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Baboli Z, Hayati R, Mosavion K, Goudarzi M, Sadeghi-Nejad B, Ghanbari F, Maleki H, Yazdani M, Hayat Davoudi G, Goudarzi G. An evaluation of fungal contamination and its relationship with PM levels in public transportation systems. ENVIRONMENTAL RESEARCH 2024; 252:118901. [PMID: 38609068 DOI: 10.1016/j.envres.2024.118901] [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: 09/26/2023] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Transmission of fungi in the air and its impact on health are regarded as important public health issues. Bioaerosols play an important role in causing or exacerbating infectious diseases, acute toxic effects, allergies, and cardiopulmonary symptoms. As many people use the public transportation system daily, it is necessary to determine the type and manner of dispersal and abundance of airborne fungi in public transport places. Three public transportation systems including a bus station, a train station, and an airport in Ahvaz city (Iran) were examined. At each of these stations, the air samples were taken from inside and outside the hall stations, and in-vehicle. A bio-stage Anderson sampler was used by suctioning air and passing it over a Petri dish containing culture medium Sabouraud Dextrose Agar (SDA). Relative humidity (RH, %), temperature (T, ◦C), and mass concentration of particulate matter (PM1, PM2.5, and PM10, μg/m3) at the sampling points were measured. The highest concentration of airborne fungi was observed in the airport. The concentration of fungi in the ambient air was higher than that in the indoor air of halls and in-vehicle. In all sampling points, the ambient predominant airborne fungi were Cladosporium and Alternaria, while the indoor predominant airborne fungi were Cladosporium, Aspergillus, and Penicillium. The indoor to outdoor ratio showed that the fungi were of an external origin. Due to the influence of the ambient air on indoor air, it is recommended to use proper ventilation and enhance the hygiene level of vehicles in public transportation systems to reduce exposure to environmentally pathogenic bioaerosols.
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Affiliation(s)
- Zeynab Baboli
- Department of Environmental Health Engineering, Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Roghayeh Hayati
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kiana Mosavion
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdis Goudarzi
- Department of Environmental Health Engineering, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Farshid Ghanbari
- Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran
| | - Heydar Maleki
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Yazdani
- Department of Environmental Health Engineering, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Golnaz Hayat Davoudi
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ghoalmreza Goudarzi
- Environmental Technologies Research Center (ETRC), Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Sautour M, Guilloteau A, Valot S, Basmaciyan L, Bailly E, Sixt N, Tetu J, Lafon I, Caillot D, Dalle F. Risk of fungal exposure in the homes of patients with hematologic malignancies. J Mycol Med 2024; 34:101492. [PMID: 38865808 DOI: 10.1016/j.mycmed.2024.101492] [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: 09/04/2023] [Revised: 05/23/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Patients with hematological malignancies are at a high risk of developing invasive fungal infections (IFI) because they undergo several cycles of treatment leading to episodes of neutropenia. In addition, they alternate between hospital stays and periods spent at home. Thus, when an IFI is diagnosed during their hospital stays, it is highly challenging to identify the origin of the fungal contamination. The objective of this study was to analyze at home fungal exposure of 20 patients with leukemia by taking air and water samples in their living residence. METHODS Air was sampled in 3 rooms of each home with a portable air system impactor. Tap water was collected at 3 water distribution points of each home. For positive samples, fungi were identified by mass spectrometry or on the basis of their morphological features. RESULTS 85 % of homes revealed the presence in air of Aspergillus spp. and those belonging to the section Fumigati presented the highest concentrations and the greatest frequency of isolation. Concerning mucorales, Rhizopus spp. and Mucor spp. were isolated in air of 20 % and 5 % of dwellings, respectively. In 4 homes, more than 70 % of the fungal species identified in air were potential opportunists; these were mainly Aspergillus spp. with concentrations greater than 20 cfu/m3. The water samples revealed the presence of Fusarium in 3 dwellings, with concentrations up to 80 cfu/L. Finally, for one patient, fungal species isolated during a period of hospitalization were phenotypically similar to those isolated in samples taken at home. For a second patient, a PCR Mucorale was positive on a sample of bronchoalveolar fluid while air samples taken at his home also revealed also the presence of mucorales. CONCLUSION The presence of opportunistic fungal species in the air of all the explored homes suggests the need for strengthened preventive measures in the home of immunocompromised patients. It would be interesting to compare the fungi isolated (from patients and from their environment) by genotyping studies aimed at specifying the correspondence existing between fungal species present in the patients' homes and those responsible for IFI in the same patients.
