1
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O'Keeffe JC, Singh N, Slavin MA. Approach to diagnostic evaluation and prevention of invasive fungal disease in patients prior to allogeneic hematopoietic stem cell transplant. Transpl Infect Dis 2023; 25 Suppl 1:e14197. [PMID: 37988269 DOI: 10.1111/tid.14197] [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: 08/14/2023] [Revised: 10/15/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
In recent years, advancements in the treatment landscape for hematological malignancies, such as acute myeloid leukemia and acute lymphoblastic leukemia, have significantly improved disease prognosis and overall survival. However, the treatment landscape is changing and the emergence of targeted oral therapies and immune-based treatments has brought forth new challenges in evaluating and preventing invasive fungal diseases (IFDs). IFD disproportionately affects immunocompromised hosts, particularly those undergoing therapy for acute leukemia and allogeneic hematopoietic stem cell transplant. This review aims to provide a comprehensive overview of the pretransplant workup, identification, and prevention of IFD in patients with hematological malignancy. The pretransplant period offers a critical window to assess each patient's risk factors and implement appropriate prophylactic measures. Risk assessment includes evaluation of disease, host, prior treatments, and environmental factors, allowing a dynamic evaluation that considers disease progression and treatment course. Diagnostic screening, involving various biomarkers and radiological modalities, plays a crucial role in early detection of IFD. Antifungal prophylaxis choice is based on available evidence as well as individual risk assessment, potential for drug-drug interactions, toxicity, and patient adherence. Therapeutic drug monitoring ensures effective antifungal stewardship and optimal treatment. Patient education and counselling are vital in minimizing environmental exposures to fungal pathogens and promoting medication adherence. A well-structured and individualized approach, encompassing risk assessment, prophylaxis, surveillance, and patient education, is essential for effectively preventing IFD in hematological malignancies, ultimately leading to improved patient outcomes and overall survival.
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Affiliation(s)
- Jessica C O'Keeffe
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Nikhil Singh
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Department of Pharmacy, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Monica A Slavin
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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2
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van Rhijn N, Coleman J, Collier L, Moore C, Richardson MD, Bright-Thomas RJ, Jones AM. Meteorological Factors Influence the Presence of Fungi in the Air; A 14-Month Surveillance Study at an Adult Cystic Fibrosis Center. Front Cell Infect Microbiol 2021; 11:759944. [PMID: 34900752 PMCID: PMC8662344 DOI: 10.3389/fcimb.2021.759944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background Cystic fibrosis is an inherited disease that predisposes to progressive lung damage. Cystic fibrosis patients are particularly prone to developing pulmonary infections. Fungal species are commonly isolated in lower airway samples from patients with cystic fibrosis. Fungal spores are prevalent in the air. Methods We performed environmental air sampling surveillance at the Manchester Adult Cystic Fibrosis Centre, UK (MACFC) over a 14-month period to assess fungal growth inside and outside the CF center. Results Airborne counts of fungal spores peaked from May to October, both in outdoor and indoor samples. Collection of meteorological data allowed us to correlate fungal presence in the air with elevated temperatures and low wind speeds. Additionally, we demonstrated patient rooms containing windows had elevated fungal counts compared to rooms not directly connected to the outdoors. Conclusions This study suggests that airborne Aspergillus fumigatus spores were more abundant during the summer months of the survey period, which appeared to be driven by increased temperatures and lower wind speeds. Indoor counts directly correlated to outdoor A. fumigatus levels and were elevated in patient rooms that were directly connected to the outdoor environment via an openable window designed for ventilation purposes. Further studies are required to determine the clinical implications of these findings for cystic fibrosis patients who are predisposed to Aspergillus related diseases, and in particular whether there is seasonal influence on incidence of Aspergillus related conditions and if screening for such complications such be increased during summer months and precautions intensified for those with a known history of Aspergillus related disease.
