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Zhang TT, Li N, Xu X, Jiang N, Lv M. Measurement and prediction of the detachment of Aspergillus niger spores in turbulent flows. JOURNAL OF HAZARDOUS MATERIALS 2024; 475:134910. [PMID: 38889465 DOI: 10.1016/j.jhazmat.2024.134910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
Aspergillus niger (A. niger) spores can induce numerous health problems. Once the airflow-imposed drag force on an A. niger spore exceeds its binding force with the colony, the spore is detached. Turbulent flow may considerably increase the spore detachment. No method is currently available for prediction of the drag force on a spore and its detachment in turbulent flows. This investigation measured the turbulent velocities and detachment of A. niger colonies in a wind tunnel. Computational fluid dynamics (CFD) was employed to model an A. niger unit subjected to turbulent flow blowing. The top 1 % quantile instantaneous velocity of the turbulent flow was specified as the steady entry flow boundary condition for solving the peak velocity distribution and the peak drag forces onto spores. The predicted spore detachment ratios were compared with the measurement data for model validation. The results revealed that the spore detachment ratios with a turbulence intensity of 17 % to 20 % can be twice to triple the ratio with a turbulence intensity of approximately 1 %, when the average velocity for blowing remains the same. The proposed CFD model can accurately predict the detachment ratios of the A. niger spores. ENVIRONMENTAL IMPLICATION: Some people are sensitive to the Aspergillus niger (A. niger) spores, and excessive exposure can cause nasal congestion, skin tingling, coughing, and even asthma. Turbulent flow can considerably increase the spore detachment, due to the increased airflow-imposed drag force on the spores during turbulence. This investigation developed a numerical model to solve for the peak velocity distribution and the peak drag forces onto spores in turbulent flows to predict the spore detachment. With the numerical tool, the airborne fungal spore concentrations would be predictable, which paves a way for intelligent and precise control of fungal aerosol pollution.
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Affiliation(s)
- Tengfei Tim Zhang
- Tianjin Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin, China; School of Civil Engineering, Dalian University of Technology, Dalian, China
| | - Nuo Li
- Tianjin Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Xinzi Xu
- Tianjin Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin, China; Department of Building Services Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Nan Jiang
- School of Mechanical Engineering, Tianjin University, Tianjin, China
| | - Mengqiang Lv
- Tianjin Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin, China.
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2
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Wong SC, Chen JH, Kwok MO, Siu CY, Yuen LL, AuYeung CH, Li CK, Li BH, Chan BW, So SY, Chiu KH, Yuen KY, Cheng VC. Air dispersal of multi-drug-resistant organisms including meticillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter baumannii and carbapenemase-producing Enterobacterales in general wards: surveillance culture of air grilles. J Hosp Infect 2024; 149:26-35. [PMID: 38705476 DOI: 10.1016/j.jhin.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The environmental surveillance of air grilles in clinical areas has not been systematically analysed. METHODS Samples were collected from frequently touched items (N = 529), air supply (N = 295) and exhaust (N = 184) grilles in six medical and 11 surgical wards for the cultures of multi-drug-resistant organisms (MDROs): meticillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenemase-producing Enterobacterales (CPE), and isolates were selected for whole-genome sequencing (WGS). The contamination rates were correlated with the colonization pressures of the respective MDROs. RESULTS From 3rd October to 21st November 2023, 9.8% (99/1008) of the samples tested positive, with MRSA (24.2%, 24/99), CRAB (59.6%, 59/99) and CPE (2.0%, 2/99), being the only detected MDROs. The contamination rate in air exhaust grilles (26.6%, 49/184) was significantly higher than in air supply grilles (5.8%, 17/295; P<0.001). The contamination rate of air exhaust grilles with any MDRO in acute medical wards (73.7%, 14/19) was significantly higher than in surgical wards (12.5%, 4/32; P<0.001). However, there was no difference in the contamination rate of air exhaust grilles between those located inside and outside the cohort cubicles for MDROs (27.1%, 13/48 vs 28.8%, 30/104; P=0.823). Nevertheless, the weekly CRAB colonization pressure showed a significant correlation with the overall environmental contamination rate (r = 0.878; 95% confidence interval (CI): 0.136-0.986; P=0.004), as well as with the contamination rate in air supply grilles (r = 0.960; 95% CI: 0.375-0.999; P<0.001) and air exhaust grilles (r = 0.850; 95% CI: 0.401-0.980; P=0.008). WGS demonstrated clonal relatedness of isolates collected from patients and air exhaust grilles. CONCLUSIONS Air grilles may serve as MDRO reservoirs. Cohort nursing in open cubicles may not completely prevent MDRO transmission through air dispersal, prompting the consideration of future hospital design.