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Affiliation(s)
- Marc Sautour
- Parasitology and Mycology Laboratory, University Hospital of Dijon, 21070 BP, Dijon 37013 CEDEX, France; UMR PAM A 02.102 Procédés Alimentaires et Microbiologiques, University Bourgogne Franche-Comté, AgroSup, Dijon, France.
| | - Adrien Guilloteau
- Hospital Hygiene and Epidemiology Unit, University Hospital of Dijon, BP, 21070, Dijon 37013 CEDEX, France
| | - Stéphane Valot
- Parasitology and Mycology Laboratory, University Hospital of Dijon, 21070 BP, Dijon 37013 CEDEX, France
| | - Louise Basmaciyan
- Parasitology and Mycology Laboratory, University Hospital of Dijon, 21070 BP, Dijon 37013 CEDEX, France; UMR PAM A 02.102 Procédés Alimentaires et Microbiologiques, University Bourgogne Franche-Comté, AgroSup, Dijon, France
| | - Eloise Bailly
- UMR PAM A 02.102 Procédés Alimentaires et Microbiologiques, University Bourgogne Franche-Comté, AgroSup, Dijon, France
| | - Nathalie Sixt
- Department of Bacteriology, University Hospital of Dijon, BP, 21070, Dijon 37013 CEDEX, France
| | - Jennifer Tetu
- Department of Bacteriology, University Hospital of Dijon, BP, 21070, Dijon 37013 CEDEX, France
| | - Ingrid Lafon
- Clinical Haematology unit, University Hospital of Dijon, BP, 21070, Dijon 37013 CEDEX, France
| | - Denis Caillot
- Clinical Haematology unit, University Hospital of Dijon, BP, 21070, Dijon 37013 CEDEX, France
| | - Frédéric Dalle
- Parasitology and Mycology Laboratory, University Hospital of Dijon, 21070 BP, Dijon 37013 CEDEX, France; UMR PAM A 02.102 Procédés Alimentaires et Microbiologiques, University Bourgogne Franche-Comté, AgroSup, Dijon, France
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3
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Ghosh S, Mukherjee R, Mahajan VS, Boucau J, Pillai S, Haldar J. Permanent, Antimicrobial Coating to Rapidly Kill and Prevent Transmission of Bacteria, Fungi, Influenza, and SARS-CoV-2. ACS APPLIED MATERIALS & INTERFACES 2022; 14:42483-42493. [PMID: 36073910 DOI: 10.1021/acsami.2c11915] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Microbial adhesion and contamination on shared surfaces can lead to life-threatening infections with serious impacts on public health, economy, and clinical practices. The traditional use of chemical disinfectants for sanitization of surfaces, however, comes with its share of health risks, such as hazardous effects on the eyes, skin, and respiratory tract, carcinogenicity, as well as environmental toxicity. To address this, we have developed a nonleaching quaternary small molecule (QSM)-based sprayable coating which can be fabricated on a wide range of surfaces such as nylon, polyethylene, surgical mask, paper, acrylate, and rubber in a one-step, photocuring technique. This contact-active coating killed pathogenic bacteria and fungi including drug-resistant strains of Staphylococcus aureus and Candida albicans within 15-30 min of contact. QSM coatings withstood multiple washes, highlighting their durability. Interestingly, the coated surfaces exhibited rapid killing of pathogens, leading to the prevention of their transmission upon contact. The coating showed membrane disruption of bacterial cells in fluorescence and electron microscopic investigations. Along with bacteria and fungi, QSM-coated surfaces also showed the complete killing of high loads of influenza (H1N1) and SARS-CoV-2 viruses within 30 min of exposure. To our knowledge, this is the first report of a coating for multipurpose materials applied in high-touch public places, hospital equipment, and clinical consumables, rapidly killing drug-resistant bacteria, fungi, influenza virus, and SARS-CoV-2.