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Affiliation(s)
- Norman van Rhijn
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - James Coleman
- Manchester Adult Cystic Fibrosis Centre, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom.,Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Lisa Collier
- Manchester Adult Cystic Fibrosis Centre, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom.,Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Caroline Moore
- Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Mycology Reference Centre, European Confederation of Medical Mycology (ECMM) Excellence Centre of Medical Mycology, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Malcolm D Richardson
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom.,Mycology Reference Centre, European Confederation of Medical Mycology (ECMM) Excellence Centre of Medical Mycology, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Rowland J Bright-Thomas
- Manchester Adult Cystic Fibrosis Centre, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom.,Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Andrew M Jones
- Manchester Adult Cystic Fibrosis Centre, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom.,Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Mycology Reference Centre, European Confederation of Medical Mycology (ECMM) Excellence Centre of Medical Mycology, Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
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3
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Dillon CF, Dillon MB. Multi-Scale Airborne Infectious Disease Transmission. Appl Environ Microbiol 2021; 87:AEM.02314-20. [PMID: 33277266 PMCID: PMC7851691 DOI: 10.1128/aem.02314-20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Airborne disease transmission is central to many scientific disciplines including agriculture, veterinary biosafety, medicine, and public health. Legal and regulatory standards are in place to prevent agricultural, nosocomial, and community airborne disease transmission. However, the overall importance of the airborne pathway is underappreciated, e.g.,, US National Library of Medicine's Medical Subjects Headings (MESH) thesaurus lacks an airborne disease transmission indexing term. This has practical consequences as airborne precautions to control epidemic disease spread may not be taken when airborne transmission is important, but unrecognized. Publishing clearer practical methodological guidelines for surveillance studies and disease outbreak evaluations could help address this situation.To inform future work, this paper highlights selected, well-established airborne transmission events - largely cases replicated in multiple, independently conducted scientific studies. Methodologies include field experiments, modeling, epidemiology studies, disease outbreak investigations and mitigation studies. Collectively, this literature demonstrates that airborne viruses, bacteria, and fungal pathogens have the capability to cause disease in plants, animals, and humans over multiple distances - from near range (< 5 m) to continental (> 500 km) in scale. The plausibility and implications of undetected airborne disease transmission are discussed, including the notable underreporting of disease burden for several airborne transmitted diseases.
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Affiliation(s)
| | - Michael B Dillon
- Atmospheric, Earth, and Energy Division, Lawrence Livermore National Laboratory Livermore, California, USA 94551
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4
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Mohamed AH, Balbool BA, Abdel-Azeem AM. Aspergillus from Different Habitats and Their Industrial Applications. Fungal Biol 2021. [DOI: 10.1007/978-3-030-67561-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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5
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Boniche C, Rossi SA, Kischkel B, Vieira Barbalho F, Nogueira D’Aurea Moura Á, Nosanchuk JD, Travassos LR, Pelleschi Taborda C. Immunotherapy against Systemic Fungal Infections Based on Monoclonal Antibodies. J Fungi (Basel) 2020; 6:jof6010031. [PMID: 32121415 PMCID: PMC7151209 DOI: 10.3390/jof6010031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/22/2020] [Accepted: 02/25/2020] [Indexed: 12/17/2022] Open
Abstract
The increasing incidence in systemic fungal infections in humans has increased focus for the development of fungal vaccines and use of monoclonal antibodies. Invasive mycoses are generally difficult to treat, as most occur in vulnerable individuals, with compromised innate and adaptive immune responses. Mortality rates in the setting of our current antifungal drugs remain excessively high. Moreover, systemic mycoses require prolonged durations of antifungal treatment and side effects frequently occur, particularly drug-induced liver and/or kidney injury. The use of monoclonal antibodies with or without concomitant administration of antifungal drugs emerges as a potentially efficient treatment modality to improve outcomes and reduce chemotherapy toxicities. In this review, we focus on the use of monoclonal antibodies with experimental evidence on the reduction of fungal burden and prolongation of survival in in vivo disease models. Presently, there are no licensed monoclonal antibodies for use in the treatment of systemic mycoses, although the potential of such a vaccine is very high as indicated by the substantial promising results from several experimental models.
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Affiliation(s)
- Camila Boniche
- Biomedical Sciences Institute, Department of Microbiology, University of São Paulo, Sao Paulo 05508-000, Brazil; (C.B.); (S.A.R.); (B.K.); (F.V.B.)
| | - Suélen Andreia Rossi
- Biomedical Sciences Institute, Department of Microbiology, University of São Paulo, Sao Paulo 05508-000, Brazil; (C.B.); (S.A.R.); (B.K.); (F.V.B.)
| | - Brenda Kischkel
- Biomedical Sciences Institute, Department of Microbiology, University of São Paulo, Sao Paulo 05508-000, Brazil; (C.B.); (S.A.R.); (B.K.); (F.V.B.)
| | - Filipe Vieira Barbalho
- Biomedical Sciences Institute, Department of Microbiology, University of São Paulo, Sao Paulo 05508-000, Brazil; (C.B.); (S.A.R.); (B.K.); (F.V.B.)
| | - Ágata Nogueira D’Aurea Moura
- Tropical Medicine Institute, Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Sao Paulo 05403-000, Brazil;
| | - Joshua D. Nosanchuk
- Departments of Medicine (Division of Infectious Diseases) and Microbiology and Immunology, Albert Einstein College of Medicine, New York, NY 10461, USA;
| | - Luiz R. Travassos
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, Sao Paulo 04021-001, Brazil;
| | - Carlos Pelleschi Taborda
- Biomedical Sciences Institute, Department of Microbiology, University of São Paulo, Sao Paulo 05508-000, Brazil; (C.B.); (S.A.R.); (B.K.); (F.V.B.)