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Affiliation(s)
- S C Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - J H Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - M O Kwok
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - C Y Siu
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - L L Yuen
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - C H AuYeung
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - C K Li
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - B H Li
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - B W Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - S Y So
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - K H Chiu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - K Y Yuen
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - V C Cheng
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China; Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
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Rinker DC, Sauters TJC, Steffen K, Gumilang A, Raja HA, Rangel-Grimaldo M, Pinzan CF, de Castro PA, dos Reis TF, Delbaje E, Houbraken J, Goldman GH, Oberlies NH, Rokas A. Strain heterogeneity in a non-pathogenic fungus highlights factors contributing to virulence. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.08.583994. [PMID: 38496489 PMCID: PMC10942418 DOI: 10.1101/2024.03.08.583994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Fungal pathogens exhibit extensive strain heterogeneity, including variation in virulence. Whether closely related non-pathogenic species also exhibit strain heterogeneity remains unknown. Here, we comprehensively characterized the pathogenic potentials (i.e., the ability to cause morbidity and mortality) of 16 diverse strains of Aspergillus fischeri, a non-pathogenic close relative of the major pathogen Aspergillus fumigatus. In vitro immune response assays and in vivo virulence assays using a mouse model of pulmonary aspergillosis showed that A. fischeri strains varied widely in their pathogenic potential. Furthermore, pangenome analyses suggest that A. fischeri genomic and phenotypic diversity is even greater. Genomic, transcriptomic, and metabolomic profiling identified several pathways and secondary metabolites associated with variation in virulence. Notably, strain virulence was associated with the simultaneous presence of the secondary metabolites hexadehydroastechrome and gliotoxin. We submit that examining the pathogenic potentials of non-pathogenic close relatives is key for understanding the origins of fungal pathogenicity.
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Affiliation(s)
- David C. Rinker
- Department of Biological Sciences and Evolutionary Studies Initiative, Vanderbilt University, Nashville, Tennessee, USA
| | - Thomas J. C. Sauters
- Department of Biological Sciences and Evolutionary Studies Initiative, Vanderbilt University, Nashville, Tennessee, USA
| | - Karin Steffen
- Department of Biological Sciences and Evolutionary Studies Initiative, Vanderbilt University, Nashville, Tennessee, USA
| | - Adiyantara Gumilang
- Department of Biological Sciences and Evolutionary Studies Initiative, Vanderbilt University, Nashville, Tennessee, USA
| | - Huzefa A. Raja
- Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Manuel Rangel-Grimaldo
- Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Camila Figueiredo Pinzan
- Faculdade de Ciencias Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Patrícia Alves de Castro
- Faculdade de Ciencias Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Thaila Fernanda dos Reis
- Faculdade de Ciencias Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Endrews Delbaje
- Faculdade de Ciencias Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Jos Houbraken
- Food and Indoor Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Gustavo H. Goldman
- Faculdade de Ciencias Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Nicholas H. Oberlies
- Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Antonis Rokas
- Department of Biological Sciences and Evolutionary Studies Initiative, Vanderbilt University, Nashville, Tennessee, USA
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Chawla H, Anand P, Garg K, Bhagat N, Varmani SG, Bansal T, McBain AJ, Marwah RG. A comprehensive review of microbial contamination in the indoor environment: sources, sampling, health risks, and mitigation strategies. Front Public Health 2023; 11:1285393. [PMID: 38074709 PMCID: PMC10701447 DOI: 10.3389/fpubh.2023.1285393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
The quality of the indoor environment significantly impacts human health and productivity, especially given the amount of time individuals spend indoors globally. While chemical pollutants have been a focus of indoor air quality research, microbial contaminants also have a significant bearing on indoor air quality. This review provides a comprehensive overview of microbial contamination in built environments, covering sources, sampling strategies, and analysis methods. Microbial contamination has various origins, including human occupants, pets, and the outdoor environment. Sampling strategies for indoor microbial contamination include air, surface, and dust sampling, and various analysis methods are used to assess microbial diversity and complexity in indoor environments. The review also discusses the health risks associated with microbial contaminants, including bacteria, fungi, and viruses, and their products in indoor air, highlighting the need for evidence-based studies that can relate to specific health conditions. The importance of indoor air quality is emphasized from the perspective of the COVID-19 pandemic. A section of the review highlights the knowledge gap related to microbiological burden in indoor environments in developing countries, using India as a representative example. Finally, potential mitigation strategies to improve microbiological indoor air quality are briefly reviewed.