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Affiliation(s)
- Sreyan Ghosh
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru, Karnataka 560064, India
| | - Riya Mukherjee
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru, Karnataka 560064, India
| | - Vinay S Mahajan
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts 02139, United States
| | - Julie Boucau
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts 02139, United States
| | - Shiv Pillai
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts 02139, United States
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru, Karnataka 560064, India
- School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru, Karnataka 560064, India
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Evaluation of indoor airborne fungal concentration in haematologic wards over a 2 year period. J Hosp Infect 2022; 127:129-130. [PMID: 35840000 DOI: 10.1016/j.jhin.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022]
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Tajiki F, Asgari HM, Zamani I, Ghanbari F. Assessing the relationship between airborne fungi and potential dust sources using a combined approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:17799-17810. [PMID: 34676476 DOI: 10.1007/s11356-021-17028-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/10/2021] [Indexed: 06/13/2023]
Abstract
Dust events impose negative socio-economic, health, and environmental impacts on vulnerable areas and reflect their sources' physiochemical and biological characteristics. This study aimed to assess the impact of two dust sources on the concentration and diversity of airborne fungi in one of the dustiest areas in the world. This study is the first attempt to investigate the relationship between dust sources fungal community and those in airborne dust. Also, the contribution of dust sources to airborne fungi was estimated. Air masses arriving at the study area were assessed using local wind rose and the HYSPLIT model. Sampling was carried out from airborne dust at the Arvand Free Zone as target areas and soil in the dried parts of the Hor al-Azim and Shadegan wetlands as source areas to explore the relationship between fungi in the dust sources and the downwind area. The samples were analyzed in the lab to extract DNA. The internal transcribed spacer (ITS) regions of the rDNA gene were amplified using the primers ITS1F and ITS4, and then PCR products were sent to the lab for sequencing. The raw DNA data were processed using the QIIME virtual box to pick operational taxonomic units and taxonomy assignments. The most common fungi at the genus level were in the order of Penicillium > Aspergillus > Alternaria > Fusarium > Paradendryphiella > Talaromyces. The similarity between air and soil fungal genera was investigated using richness and diversity indices, the phylogenetic tree, and principal component analysis. The results showed that the community structures of ambient fungi in the Hor al-Azim and Shadegan dust sources were more similar to those on dusty days than non-dusty days. The source tracker model was used to quantify the contributions of known dust sources to airborne fungi. The results showed that the main source of airborne fungi was Hor al-Azim on dusty and non-dusty days. This study's results can help managers identify and prioritize dust sources regarding fungal species.
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Affiliation(s)
- Forough Tajiki
- Department of Environment, Faculty of Natural Resources, Khorramshahr University of Marine Sciences and Technology, P.B. 699, Khorramshahr, Iran
| | - Hossein Mohammad Asgari
- Department of Environment, Faculty of Natural Resources, Khorramshahr University of Marine Sciences and Technology, P.B. 699, Khorramshahr, Iran.
| | - Isaac Zamani
- Department of Marine Biology, Faculty of Marine and Oceanic Sciences, Khorramshahr University of Marine Sciences and Technology, P.B. 699, Khorramshahr, Iran
| | - Farshid Ghanbari
- Research Center for Environmental Contaminants (RCEC), Abadan Faculty of Medical Sciences, Abadan, Iran
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Suleyman G, Alangaden GJ. Nosocomial Fungal Infections: Epidemiology, Infection Control, and Prevention. Infect Dis Clin North Am 2021; 35:1027-1053. [PMID: 34752219 DOI: 10.1016/j.idc.2021.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Invasive fungal infections are an important cause of morbidity and mortality in hospitalized patients and in the immunocompromised population. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis (IC) and invasive aspergillosis (IA). Included are descriptions of nosocomial infections caused by Candida auris, an emerging pathogen, and IC- and IA-associated with coronavirus disease 2019. The characteristics and availability of newer nonculture-based tests for identification of nosocomial fungal pathogens are discussed. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.