- Tropical Medicine Institute, Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Sao Paulo 05403-000, Brazil;
- Correspondence:
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La Milia DI, Vincenti S, Fiori B, Pattavina F, Torelli R, Barbara A, Wachocka M, Moscato U, Sica S, Amato V, Ricciardi W, Laurenti P. Monitoring of Particle Environmental Pollution and Fungal Isolations During Hospital Building-Work Activities in a Hematology Ward. Mediterr J Hematol Infect Dis 2019; 11:e2019062. [PMID: 31700587 PMCID: PMC6827607 DOI: 10.4084/mjhid.2019.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/06/2019] [Indexed: 01/15/2023] Open
Abstract
Building-work activities could cause dust contamination and fungal spores' dissemination. A significant relationship was found between building-work activities and the incidence of invasive aspergillosis, in profoundly immunocompromised patients. Renovation-works activities were carried out by four building sites of the hematology ward in a Teaching Hospital without the interruption of clinical activities. These sites were monitored by environmental sampling to determine the particles and fungi count. Clinical surveillance was made using galactomannan antigen test as a proxy for invasive aspergillosis diagnosis. A definitive diagnosis of IA was confirmed by clinical and radiological features. The galactomannan antigen test showed no significant difference between presence (2,75%) and absence (5,03%) of renovation work activities (p=0,522). During the renovation activities, an increment of IA cases with respect to the control period was not recorded. The particle counts showed higher values of small and big-diameter particles before the renovation works if compared to the end of the activities. It was probably due to the containment measures implemented during and immediately after the final phases of the building site. The Fungi counts showed no significant differences between the phase before and after the renovation activities. Our findings show that is possible to perform renovation work, during clinical activities, by increasing clinical and environmental surveillance.
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Affiliation(s)
| | - Sara Vincenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Barbara Fiori
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - Fabio Pattavina
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Riccardo Torelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | | | | | - Umberto Moscato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - Simona Sica
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | | | - Walter Ricciardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
| | - Patrizia Laurenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Università Cattolica del Sacro Cuore, Roma, Italia
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7
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Sood G, Vaidya D, Dam L, Grubb LM, Zenilman J, Krout K, Khouri-Stevens Z, Bennett R, Blanding R, Riedel S, Milner S, Price LA, Perl TM. A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy. Am J Infect Control 2018; 46:1047-1050. [PMID: 29609856 DOI: 10.1016/j.ajic.2018.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To describe a polymicrobial fungal outbreak after Hurricane Sandy. DESIGN An observational concurrent outbreak investigation and retrospective descriptive review. SETTING A regional burn intensive care unit that serves the greater Baltimore area, admitting 350-450 burn patients annually. PATIENTS Patients with burn injuries and significant dermatologic diseases such as toxic epidermal necrolysis who were admitted to the burn intensive care unit. METHODS An outbreak investigation and a retrospective review of all patients with non-candida fungal isolates from 2009-2016 were performed. RESULTS A polymicrobial fungal outbreak in burn patients was temporally associated with Hurricane Sandy and associated with air and water permeations in the hospital facility. The outbreak abated after changes to facility design. CONCLUSIONS Our results suggest a possible association between severe weather events like hurricanes and nosocomial fungal outbreaks. This report adds to the emerging literature on the effect of severe weather on healthcare-associated infections.
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Affiliation(s)
- Geeta Sood
- The Johns Hopkins University, School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Baltimore, MD.
| | - Dhananjay Vaidya
- The Johns Hopkins University, School of Medicine, Department of Medicine, Division of General Internal Medicine, Baltimore, MD
| | - Lisa Dam
- Johns Hopkins Bayview Medical Center, Baltimore, MD
| | - Lisa M Grubb
- Johns Hopkins Bayview Medical Center, Baltimore, MD
| | - Jonathan Zenilman
- The Johns Hopkins University, School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Baltimore, MD
| | - Kelly Krout
- Johns Hopkins Bayview Medical Center, Baltimore, MD
| | | | | | | | - Stefan Riedel
- The Johns Hopkins University, School of Medicine, Department of Pathology, Division of Microbiology, Baltimore, MD
| | - Stephen Milner
- The Johns Hopkins University, School of Medicine, Department of Plastic Surgery, Baltimore, MD
| | - Leigh Ann Price
- The Johns Hopkins University, School of Medicine, Department of Plastic Surgery, Baltimore, MD
| | - Trish M Perl
- The Johns Hopkins University, School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Baltimore, MD
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8
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Viegas C, Moreira R, Faria T, Caetano LA, Carolino E, Gomes AQ, Viegas S. Aspergillus prevalence in air conditioning filters from vehicles: Taxis for patient transportation, forklifts, and personal vehicles. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 74:341-349. [PMID: 29727587 DOI: 10.1080/19338244.2018.1472545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 06/08/2023]
Abstract
The frequency and importance of Aspergillus infections is increasing worldwide. This study aimed to assess the occupational exposure of forklifts and taxi drivers to Aspergillus spp. Nineteen filters from air conditioning system of taxis, 17 from forklifts and 37 from personal vehicles were assessed. Filters extract were streaked onto MEA, DG18 and in azole-supplemented media. Real-time quantitative PCR amplification of selected Aspergillus species-complex was also performed. Forklifts filter samples presented higher median values. Aspergillus section Nigri was the most observed in forklifts filters in MEA (28.2%) and in azole-supplemented media. DNA from Aspergillus sections Fumigati and Versicolores was successfully amplified by qPCR. This study enlightens the added value of using filters from the air conditioning system to assess Aspergillus spp. occupational exposure. Aspergillus azole resistance screening should be included in future occupational exposure assessments.