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Affiliation(s)
- Hitikk Chawla
- Institute for Cell Biology and Neuroscience, Goethe University Frankfurt, Frankfurt, Germany
| | - Purnima Anand
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Kritika Garg
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, India
| | - Neeru Bhagat
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Shivani G. Varmani
- Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Tanu Bansal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Andrew J. McBain
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Ruchi Gulati Marwah
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
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Suehara MB, Silva MCPD. Prevalence of airborne fungi in Brazil and correlations with respiratory diseases and fungal infections. CIENCIA & SAUDE COLETIVA 2023; 28:3289-3300. [PMID: 37971011 DOI: 10.1590/1413-812320232811.08302022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 04/02/2023] [Indexed: 11/19/2023] Open
Abstract
Airborne fungi are dispersed through the air. The aim of this study was to determine the prevalence of airborne fungi in Brazil and understand the relationship between fungal growth and respiratory diseases and infections. We conducted an integrative literature review of studies conducted in Brazil based on searches of the PubMed, MEDLINE-BIREME, SciELO, and LILACS databases for full-text articles published between 2000 and 2022. The searches returned 147 studies, of which only 25 met the inclusion criteria. The most prevalent genera of airborne fungi in Brazil are Aspergillus, Penicillium, Cladosporium, Curvularia, and Fusarium. The studies were conducted in the states of Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, and Minas Gerais. The findings also show the relationship between fungi and meteorological factors and seasonality, the sensitivity of atopic individuals to fungi, and the main nosocomial mycoses reported in the literature. This work demonstrates the importance of maintaining good microbiological air quality to prevent potential airborne diseases.
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Affiliation(s)
- Marcelo Batista Suehara
- Universidade Federal da Integração Latino-Americana - Unidade PTI. Av. Tarquínio Joslin dos Santos 1000, Polo Universitário. 85870-650 Foz do Iguaçu PR Brasil.
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Puhlmann D, Bergmann D, Besier S, Hogardt M, Wichelhaus TA, Langhans S, Hack D, Reinheimer C, Vehreschild MJGT, Jung J, Kempf VAJ. Analysis of Mould Exposure of Immunosuppressed Patients at a German University Hospital. Microorganisms 2023; 11:2652. [PMID: 38004663 PMCID: PMC10672964 DOI: 10.3390/microorganisms11112652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Moulds are ubiquitous components of outdoor and indoor air and local conditions, temperature, humidity and season can influence their concentration in the air. The impact of these factors on mould exposure in hospitals and the resulting risk of infection for low to moderately immunocompromised patients is unclear. In the present retrospective analysis for the years 2018 to 2022, the monthly determined mould contamination of the outdoor and indoor air at the University Hospital Frankfurt am Main is compared with the average air temperature and the relative humidity. Mould infections (Aspergillus spp., Mucorales) of low to moderately immunosuppressed patients of a haematological-oncological normal ward were determined clinically according to the criteria of the European Organisation for Research and Treatment of Cancer (EORTC, Brussels, Belgium) and of the National Reference Centre for Surveillance of Nosocomial Infections (NRC-NI, Berlin, Germany). The data revealed that in the summer months (May-October), increased mould contamination was detectable in the outdoor and indoor air compared to the winter months (November-April). The mould levels in the patient rooms followed the detection rates of the outdoor air. Two nosocomial Aspergillus infections, one nosocomial Mucorales (Rhizopus spp.) infection (according to both NRC-NI and EORTC criteria) and five Aspergillus spp. infections (according to EORTC criteria) occurred in 4299 treated patients (resulting in 41,500 patient days). In our study, the incidence density rate of contracting a nosocomial mould infection (n = 3) was approximately 0.07 per 1000 patient days and appears to be negligible.
