clonally spread between medical facilities in the ICU by analyzing 16S rRNA. 20 Even CR-KPs in public settings are reported from time to time, 21 and the potential transmission of this CR-KP in the environment is worrisome.…”

Section: Discussionmentioning

confidence: 99%

Evidence of Sharing of Carbapenem-Resistant Klebsiella pneumoniae Strains Between Intensive Care Unit Patients and the Environment

Kang

et al. 2022

IDR

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Purpose Carbapenem-resistant Klebsiella pneumoniae (CR-KP) has emerged as an important public health threat. Intestinal colonization with CR-KP increases the risk of infection and death, especially in intensive care unit patients. To clarify the source of colonizing bacteria is very important to prevent the spread of CR-KP, so the purpose of this study was to explore the relationship between the ward environment and intestinal colonization of CR-KP. Methods In this study, 353 environmental swabs from ICU (Intensive Care Unit) wards and 241 anal swab samples from ICU patients were collected and screened on MacConkey plates containing 2 μg/mL ertapenem, and the origin and genotype of CR-KP were analyzed by PCR and sequencing. The sequence type of the strains was also obtained by multi-locus sequence type (MLST) analysis, and plasmid conjugation test was used to clarify whether CR-KP can promote the transmission of drug resistance genes through plasmid integration and rearrangement. Results A total of 20 CR-KP environmental strains and 7 intestinal strains were obtained, most of which were bla OXA-48 resistant genotypes. Four different STs were identified by multi-locus sequence type (MLST) analysis, among which the large logarithm was ST485 type, and PFGE clustering showed that the similarity between them was >85%. In the plasmid transcoupling assay, we report that one of the Klebsiella pneumoniae drug-resistant plasmids was successfully transferred to E. coli, indicating that it may promote the spread of drug-resistant genes through plasmid integration and rearrangement. Conclusion Our research suggests that the environment may be a potential source of CR-KP and that there is a need for us to adopt more effective disinfection measures.

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“…Outbreaks often centred around ICUs and neonatal ICUs (NICUs) [118,124,128], with reports of fungemia triggering investigation (see Table 2). As this species produces biofilm, it is unsurprising that it has been recovered from devices such as NICU incubators and humidifiers, patient beds, nurse workstations, computers, floors, and hands of healthcare workers [113,159,160]. However, in many of the outbreaks, a point source was not identified [112].…”

Section: Candida Parapsilosismentioning

confidence: 99%

Outbreaks of Fungal Infections in Hospitals: Epidemiology, Detection, and Management

Douglas,

Stewart,

Halliday

et al. 2023

JoF

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Nosocomial clusters of fungal infections, whilst uncommon, cannot be predicted and are associated with significant morbidity and mortality. Here, we review reports of nosocomial outbreaks of invasive fungal disease to glean insight into their epidemiology, risks for infection, methods employed in outbreak detection including genomic testing to confirm the outbreak, and approaches to clinical and infection control management. Both yeasts and filamentous fungi cause outbreaks, with each having general and specific risks. The early detection and confirmation of the outbreak are essential for diagnosis, treatment of affected patients, and termination of the outbreak. Environmental sampling, including the air in mould outbreaks, for the pathogen may be indicated. The genetic analysis of epidemiologically linked isolates is strongly recommended through a sufficiently discriminatory approach such as whole genome sequencing or a method that is acceptably discriminatory for that pathogen. An analysis of both linked isolates and epidemiologically unrelated strains is required to enable genetic similarity comparisons. The management of the outbreak encompasses input from a multi-disciplinary team with epidemiological investigation and infection control measures, including screening for additional cases, patient cohorting, and strict hygiene and cleaning procedures. Automated methods for fungal infection surveillance would greatly aid earlier outbreak detection and should be a focus of research.

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ICU environmental surfaces are a reservoir of fungi: species distribution in northern Italy

Cited by 10 publications

References 22 publications

Environmental surveillance of fungi and susceptibility to antifungal agents in tertiary care hospitals

Environmental surveillance of fungi and susceptibility to antifungal agents in tertiary care hospitals

Evidence of Sharing of Carbapenem-Resistant Klebsiella pneumoniae Strains Between Intensive Care Unit Patients and the Environment

Outbreaks of Fungal Infections in Hospitals: Epidemiology, Detection, and Management

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