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Affiliation(s)
- Carla Viegas
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa
| | - Ricardo Moreira
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Tiago Faria
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - Liliana Aranha Caetano
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Elisabete Carolino
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Anita Quintal Gomes
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- University of Lisbon Institute of Molecular Medicine, Faculty of Medicine, Lisbon, Portugal
| | - Susana Viegas
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa
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Fernandez IJ, Crocetta FM, Demattè M, Farneti P, Stanzani M, Lewis RE, Fornaciari M, Pasquini E, Sciarretta V. Acute Invasive Fungal Rhinosinusitis in Immunocompromised Patients: Role of an Early Diagnosis. Otolaryngol Head Neck Surg 2018; 159:386-393. [DOI: 10.1177/0194599818765744] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy. Subjects and Methods The impact of time to treatment and clinical, pathologic, and microbiological variables were analyzed among patients with histologically and microbiologically proven AIFRS. The outcomes of patients treated before the introduction of the early diagnosis protocol were compared with those treated afterward. Results Nineteen patients affected by AIFRS were eligible for the study. Treatment delay >4 days ( P = .002), infection caused by Mucorales ( P = .015), and extension of the disease were negative prognostic variables ( P = .017). The application of our protocol significantly reduced the delay for diagnosis and appropriate treatment by an average of 7.3 days ( P = .02). Conclusion The promptness of the diagnosis and surgical treatment may play a significant role in the management of AIFRS, as it appears to be significantly associated with the disease outcome. Our protocol may help to reduce the time required for diagnosis of high-risk hematologic patients.
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Affiliation(s)
- Ignacio Javier Fernandez
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Francesco Maria Crocetta
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marco Demattè
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Paolo Farneti
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marta Stanzani
- Haematology Unit “Istituto Seràgnoli,” Specialist Diagnostic and Experimental Medicine, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Russel E. Lewis
- Infectious Disease Unit, Department of Medical and Surgical Sciences, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Martina Fornaciari
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Ernesto Pasquini
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Vittorio Sciarretta
- Otorhinolaryngology Head and Neck Surgery Unit, Head and Neck and Sensory Organs Department, Sant’Orsola–Malpighi Hospital, University of Bologna, Bologna, Italy
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Loeffert ST, Vanhems P, Tissot E, Dananché C, Cassier P, Bénet T, Perraud M, Thibaudon M, Gustin MP. Evaluation of Hirst-type spore traps in outdoor Aspergillaceae monitoring during large demolition work in hospital. PLoS One 2018; 13:e0191135. [PMID: 29346411 PMCID: PMC5773167 DOI: 10.1371/journal.pone.0191135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/14/2017] [Indexed: 11/23/2022] Open
Abstract
Demolition can generate fungal spore suspensions in association with various adverse health effects, such as high risk of invasive aspergillosis in immunocompromised patients. One block of Edouard Herriot Hospital was entirely demolished. The aim of the present study was to evaluate Hirst-type spore traps utility in monitoring outdoor Aspergillaceae (Aspergillus spp. + Penicillium spp.) spores in part of Edouard Herriot Hospital (Lyon, France) undergoing major demolition. Three periods were scheduled in 2015: (A) Gutting of building and asbestos removal, (B) Demolition of floors, (C) Excavation and earthwork. Outdoor Aspergillaceae fungal load was monitored by cultivable (Air Ideal®, bioMérieux) and non-cultivable methods (Lanzoni VPPS-2000, Analyzair®, Bologna, Italy). Differences of Aspergillaceae recorded with Hirst-type spore traps were observed between Gerland and Edouard Herriot Hospital. Differences between Aspergillaceae were recorded between day time and night time at Gerland and Edouard Herriot Hospital. Daily paired differences between Aspergillaceae recorded with non-cultivable methodology at Edouard Herriot Hospital and in an area without demolition work were significant in Period A vs Period B (p = 10–4) and Period A vs Period C (p = 10–4). Weak correlation of daily Aspergillaceae recorded by both methods at Edouard Herriot Hospital was significant only for Period C (r = 0.26, p = 0.048, n = 58). Meteorological parameters and type of demolition works were found to heavily influenced Aspergillaceae dispersion. Non-cultivable methodology is a promising tool for outdoor Aspergillaceae scrutiny during major demolition work in hospital, helping infection control staff to rapidly implement control measures.