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Affiliation(s)
- Danuta Puhlmann
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Dominic Bergmann
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Silke Besier
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Michael Hogardt
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Thomas A. Wichelhaus
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Sabine Langhans
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Daniel Hack
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Claudia Reinheimer
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
- University Centre of Competence for Infection Control of the State of Hesse, 60590 Frankfurt am Main, Germany
- University Centre for Infectious Diseases (UCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Maria J. G. T. Vehreschild
- Department for Internal Medicine II, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Jens Jung
- Department 1—Finance and Patient Services, University Hospital, 60590 Frankfurt am Main, Germany
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (D.P.)
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Sabuco-Tébar EA, Arense-Gonzalo JJ, Campayo-Rojas FJ. Relationship Between Airborne Fungi Presence and the Position of the High Efficiency Particulate Air Filter in the Heating, Ventilation, and Air Conditioning System. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:56-68. [PMID: 37365804 DOI: 10.1177/19375867231181556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
AIM Establish the influence of the terminal or nonterminal position of High Efficiency Particulate Air (HEPA) filters in the Heating, Ventilation, and Air Conditioning (HVAC) system on the presence of airborne fungi in controlled environment rooms. BACKGROUND Fungal infections are an important cause of morbidity and mortality in hospitalized patients. METHODS This study was realized from 2010 to 2017, in rooms with terminal and nonterminal HEPA filters, in eight Spanish hospitals. In rooms with terminal HEPA filters, 2,053 and 2,049 samples were recollected, and in rooms with nonterminal HEPA filters, 430 and 428 samples were recollected in the air discharge outlet (Point 1) and in the center of the room (Point 2), respectively. Temperature, relative humidity, air changes per hour, and differential pressure were recollected. RESULTS Multivariable analysis showed higher odds ratio (OR) of airborne fungi presence when HEPA filters were in nonterminal position (OR: 6.78; 95% CI [3.77, 12.20]) in Point 1 and (OR: 4.43; 95% CI [2.65, 7.40]) in Point 2. Other parameters influenced airborne fungi presence, such as temperature (OR: 1.23; 95% CI [1.06, 1.41]) in Point 2 differential pressure (OR: 0.86; 95% CI [0.84, 0.90]) and (OR: 0.88; 95% CI [0.86, 0.91]) in Points 1 and 2, respectively. CONCLUSIONS HEPA filter in terminal position of the HVAC system reduces the presence of airborne fungi. To decrease the presence of airborne fungi, adequate maintenance of the environmental and design parameters is necessary in addition to the terminal position of the HEPA filter.
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Affiliation(s)
- Emiliana A Sabuco-Tébar
- Department of Preventive Medicine, "Reina Sofia" University Clinical Hospital, Murcia, Spain
| | - Julián J Arense-Gonzalo
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Spain
| | - F Javier Campayo-Rojas
- Department of Preventive Medicine, "Reina Sofia" University Clinical Hospital, Murcia, Spain
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8
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Arigela R, Gopalakrishnan S, Raghunathan R. Passive fungal spore release from fruit and vegetable solid waste. JOURNAL OF HAZARDOUS MATERIALS 2023; 458:131938. [PMID: 37418968 DOI: 10.1016/j.jhazmat.2023.131938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/15/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023]
Abstract
Food substrates in municipal solid wastes processing facilities and open dumpsites are a source for the release of fungal spores into air and can cause potential health and climate effects. Experiments were conducted in a laboratory scale flux chamber to measure the fungal growth and spore release from representative exposed cut fruit and vegetable substrates. The aerosolised spores were measured using an optical particle sizer. The results were compared to experiments conducted previously with a test species (Penicillium chrysogenum) on a synthetic media (czapek yeast extract agar). Significantly higher surface spore densities were observed for the fungi on the food substrates as compared to that on the synthetic media. The spore flux was high initially and then decreased on continued exposure to air. The spore emission flux normalised to the surface spore densities indicated that the emission from the food substrates was lower than the emissions from the synthetic media. A mathematical model was applied to the experimental data and the observed flux trends were explained in terms of the model parameters. A simple application of the data and the model to release from a municipal solid waste dumpsite was shown.
