Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

doi:10.3205/dgkh000410

Cited by 2 publications

(2 citation statements)

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“…During their research over a period of 10 years, the researchers observed this phenomenon several times [26]. Hospital renovation/construction is considered to be a major source of invasive healthcare-associated fungal infections; thus, planning such activities requires the preparation of appropriate safeguards [5,15,21]. It can be emphasized that there is a need for monitoring airborne fungal spore concentrations and determining breakpoint values [27].…”

Section: Discussionmentioning

confidence: 99%

“…The risk can be reduced by the installation of air-conditioning systems with HEPA (high-efficiency particulate air) filters, a high frequency of air exchanges (at least 12 per hour) and appropriate differentiation of air pressure in individual rooms, limiting the influx of microorganisms from unprotected areas. The isolation rooms in such wards consist of a patient room with positive air pressure, a shower, a toilet, and an anteroom (with negative air pressure), which separates the patient room from the corridor (most often without a HEPA filter) [5,15]. The proper functioning of HEPA systems requires adequate technical supervision, including the replacement of filters, and should be supported with microbiological surveillance of the air quality [5].…”

Section: Introductionmentioning

confidence: 99%

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Quantitative and Qualitative Airborne Mycobiota Surveillance in High-Risk Hospital Environment

et al. 2023

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(1) Background: The primary aim of the presented study was to assess the prevalence of fungi in the indoor air of selected hospital wards, and the additional goal was to evaluate the susceptibility of cultured isolates of Aspergillus fumigatus to triazoles. (2) Methods: Three hematology departments and a hospital for lung diseases were surveyed in 2015 and/or 2019. Air samples were taken with a MicroBio MB1 air sampler on Sabouraud agar. The susceptibility of Aspergillus fumigatus isolates to voriconazole, posaconazole and itraconazole was tested with a microdilution method, according to EUCAST. (3) Results: The amount of fungi cultured from rooms equipped with sterile air circulation, as well as flow devices for air disinfection, was significantly lower compared to that from unprotected rooms. The areas most contaminated with fungi were corridors and bathrooms. The dominant species were Cladosporium and Penicillium. A. fumigatus was rare in hematological departments (6/61, 9.8% examinations performed in 2014 and 2/40, 5% in 2019), whereas in the hospital for lung diseases an outbreak of A. fumigatus spores with up to 300 CFU/m3 was noted in March 2015. No triazole-resistant A. fumigatus isolate was detected. (4) Conclusions: Regular microbiological testing of the hospital environment can contribute to the detection of spore outbreaks, and thus enable the implementation of corrective procedures (e.g., additional disinfection, changing of HEPA filters).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantitative and Qualitative Airborne Mycobiota Surveillance in High-Risk Hospital Environment

et al. 2023

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Metamizole-induced agranulocytosis (MIA): a mini review

Tomidis Chatzimanouil,

Goppelt,

Zeissig

et al. 2023

Mol Cell Pediatr

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Metamizole is an analgesic, antipyretic, and spasmolytic drug in Germany only approved for the treatment of severe pain or high fever that does not respond to other measures. In recent years, an increased use has been described among both adults and children, often against the approved indication. The most important side effect of metamizole is the development of agranulocytosis (neutrophil count < 500/µL). Incidence of metamizole-induced agranulocytosis (MIA) ranges depending on the study from 0.96 cases per million per year to 1:1602 per patient and metamizole prescription. The risk of agranulocytosis in children remains unclear, but is probably lower than in adults. Female gender and older age are associated with higher incidence, reflecting prescription distribution. MIA is dose-independent and risk seems to increase with duration of intake. In patients with past exposure, re-exposure may lead to rapid onset. MIA is believed to be induced either through immunologic or toxic mechanisms. MIA presents with fever, sore throat, fatigue, and mucosal inflammation, up to ulceration. Even in the case of suspected MIA, treatment with metamizole should be immediately paused and an examination of the blood cell count is required. In case of local or systemic infections, empirical therapy with broad-spectrum antibiotics should be administered. G-CSF therapy should be limited to patients with poor prognostic factors. The patient should be monitored closely until the neutrophil count returns to normal. Re-exposure to metamizole must be avoided.

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Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

Cited by 2 publications

References 408 publications

Quantitative and Qualitative Airborne Mycobiota Surveillance in High-Risk Hospital Environment

Quantitative and Qualitative Airborne Mycobiota Surveillance in High-Risk Hospital Environment

Metamizole-induced agranulocytosis (MIA): a mini review

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