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Affiliation(s)
- Sophie Tiphaine Loeffert
- Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, France, Université de Lyon 1, France
- * E-mail:
| | - Philippe Vanhems
- Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, France, Université de Lyon 1, France
- Unité d'hygiène, épidémiologie et prévention, Groupement hospitalier Edouard Herriot, Lyon, France
| | | | - Cédric Dananché
- Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, France, Université de Lyon 1, France
- Unité d'hygiène, épidémiologie et prévention, Groupement hospitalier Edouard Herriot, Lyon, France
| | - Pierre Cassier
- Laboratoire de Biologie Sécurité Environnement, Groupement hospitalier Edouard Herriot, Lyon, France
| | - Thomas Bénet
- Unité d'hygiène, épidémiologie et prévention, Groupement hospitalier Edouard Herriot, Lyon, France
| | - Michel Perraud
- Laboratoire de Biologie Sécurité Environnement, Groupement hospitalier Edouard Herriot, Lyon, France
| | - Michel Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - Marie-Paule Gustin
- Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, France, Université de Lyon 1, France
- Département de santé publique, Institut des Sciences Pharmaceutiques et Biologiques (ISPB)-Faculté de Pharmacie, Université de Lyon 1, France
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Sivagnanam S, Sengupta DJ, Hoogestraat D, Jain R, Stednick Z, Fredricks DN, Hendrie P, Whimbey E, Podczervinski ST, Krantz EM, Duchin JS, Pergam SA. Seasonal clustering of sinopulmonary mucormycosis in patients with hematologic malignancies at a large comprehensive cancer center. Antimicrob Resist Infect Control 2017; 6:123. [PMID: 29225797 PMCID: PMC5718160 DOI: 10.1186/s13756-017-0282-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/23/2017] [Indexed: 12/22/2022] Open
Abstract
Background Invasive Mucorales infections (IMI) lead to significant morbidity and mortality in immunocompromised hosts. The role of season and climatic conditions in case clustering of IMI remain poorly understood. Methods Following detection of a cluster of sinopulmonary IMIs in patients with hematologic malignancies, we reviewed center-based medical records of all patients with IMIs and other invasive fungal infections (IFIs) between January of 2012 and August of 2015 to assess for case clustering in relation to seasonality. Results A cluster of 7 patients were identified with sinopulmonary IMIs (Rhizopus microsporus/azygosporus, 6; Rhizomucor pusillus, 1) during a 3 month period between June and August of 2014. All patients died or were discharged to hospice. The cluster was managed with institution of standardized posaconazole prophylaxis to high-risk patients and patient use of N-95 masks when outside of protected areas on the inpatient service. Review of an earlier study period identified 11 patients with IMIs of varying species over the preceding 29 months without evidence of clustering. There were 9 total IMIs in the later study period (12 month post-initial cluster) with 5 additional cases in the summer months, again suggesting seasonal clustering. Extensive environmental sampling did not reveal a source of mold. Using local climatological data abstracted from National Centers for Environmental Information the clusters appeared to be associated with high temperatures and low precipitation. Conclusions Sinopulmonary Mucorales clusters at our center had a seasonal variation which appeared to be related to temperature and precipitation. Given the significant mortality associated with IMIs, local climatic conditions may need to be considered when considering center specific fungal prevention and prophylaxis strategies for high-risk patients.
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Affiliation(s)
- Shobini Sivagnanam
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, E4-100, Seattle, WA 98109 USA
| | - Dhruba J Sengupta
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA USA
| | - Daniel Hoogestraat
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA USA
| | - Rupali Jain
- Department of Pharmacy, University of Washington Medical Center, Seattle, WA USA
| | - Zach Stednick
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, E4-100, Seattle, WA 98109 USA
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, E4-100, Seattle, WA 98109 USA.,Clincial Research Division, Fred Hutchinson Cancer Res. Ctr, Seattle, WA USA.,Department of Medicine, University of Washington Medical Center, Seattle, WA USA
| | - Paul Hendrie
- Clincial Research Division, Fred Hutchinson Cancer Res. Ctr, Seattle, WA USA.,Department of Medicine, University of Washington Medical Center, Seattle, WA USA
| | - Estella Whimbey
- Department of Medicine, University of Washington Medical Center, Seattle, WA USA
| | | | - Elizabeth M Krantz
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, E4-100, Seattle, WA 98109 USA
| | - Jeffrey S Duchin
- Public Health, Seattle and King County, Seattle, WA USA.,Department of Medicine, University of Washington Medical Center, Seattle, WA USA
| | - Steven A Pergam
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, E4-100, Seattle, WA 98109 USA.,Clincial Research Division, Fred Hutchinson Cancer Res. Ctr, Seattle, WA USA.,Department of Medicine, University of Washington Medical Center, Seattle, WA USA.,Infection Prevention, Seattle Cancer Care Alliance, Seattle, WA USA
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Briffa M, Decelis S, Brincat JP, Grima JN, Gatt R, Valdramidis V. Evaluation of polyurethane foam materials as air filters against fungal contamination. Food Control 2017. [DOI: 10.1016/j.foodcont.2016.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Douglas AP, Slavin MA. Risk factors and prophylaxis against invasive fungal disease for haematology and stem cell transplant recipients: an evolving field. Expert Rev Anti Infect Ther 2016; 14:1165-1177. [PMID: 27710140 DOI: 10.1080/14787210.2016.1245613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Due to increasing intensity and complexity of therapies and longer survivorship, many patients with haematologic malignancy (HM) are at risk of invasive fungal disease (IFD). Mortality from IFD is high and treatment of an episode of IFD results in an excess length of hospital stay and costs and delays delivery of curative therapy of the underlying haematologic condition. Therefore, prevention and early recognition and treatment of IFD are crucial. Areas covered: Risk factors particular to certain HMs and haematopoietic stem cell transplantation, as well as those risk factors universal to all HM groups are examined. Expert commentary: Risk stratification identifies those patients who would benefit most from mould active versus yeast active prophylaxis and those who can be safely managed with monitoring and clinically driven interventions for IFD. This approach aids in antifungal stewardship.