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Affiliation(s)
- Ravinder Arigela
- Department of Chemical Engineering, Indian Institute of Technology-Madras, Chennai, India
| | - Saranya Gopalakrishnan
- Department of Chemical Engineering, Indian Institute of Technology-Madras, Chennai, India
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9
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Hajhosseini M, Sharifi I, Bamorovat M, Karamoozian A, Amanizadeh A, Agha Kuchak Afshari S. Monitoring of airborne fungi during the second wave of COVID-19 in selected wards of the referral university hospital in southeastern Iran. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:1132. [PMID: 37653110 DOI: 10.1007/s10661-023-11791-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
Microbiological monitoring of the air hospital is essential for prevention and control, due to the possible airborne route of infection transmission, especially in high-risk wards. This study aimed to monitor the airborne fungi during the second wave of the COVID-19 pandemic in selected wards of the biggest university educational hospital in Kerman, southeastern Iran. This study was conducted in 11 different wards, separated into the patient room and nursing station, of the Afzalipour hospital from May to August 2021. Fungal isolates were characterized to the species level by conventional and sequencing methods. Out of 93 obtained fungal colonies, 70 (75.3%) isolates were filamentous and 23 (24.7%) isolates were yeast. Aspergillus species were the predominant fungal isolates among the filamentous colonies (n=19; 27.1%), and Naganishia albida (formerly Cryptococcus albidus) was identified as the most common yeast isolate (n=13/23; 56.8%). The infectious ward was the most contaminated unit (n=19/93), while the least contaminated units were the neonatal intensive care unit (n=3/93), and oncology (n=3/93). The statistical findings displayed that the number of fungal isolates in patients' rooms is significantly higher than in nurses' stations (p-value=0.013). Our study demonstrated the presence of diverse fungal species in all wards of the hospital. Considering the presence of airborne fungi in hospitals and related public health problems is one of the critical issues for health systems management. In this regard, efficient monitoring of airborne fungi might play an influential role in hospital infection control and surveillance, particularly in high-risk hospitalization patients in critical wards.
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Affiliation(s)
- Mahdi Hajhosseini
- Department of Environmental Health Engineering, School of Public Health, Environmental Science and Technology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Karamoozian
- Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azam Amanizadeh
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Medical Parasitology and Mycology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Setareh Agha Kuchak Afshari
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Medical Parasitology and Mycology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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10
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Serra Neto A, Marques SG, Bomfim MRQ, Monteiro SG, de Souza RC, Nunes RA. Microbiological Analysis of Surgeons' Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study. Microorganisms 2023; 11:1895. [PMID: 37630455 PMCID: PMC10456775 DOI: 10.3390/microorganisms11081895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus, representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia, Acinetobacter baumanii, Pseudomonas aeruginosa, Pseudomonas gessardi, Pantoea septica, Serratia marcescens, and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons' hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings.
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Affiliation(s)
- Artur Serra Neto
- Departamento de Cirurgia Geral, Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), São Luís 65020-070, Brazil
| | - Sirlei G. Marques
- Departamento de Planejamento de Gestão da Qualidade e Vigilância em Saúde, Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), São Luís 65020-070, Brazil;
| | - Maria Rosa Q. Bomfim
- Departamento de Biologia Molecular, Universidade Ceuma (UNICEUMA), São Luís 65075-120, Brazil;
| | - Silvio G. Monteiro
- Departamento de Biologia, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Rosangela C. de Souza
- Departamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Rodolfo A. Nunes
- Departamento de Cirurgia Geral, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20550-900, Brazil;
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11
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Roman-Montes CM, Bojorges-Aguilar S, Corral-Herrera EA, Rangel-Cordero A, Díaz-Lomelí P, Cervantes-Sanchez A, Martinez-Guerra BA, Rajme-López S, Tamez-Torres KM, Martínez-Gamboa RA, González-Lara MF, Ponce-de-Leon A, Sifuentes-Osornio J. Fungal Infections in the ICU during the COVID-19 Pandemic in Mexico. J Fungi (Basel) 2023; 9:jof9050583. [PMID: 37233294 DOI: 10.3390/jof9050583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Background: Invasive Fungal Infections (IFI) are emergent complications of COVID-19. In this study, we aim to describe the prevalence, related factors, and outcomes of IFI in critical COVID-19 patients. Methods: We conducted a nested case-control study of all COVID-19 patients in the intensive care unit (ICU) who developed any IFI and matched age and sex controls for comparison (1:1) to evaluate IFI-related factors. Descriptive and comparative analyses were made, and the risk factors for IFI were compared versus controls. Results: We found an overall IFI prevalence of 9.3% in COVID-19 patients in the ICU, 5.6% in COVID-19-associated pulmonary aspergillosis (CAPA), and 2.5% in invasive candidiasis (IC). IFI patients had higher SOFA scores, increased frequency of vasopressor use, myocardial injury, and more empirical antibiotic use. CAPA was classified as possible in 68% and 32% as probable by ECMM/ISHAM consensus criteria, and 57.5% of mortality was found. Candidemia was more frequent for C. parapsilosis Fluconazole resistant outbreak early in the pandemic, with a mortality of 28%. Factors related to IFI in multivariable analysis were SOFA score > 2 (aOR 5.1, 95% CI 1.5-16.8, p = 0.007) and empiric antibiotics for COVID-19 (aOR 30, 95% CI 10.2-87.6, p = <0.01). Conclusions: We found a 9.3% prevalence of IFIs in critically ill patients with COVID-19 in a single center in Mexico; factors related to IFI were associated with higher SOFA scores and empiric antibiotic use for COVID-19. CAPA is the most frequent type of IFI. We did not find a mortality difference.
