The indoor air as a potential determinant of the frequency of invasive aspergillosis in the intensive care

Boff, Cristiane; Zoppas, Barbara Catarina de Antoni; Aquino, Valério Rodrigues; Kuplich, Nádia Mora; Miron, Diogo; Pasqualotto, Alessandro C.

doi:10.1111/myc.12070

Cited by 17 publications

(25 citation statements)

References 19 publications

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“…This observation corroborates the need of efficient systematic fungal environmental surveillance. Environmental studies about water contamination (Warris et al., ), food contamination (Marr et al., ), and the influence of weather conditions on fungal contamination (Boff et al., ; Panackal et al., ) have already been conducted.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home

et al. 2014

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This study emphasizes the fact that preventive measures should not be aimed only at the hospital setting: among patients diagnosed with invasive aspergillosis/invasive fungal infection (IA/IFI), 5 of 14 (36%) were exposed to opportunistic fungal species at home exclusively. Moreover, four of these five patients were living in homes having the highest percentage of Aspergillus fumigatus and Aspergillus flavus (>15%), one of which had 48% of A. fumigatus. Therefore, our work supports the need for a counselor to carry out an environmental survey in patients’ homes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home

et al. 2014

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“…According to Taccone et al, the mortality predictors for critically ill with IPA include age, SOFA score, mechanical ventilation, and renal replacement therapy at diagnosis [26,88].…”

Section: Invasive Aspergillosismentioning

confidence: 99%

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

et al. 2017

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Purpose:To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. Methods:A systematic review of the medical literature taking account of national and international guidelines and expert opinion. Results:Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [β-1 → 3-d-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. Conclusions:Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be performed.

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“…The presence of pathogenic fungi is associated with various diseases, among them the aspergillosis; determining specific pathological conditions, especially in immunocompromised patients, neonates and children (Cristina et al, 2009). Furthermore, fungi contamination of the indoor atmosphere may influence the occurrence of invasive aspergillosis in intensive care units (Boff et al, 2013). The isolation of several Aspergillus species previously described as pathogenic in this study suggests the possibility of development of various symptoms that can lead to illness, absenteeism of employees, as well as emerging risk to patients in the ICU.…”

Section: Resultsmentioning

confidence: 58%

“…Infections in newborns are always considered from hospital, except for those transmitted via placenta and those associated with premature rupture of membranes for more than 24 hours (Duarte and Mendonça, 2005). The first reports about the importance of the hospital environment as a transmission source of infectious agents associated with air pollution analyzed the spores of Aspergillus sp, thus, exposure to air contaminated by fungi and its metabolites in indoor air-conditioned have worried the scientific and health community around the world (Boff et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Airborne Fungi in Neonatal Intensive Care Unit of a Public Hospital in Brazil

Souza¹,

Nascimento²,

Araújo³

et al. 2019

Int.J.Curr.Microbiol.App.Sci

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Fungi are opportunistic organisms with wide geographical distribution and can also be found in the hospital environment. These microorganisms can cause infections, especially in immunocompromised patients. The aim of this study was to evaluate airborne fungal contamination in two neonatal intensive care units (ICU) of a public hospital before and after cleaning. The technique of Petri dishes exposure containing Sabouraud agar with 50mg/L chloramphenicol was used for sample collection. Air conditioning filters were also sampled using a sterile swab for fungal collection. The identification of fungal isolates was performed by observing macroscopic and microscopic structures. A total of 1305 colony forming units was isolated, where: 718 (55.0%) were isolated before neonatal ICU cleaning and 587 (45.0%) after cleaning. Forty-two species belonging to 24 genera were identified, being Cladosporium cladosporioides, Penicillium aurantiogriseum and Aspergillus oryzae the most frequent species in the analyzed samples. The presence of pathogenic fungi in ICUs demonstrates the need for constant monitoring of indoor air quality in order to better control airborne contamination in hospital environments.

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The indoor air as a potential determinant of the frequency of invasive aspergillosis in the intensive care

Cited by 17 publications

References 19 publications

Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home

Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

Airborne Fungi in Neonatal Intensive Care Unit of a Public Hospital in Brazil

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