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Affiliation(s)
- Abby P Douglas
- a Department of Infectious Diseases , Peter MacCallum Cancer Centre , Melbourne , VIC , Australia
| | - Monica A Slavin
- a Department of Infectious Diseases , Peter MacCallum Cancer Centre , Melbourne , VIC , Australia.,b Victorian Infectious Diseases Service , Royal Melbourne Hospital , Melbourne , VIC , Australia.,c Department of Medicine , University of Melbourne , Melbourne , VIC , Australia
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Schlosser O, Robert S, Debeaupuis C. Aspergillus fumigatus and mesophilic moulds in air in the surrounding environment downwind of non-hazardous waste landfill sites. Int J Hyg Environ Health 2016; 219:239-51. [DOI: 10.1016/j.ijheh.2016.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 01/12/2023]
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15
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Schweer KE, Jakob B, Liss B, Christ H, Fischer G, Vehreschild MJGT, Cornely OA, Vehreschild JJ. Domestic mould exposure and invasive aspergillosis—air sampling ofAspergillusspp. spores in homes of hematological patients, a pilot study. Med Mycol 2016; 54:576-83. [DOI: 10.1093/mmy/myw007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 11/14/2022] Open
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17
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Picot-Guéraud R, Khouri C, Brenier-Pinchart MP, Saviuc P, Fares A, Sellon T, Thiebaut-Bertrand A, Mallaret MR. En-suite bathrooms in protected haematology wards: a source of filamentous fungal contamination? J Hosp Infect 2015; 91:244-9. [PMID: 26341270 DOI: 10.1016/j.jhin.2015.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND In spite of 25 recently built high-risk haematology rooms with a protected environment and fitted with en-suite bathrooms in our university hospital centre in 2008, sporadic cases of hospital-acquired invasive aspergillosis remained in these wards. AIM This study aimed to identify unsuspected environmental sources of filamentous fungal contamination in these rooms. METHODS Over two months, environmental fungal flora in the air (150 samples) as well as air particle counting and physical environmental parameters (airspeed, temperature, humidity, pressure) were prospectively monitored twice on the sampling day in all 25 protected rooms and en-suite bathrooms in use, and on bathroom surfaces (150 samples). FINDINGS In rooms under laminar airflow, in the presence of patients during sampling sessions, fungi were isolated in two samples (4%, 2/50) with a maximum value of 2cfu/500L (none was Aspergillus sp.). However, 88% of the air samples (44/50) in the bathroom were contaminated with a median range and maximum value of 2 and 16cfu/500L. Aspergillus spp. were involved in 24% of contaminated samples (12/44) and A. fumigatus in 6% (3/44). Bathroom surfaces were contaminated by filamentous fungi in 5% of samples (8/150). CONCLUSION This study highlighted that en-suite bathrooms in protected wards are likely to be a source of fungi. Before considering specific treatment of air in bathrooms, technicians have first corrected the identified deficiencies: replacement of high-efficiency particulate air filters, improvement of air control automation, and restoration of initial technical specifications. Assessment of measure effectiveness is planned.
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Affiliation(s)
- R Picot-Guéraud
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France.