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Affiliation(s)
- Carla M Roman-Montes
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Saul Bojorges-Aguilar
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Ever Arturo Corral-Herrera
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Andrea Rangel-Cordero
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Paulette Díaz-Lomelí
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Axel Cervantes-Sanchez
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Bernardo A Martinez-Guerra
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Sandra Rajme-López
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Karla María Tamez-Torres
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Rosa Areli Martínez-Gamboa
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Maria Fernanda González-Lara
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - Alfredo Ponce-de-Leon
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
| | - José Sifuentes-Osornio
- General Direction, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City 14080, Mexico
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12
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Huang L, Huang X, Wang Z, Zhang Y. Stem Cell Treatment for Diabetic Foot Ulcers: A Meta-analysis of Randomized Clinical Trials. Adv Skin Wound Care 2023; 36:234-241. [PMID: 36924415 DOI: 10.1097/01.asw.0000923320.13406.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
GENERAL PURPOSE To provide information on the efficacy of stem cells in the treatment of diabetic foot ulcers. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Explain outcomes from the use of stem cell treatment for diabetic foot ulcers. 2. Identify features in the methodology of randomized controlled trials examining the efficacy of stem cells in the treatment of diabetic foot ulcers.
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13
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What's New in Prevention of Invasive Fungal Diseases during Hospital Construction and Renovation Work: An Overview. J Fungi (Basel) 2023; 9:jof9020151. [PMID: 36836266 PMCID: PMC9966904 DOI: 10.3390/jof9020151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
The goal of the overview was to give insight into the recent data of invasive fungal diseases (IFDs) associated with construction and renovation in healthcare settings as well as the recent evidence about available prevention and infection control measures. The number of studies describing IFD outbreaks associated with construction or renovation is on the rise again. Applying adequate prevention measures is still a challenge not just for healthcare workers but also for architects and construction workers as well. The role of multidisciplinary teams in the planning and monitoring of prevention measures cannot be overemphasized. Dust control is an inevitable part of every prevention plan. HEPA filters are helpful in the prevention of fungal outbreaks in hematologic patients, but further studies are needed to clarify the extent in which they contribute as specific control measures. The cut-off value for a "threating" level of fungal spore contamination still remains to be defined. The value of antifungal prophylaxis is difficult to assess because other preventive measures are simultaneously applied. Recommendations are still based on few meta-analyses, a large number of descriptive reports, and the opinion of respective authorities. Outbreak reports in the literature are a valuable resource and should be used for education as well as for preparing outbreak investigations.
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Sabuco-Tébar EA, Arense-Gonzalo JJ, Campayo-Rojas FJ. Evaluation of the Results of a Periodic Environmental Biosecurity Assessment Program on Air Quality in Controlled Environment Rooms of Hospitals. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:161-174. [PMID: 36424764 DOI: 10.1177/19375867221123608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Determine the utility of the Periodic Environmental Biosecurity Assessment Program (PEBAP) in achieving clean air as measured by the number of colony-forming units (CFU) of fungi and bacteria in the air. BACKGROUND There is no international consensus on the sampling frequency, the recommended limits for microorganisms in the air nor on the usefulness of routine microbiological air monitoring of hospitals. METHODS During the PEBAP, data were recollected between 2010 and 2017 in eight hospitals in southeast Spain. Air samples were collected in very high risk rooms (VHRRs) and high risk rooms (HRRs), unoccupied, using active sampling methods. Temperature, relative humidity, air changes per hour (ACH), and differential pressure were measured. When limits of CFU of opportunistic fungi and bacteria established in the PEBAP were exceeded, corrective measures were adopted. RESULTS We found a reduction (p < .01) of percentage of air samples with fungi growth throughout the years of PEBAP in all rooms. Aspergillus was the most frequent opportunistic fungus. We found a high compliance of the standards of CFU of bacteria in HRR, and the percentage of compliance in VHRR was lower than in HRR in all years. Differences in environmental and design parameters were statistically significant (p < .05) between rooms, except for ACH. CONCLUSIONS PEBAP resulted in a useful tool to maintain and improve air quality in hospitals. The control of environmental biosecurity requires a multidisciplinary approach from preventive medicine, engineering, and cleaning services. Aspergillus is the most frequent opportunistic fungus in southeast Spain.
