The Epidemiology of Invasive Pulmonary Aspergillosis at a Large Teaching Hospital

Abstract

The SOT IPA rate decreased after intervals 1 and 2, although the hospitalwide IPA rate remained stable during the study period. Post-earthquake hospital demolition and construction occurring after interval 2 was not associated with an increase in the rate of IPA at our institution.

Positive-pressure isolation and the prevention of invasive aspergillosis. What is the evidence?

“…In a retrospective study from California, invasive pulmonary aspergillosis was classified as hospital-acquired if the patient had a respiratory culture or histopathological report consistent with aspergillosis that was obtained seven or more days after admission with at least one prior negative respiratory culture before the positive sample. 18 Over a nine-year period, 505 patients were identified as having Aspergillus species according to microbiological records; 72 patients with definite aspergillus infection and 433 who were colonized only. Acquisition of IA was deemed to be hospital-acquired in 25% of cases, community-acquired in 62.5% of cases and in the remainder of indeterminate origin.…”

“…Even the occurrence of an earthquake in the Los Angeles area in 1994 and the subsequent demolition and construction activity did not result in an increase in the incidence of IA. 18 A retrospective cohort study was undertaken to investigate the cause of an outbreak of 10 cases of nosocomial IA from a patient population of 91 admitted for four or more days on a haematology oncology unit in New York. It was believed that this outbreak was due to high counts of aspergillosis spores in air from non-bone marrow transplant areas, and after the installation of HEPA filters, the incidence decreased.…”

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

“…IPA is well known to account for a large number of mortalities due to fungi in haematological and solid-organ transplant patients [5]. According to recent autopsy series, its incidence has grown over the last 20 yrs [6][7][8]; this is probably related to the increasing use of immunosuppressive and corticosteroid therapies in this patient population [9,10].…”

An Exposure Model for Identifying Health Risk due to Environmental Microbial Contamination in the Healthcare Setting

“…can disturb bioaerosols that may be impeded and release them into the building. (Arnow, Andersen et al 1978;Loo, Bertrand et al 1996;Pegues, Daar et al 2001;CDC 2003) Therefore, a residual risk of exposure remains, even if the exposure is considered impeded. 4.…”