| | - C Khouri
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France
| | - M-P Brenier-Pinchart
- CHU Grenoble, Pôle Biologie et Pathologie, Laboratoire de Parasitologie-Mycologie, Grenoble, France; Université Grenoble Alpes, CNRS, LAPM, Grenoble, France
| | - P Saviuc
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France
| | - A Fares
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France
| | - T Sellon
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France
| | | | - M-R Mallaret
- CHU Grenoble, Pôle Santé Publique, Unité d'Hygiène Hospitalière, Grenoble, France; Université Grenoble Alpes, CNRS, TIMC-IMAG, Grenoble, France
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Sabino R, Verissimo C, Parada H, Brandao J, Viegas C, Carolino E, Clemons KV, Stevens DA. Molecular screening of 246 Portuguese Aspergillus isolates among different clinical and environmental sources. Med Mycol 2014; 52:519-29. [DOI: 10.1093/mmy/myu006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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A 10-year survey of fungal aerocontamination in hospital corridors: a reliable sentinel to predict fungal exposure risk? J Hosp Infect 2014; 87:34-40. [DOI: 10.1016/j.jhin.2014.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 02/19/2014] [Indexed: 11/20/2022]
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20
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Brenier-Pinchart MP, Abaibou H, Berendsen T, Szymanski G, Beghri M, Bailly S, Lasnet F, Thiebaut-Bertrand A, Mabilat C, Pelloux H. Usefulness of pan-fungal NASBA test for surveillance of environmental fungal contamination in a protected hematology unit. Med Mycol 2014; 52:433-7. [PMID: 24577010 DOI: 10.1093/mmy/myt017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A pan-fungal nucleic acid sequence based applification (NASBA) test was adapted and used for the first time to detect and quantify the level of filamentous fungi in environmental samples. Surface samples (n = 356) collected in a controlled air flow hematology ward were tested by mycological culture and the pan-fungal NASBA test. The overall percentage of agreement between culture and NASBA was 88%, the Kappa coefficient was equal to 0.61 (95%CI = [0.51; 0.72]). This pan-fungal NASBA test could be a promising tool to rapidly monitor the absence of molds in controlled environments.
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Cavallo M, Andreoni S, Martinotti MG, Rinaldi M, Fracchia L. Monitoring environmental Aspergillus spp. contamination and meteorological factors in a haematological unit. Mycopathologia 2013; 176:387-94. [PMID: 24158616 DOI: 10.1007/s11046-013-9712-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/09/2013] [Indexed: 12/12/2022]
Abstract
The opportunistic pathogens belonging to the Aspergillus genus are present in almost all seasons of the year, and their concentration is related to meteorological conditions. The high density of Aspergillus spp. conidia in a haematological hospital ward may be a significant risk factor for developing invasive fungal diseases in immunocompromised patients. Aim of the present study was to evaluate the variability of airborne Aspergillus spp. conidia contamination in a Haematological Unit (HU) within a period of 16 months in relation with some meteorological parameters. An environmental Aspergillus surveillance was conducted in the HU in four rooms and their bathrooms, in the corridor and in three external sites using an agar impact sampler. During each sampling, temperature and relative humidity at each site were recorded and current wind speed and rainfall events were taken from the official weather service. Aspergillus spp. conidia concentration differed significantly across the sampling sites. Internal Aspergillus spp. loads were significantly dependent on temperature, internal relative humidity and rain. External conidia concentrations were significantly influenced by outdoor temperature and relative humidity. A suitable indicator was introduced to evaluate the seasonal distribution of Aspergillus spp. conidia in the sampling sites, and a significant dependence on this indicator was observed inside the HU. Seventeen different fungal species belonging to the Aspergillus genus were detected during the sampling period. Aspergillus fumigatus was the most frequently isolated species and its distribution depended significantly on the seasonal indicator both inside and outside the hospital ward.
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Affiliation(s)
- M Cavallo
- Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale "A. Avogadro", Largo Donegani 2, 28100, Novara, Italy
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Boff C, Zoppas BCDA, Aquino VR, Kuplich NM, Miron D, Pasqualotto AC. The indoor air as a potential determinant of the frequency of invasive aspergillosis in the intensive care. Mycoses 2013; 56:527-31. [PMID: 23565625 DOI: 10.1111/myc.12070] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 01/18/2013] [Accepted: 02/18/2013] [Indexed: 11/27/2022]
Abstract
Invasive aspergillosis (IA) seems to be an emerging condition in intensive care units (ICUs). However, little attention has been given to the role of environmental factors that could increase the risk for IA in the ICU. The objective of this study was to determine the concentration of airborne fungi in three Brazilian ICUs, in an attempt to correlate fungal burden with the frequency of Aspergillus spp isolation from clinical samples of patients hospitalised in these units. During a 1-year period we quantitatively evaluated the presence of fungi in the air of three ICUs in Porto Alegre, Brazil. The quantity of fungi was correlated with environmental factors. Only one of the ICUs studied showed equal concentrations of Aspergillus conidia in the indoor air, in comparison with the outdoor environment. All cases of Aspergillus colonisation and IA cases observed during the study occurred in that particular ICU. Environmental factors have a direct influence on fungal spore concentration in the air in ICUs, as well as air filtration systems in air conditioners. Fungal contamination of the indoor air may influence the frequency of AI in ICU patients.