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Affiliation(s)
- Emiliana A Sabuco-Tébar
- Department of Preventive Medicine, "Reina Sofia" University Clinical Hospital, Murcia, Spain
| | - Julián J Arense-Gonzalo
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Spain
| | - F Javier Campayo-Rojas
- Department of Preventive Medicine, "Reina Sofia" University Clinical Hospital, Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Spain
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15
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Piletić K, Linšak DT, Kovač B, Mežnarić S, Repustić M, Radmanović-Skrbić M, Gobin I. Ozone disinfection efficiency against airborne microorganisms in hospital environment: a case study. Arh Hig Rada Toksikol 2022; 73:270-276. [PMID: 36607720 PMCID: PMC9985346 DOI: 10.2478/aiht-2022-73-3651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/01/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023] Open
Abstract
Even though ozone has shown its potential for air disinfection in hospital environment, its more frequent use has earned attention only with the COVID-19 pandemic due to its proven antimicrobial effect and low cost of production. The aim of this study was to determine its antimicrobial efficiency against the most common bacterial species in a real-life setting, that is, in the air of one postoperative room of the General Hospital Dr Ivo Pedišić (Sisak, Croatia). Air was sampled for aiborne bacteria before and after treatment with the ozone concentration of 15.71 mg/m3 for one hour. The most dominant Gram-positive bacteria of the genera Micrococcus, Staphylococcus, and Bacillus were reduced by 33 %, 58 %, and 61 %, respectively. The genus Micrococcus proved to be the most resistant. Considering our findings, we recommend longer air treatment with higher ozone concentrations in combination with mechanical cleaning and frequent ventilation.
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Affiliation(s)
- Kaća Piletić
- University of Rijeka Faculty of Medicine, Department of Microbiology and Parasitology, Rijeka, Croatia
| | - Dijana Tomić Linšak
- University of Rijeka Faculty of Medicine, Department of Health Ecology, Rijeka, Croatia
| | - Bruno Kovač
- University of Rijeka Faculty of Medicine, Department of Microbiology and Parasitology, Rijeka, Croatia
| | - Silvestar Mežnarić
- University of Rijeka Faculty of Medicine, Department of Microbiology and Parasitology, Rijeka, Croatia
| | | | | | - Ivana Gobin
- University of Rijeka Faculty of Medicine, Department of Microbiology and Parasitology, Rijeka, Croatia
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16
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Li X, Liu D, Yao J. Aerosolization of fungal spores in indoor environments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 820:153003. [PMID: 35031366 DOI: 10.1016/j.scitotenv.2022.153003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
Fungi in indoor environments can cause adverse health effects through inhalation and epidermal exposure. The risk of fungal exposure originates from the aerosolization of fungal spores. However, spore aerosolization is still not well understood. This paper provides a review of indoor fungal contamination, especially the aerosolization of fungal spores. We attempted to summarize what is known today and to identify what more information is needed to predict the aerosolization of fungal spores. This paper first reviews fungal contamination in indoor environments and HVAC systems. The detachment of fungal spores from colonies and the spore aerosolization principle are then summarized. Based on the above discussion, prediction methods for spore aerosolization are discussed. This review further clarifies the current situation and future efforts required to accurately predict spore aerosolization. This information is useful for forecasting and controlling the aerosolization of fungal spores.
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Affiliation(s)
- Xian Li
- School of Civil Engineering and Architecture, Linyi University, Linyi 276000, China.
| | - Dan Liu
- School of Civil Engineering and Architecture, Linyi University, Linyi 276000, China
| | - Jian Yao
- School of Civil Engineering and Architecture, Linyi University, Linyi 276000, China
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