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Ichai P, Saliba F, Baune P, Daoud A, Coilly A, Samuel D. Impact of negative air pressure in ICU rooms on the risk of pulmonary aspergillosis in COVID-19 patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:538. [PMID: 32867810 PMCID: PMC7458783 DOI: 10.1186/s13054-020-03221-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/03/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Philippe Ichai
- Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm U1193, 12 Avenue Paul Vaillant Couturier, F-94804, Villejuif, France.
| | - Faouzi Saliba
- Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm U1193, 12 Avenue Paul Vaillant Couturier, F-94804, Villejuif, France
| | - Patricia Baune
- Infection Control Team, AP-HP Hôpital Paul-Brousse, F-94800, Villejuif, France
| | - Asma Daoud
- Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm U1193, 12 Avenue Paul Vaillant Couturier, F-94804, Villejuif, France
| | - Audrey Coilly
- Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm U1193, 12 Avenue Paul Vaillant Couturier, F-94804, Villejuif, France
| | - Didier Samuel
- Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm U1193, 12 Avenue Paul Vaillant Couturier, F-94804, Villejuif, France
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Poovelikunnel TT, Barakat A, O'Hara A, Humphreys HJ, Newmann V, Talento AF. Are positive-pressure ventilation lobby rooms effective for protective and source isolation? J Hosp Infect 2020; 106:53-56. [PMID: 32526255 PMCID: PMC7278628 DOI: 10.1016/j.jhin.2020.05.043] [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: 03/06/2020] [Accepted: 05/28/2020] [Indexed: 11/15/2022]
Abstract
High-efficiency particulate air supplied to a positive-pressure ventilation lobby (PPVL) in isolation rooms offers the dual advantage of protective and source isolation. This study demonstrates the in-use validity of PPVL rooms for protective isolation of patients. Of the 48 PPVL air samples investigated, Aspergillus fumigatus was detected from only one (2%) sample. Local and remote monitoring of the PPVL rooms is essential for the safety of patients and healthcare workers. Remote and point-of-use engineering controls are essential for ongoing ventilation monitoring, but this should be complemented by visual inspection of the isolation suite. Periodic microbiological monitoring should also be considered with other control measures.
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Affiliation(s)
| | | | - A O'Hara
- Beaumont Hospital, Dublin, Ireland
| | - H J Humphreys
- Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
| | | | - A F Talento
- Beaumont Hospital, Dublin, Ireland; Trinity College Dublin, Ireland
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Prevention of healthcare-associated invasive aspergillosis during hospital construction/renovation works. J Hosp Infect 2019; 103:1-12. [DOI: 10.1016/j.jhin.2018.12.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 12/31/2018] [Indexed: 01/10/2023]
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Lichtheimia corymbifera Colonization Leading to Pulmonary Infection Can Be Prevented with Liposomal Amphotericin B in a New Murine Model. Antimicrob Agents Chemother 2019; 63:AAC.02544-18. [PMID: 31138564 DOI: 10.1128/aac.02544-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/17/2019] [Indexed: 01/26/2023] Open
Abstract
The incidence of pulmonary mucormycosis is constantly increasing, especially in hematological patients staying in high-efficiency particulate air-filtered rooms. Pulmonary inhalation of spores may occur outside the hospital, leading to invasive disease once patients received chemotherapies. We developed a new pulmonary mucormycosis mouse model mimicking the expected pathophysiology in human to study antifungal drugs. Naive mice were inoculated intratracheally with Lichtheimia corymbifera spores. After 3 days, mice received corticosteroids and cyclophosphamide and secondarily developed the disease, while only 5% of the initial inoculum was present in the lungs at day 3. Lung colonization with L. corymbifera spores in immunocompetent mice can last at least 44 days. Antifungal drug was administered the day of immunosuppression. Injection of a single 15 mg/kg of body weight dose of liposomal amphotericin B significantly improved survival and pulmonary fungal burden compared with controls, whereas 80 mg/kg oral posaconazole did not. These results show that a unique dose of liposomal amphotericin B offers a real potential decolonization treatment to prevent infection in our mouse model of L. corymbifera lung colonization followed by lung infection.
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