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Affiliation(s)
- Cristiane Boff
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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23
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BRUN CP, MIRON D, SILLA LMR, PASQUALOTTO AC. Fungal spore concentrations in two haematopoietic stem cell transplantation (HSCT) units containing distinct air control systems. Epidemiol Infect 2013; 141:875-9. [PMID: 22691688 PMCID: PMC9151894 DOI: 10.1017/s0950268812001124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 05/10/2012] [Accepted: 05/10/2012] [Indexed: 11/06/2022] Open
Abstract
Invasive fungal diseases have emerged as important causes of morbidity and mortality in haematological patients. In this study air samples were collected in two haematopoietic stem cell transplantation (HSCT) units, in which distinct air-control systems were in place. In hospital 1 no high-efficiency particulate air (HEPA) filter was available whereas in hospital 2 HSCT rooms were equipped with HEPA filters, with positive air pressure in relation to the corridor. A total of 117 samples from rooms, toilets and corridors were obtained during December 2009 to January 2011, using a six-stage Andersen sampler. In both hospitals, the concentration of potentially pathogenic fungi in the air was reduced in patients' rooms compared to corridors (P < 0·0001). Despite the presence of a HEPA filter in hospital 2, rooms in both hospitals showed similar concentrations of potentially pathogenic fungi (P = 0·714). These findings may be explained by the implementation of additional protective measures in hospital 1, emphasizing the importance of such measures in protected environments.
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Affiliation(s)
- C. P. BRUN
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Santa Casa Complexo Hospitalar, Porto Alegre, Brazil
| | - D. MIRON
- Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - L. M. R. SILLA
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - A. C. PASQUALOTTO
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Santa Casa Complexo Hospitalar, Porto Alegre, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Diversity and Distribution Patterns of Airborne Microfungi in Indoor and Outdoor Hospital Environments in Khorramabad, Southwest Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.5074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Viegas C, Carolino E, Sabino R, Viegas S, Veríssimo C. Fungal contamination in swine: a potential occupational health threat. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:272-280. [PMID: 23514069 DOI: 10.1080/15287394.2013.757205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Poor air quality in a pig-confinement building may potentially place farmers at higher health risk than other workers for exposure to airborne pollutants that may reach infectious levels. The aim of this study was to assess worker exposure to fungi in indoor environments in Portuguese swine buildings. Air samples from 7 swine farms were collected at a flow rate of 140 L/min, at 1 m height, onto malt extract agar supplemented with chloramphenicol (MEA). Surfaces samples of the same indoor sites were obtained by swabbing the surfaces. Samples from the floor covering were also collected from four of seven swine farms. All collected samples were incubated at 27°C for 5-7 days. After lab processing and incubation of obtained samples, quantitative colony-forming units (CFU)/m(3), CFU/cm(2), and CFU/g and qualitative results were determined with identification of isolated fungal species. Aspergillus versicolor was the most frequent species found in air (21%), followed by Scopulariopsis brevicaulis (17%) and Penicillium sp. (14%). Aspergillus versicolor was also the most frequent species noted on surfaces (26.6%), followed by Cladosporium sp. (22.4%) and Scopulariopsis brevicaulis (17.5%). Chrysosporium was the most frequently found genera in the new floor covering (38.5%), while Mucor was the most prevalent genera (25.1%) in used floor covering. Our findings corroborate a potential occupational health threat due to fungi exposure and suggest the need for a preventive strategy.
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Affiliation(s)
- C Viegas
- Higher School of Health Technologies of Lisbon-IPL, Lisbon, Portugal
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Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital. J Infect 2012; 65:559-67. [DOI: 10.1016/j.jinf.2012.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 07/19/2012] [Accepted: 08/08/2012] [Indexed: 11/24/2022]
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Invasive aspergillosis: drug-dispensing systems as a source of filamentous fungal contamination in high-risk units? J Hosp Infect 2012; 82:293-6. [PMID: 23102819 DOI: 10.1016/j.jhin.2012.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 08/24/2012] [Indexed: 11/23/2022]
Abstract
High-risk units with air-control measures at Grenoble University Hospital are equipped with automated dispensing systems that are filled daily using drug trolleys routed from the pharmacy to the ward. The aim of this study was to evaluate the level of filamentous fungi (FF) contamination present in trolleys under usual conditions and after cleaning with Aniosurf(®) (fungicidal disinfectant). FF were detected in all samples, and 83.3% of samples were contaminated with Aspergillus fumigatus. Cleaning trolleys with Aniosurf(®) decreased the level of FF significantly, but contamination re-appeared within 24 h due to storage in a non-controlled environment.
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Brenier-Pinchart MP, Lebeau B, Borel JL, Quesada JL, Mallaret M, Garban F, Brion JP, Molina L, Bosson JL, Thiebaut-Bertrand A, Grillot R, Pelloux H. Community-acquired invasive aspergillosis and outdoor filamentous fungal spore load: a relationship? Clin Microbiol Infect 2011; 17:1387-90. [DOI: 10.1111/j.1469-0691.2011.03523.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pagano L, Akova M, Dimopoulos G, Herbrecht R, Drgona L, Blijlevens N. Risk assessment and prognostic factors for mould-related diseases in immunocompromised patients. J Antimicrob Chemother 2010; 66 Suppl 1:i5-14. [DOI: 10.1093/jac/dkq437] [Citation(s) in RCA: 156] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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