Technical note: the effect of different incubation temperatures on the recovery of Aspergillus species from hospital air

Evaluation of Hirst-type spore traps in outdoor Aspergillaceae monitoring during large demolition work in hospital

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.

Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study

INTRODUCTION

Monitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk.

METHODS AND ANALYSIS

A daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min^-1. Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel. Aspergillus fumigatus strains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines.

ETHICS AND DISSEMINATION

This study was approved by the clinical research and ethics committees of EHH.

ISOLAMENTO E IDENTIFICAÇÃO DE FUNGOS DO GÊNERO Aspergillus spp. DE ÁGUA UTILIZADA NA REABILITAÇÃO DE PINGUINS-DEMAGALHÃES

Resumo A aspergilose caracteriza-se por ser a principal causa de mortalidade de pinguins em cativeiro. A infecção pelo gênero Aspergillus ocorre principalmente por via aérea, porém o fungo pode ter dispersão pela água. Neste sentido, este trabalho teve como objetivo avaliar a água do tanque onde os pinguins-de-Magalhães permanecem para reabilitação no Centro de Recuperação de Animais Marinhos de Rio Grande, RS, Brasil, quanto à presença de fungos filamentosos do gênero Aspergillus. As amostras de água foram coletadas semanalmente durante um período de 10 meses e processadas em um período máximo de seis horas utilizando-se a técnica da membrana filtrante, com incubação a 25 ºC e 37 ºC por até sete dias. Das 40 amostras analisadas, 32 foram positivas para o isolamento do gênero Aspergillus, sendo que dessas 60% pertenciam à espécie A. fumigatus. Algumas variáveis interferiram significativamente no isolamento do gênero Aspergillus e/ou da espécie A. fumigatus, como temperatura de incubação, sazonalidade e densidade populacional. Este trabalho demonstra que Aspergillus spp. está presente na água, podendo essa ser uma potencial fonte de infecção para os pinguins em reabilitação.