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Affiliation(s)
- Geehan Suleyman
- Infection Prevention and Control, Henry Ford Hospital, Wayne State University, 2799 West Grand Boulevard, CFP Suite 317, Detroit, MI 48202, USA
| | - George J Alangaden
- Division of Infectious Diseases, Henry Ford Hospital, Wayne State University, 2799 West Grand Boulevard, CFP Suite 316, Detroit, MI 48202, USA.
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Nakanishi Y, Kasahara K, Koizumi A, Tokutani J, Yoshihara S, Mikasa K, Imamura T. Evaluation of Nosocomial Infection Control Measures to Minimize the Risk of Aspergillus Dispersion During Major Demolition Work: A Case Study of a Japanese University Hospital. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:58-74. [PMID: 33957793 DOI: 10.1177/19375867211009979] [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: 11/15/2022]
Abstract
OBJECTIVES To verify the effectiveness of our infection control measures based on the infection control risk assessment (ICRA) to minimize the risk of Aspergillus dispersion before, during, and after demolition work in a university hospital. BACKGROUND It is widely accepted that invasive aspergillosis is associated with construction, renovation, and demolition activities within or close to hospital sites. However, the risk is underestimated, and only limited preventive measures are taken in Japanese hospitals. METHOD The demolition process, carried out in July 2014, was supervised by our facility management in collaboration with the infection prevention team and followed an adapted ICRA tool. Dust containment measures were implemented to reduce the risk of airborne Aspergillus contamination. Air sampling was performed at four wards in the adjacent hospital buildings to assess the containment measures' effectiveness. RESULTS A high, undetermined number of colonies of bacteria and molds were detected on all outside balconies before demolition. During demolition, Aspergillus spp. was detected only in the ward closest to the demolition site. However, no case of aspergillosis was reported. The difference-in-difference analysis revealed that the interaction between the demolition activity, height of the ward, and distance of the air intake to the demolition activities resulted in a significant increase in the numbers of Aspergillus spp. CONCLUSIONS When large-scale demolition work occurs in hospital premises, Aspergillus spp. may increase in the ward where the vertical and horizontal distance of air intake from the demolition site is close, even though infection control measures based on the ICRA are implemented.
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Affiliation(s)
- Yasuhiro Nakanishi
- Department of Public Health, Health Management and Policy, 12967Nara Medical University, Japan.,Corporate Administration Department, Research Promotion Division, 12967Nara Medical University, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, 12967Nara Medical University, Japan.,Infection Control Team, 243062Nara Medical University Hospital, Japan
| | - Akira Koizumi
- Infection Control Team, 243062Nara Medical University Hospital, Japan.,Central Clinical Laboratory, 243062Nara Medical University Hospital, Japan
| | - Junko Tokutani
- Infection Control Team, 243062Nara Medical University Hospital, Japan.,Department of Nursing, 243062Nara Medical University Hospital, Japan
| | - Shingo Yoshihara
- Department of Public Health, Health Management and Policy, 12967Nara Medical University, Japan.,Center for Infectious Diseases, 12967Nara Medical University, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, 12967Nara Medical University, Japan
| | - Tomoaki Imamura
- Department of Public Health, Health Management and Policy, 12967Nara Medical University, Japan
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Performance evaluation of a new mobile air-treatment technology at-rest and under normal work conditions in a conventional hematology room. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00480-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Gallon V, Le Cann P, Sanchez M, Dematteo C, Le Bot B. Emissions of VOCs, SVOCs, and mold during the construction process: Contribution to indoor air quality and future occupants' exposure. INDOOR AIR 2020; 30:691-710. [PMID: 31943356 DOI: 10.1111/ina.12647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
Building materials and human activities are important sources of contamination indoors, but little information is available regarding contamination during construction process which could persist during the whole life of buildings. In this study, six construction stages on two construction sites were investigated regarding the emissions of 43 volatile organic compounds (VOCs), 46 semi-volatile organic compounds (SVOCs), and the presence of 4 genera of mold. Results show that the future indoor air quality does not only depend on the emissions of each building product but that it is also closely related to the whole implementation process. Mold spore measurements can reach 1400 CFU/m3 , which is particularly high compared with the concentrations usually measured in indoor environments. Relatively low concentrations of VOCs were observed, in relation to the use of low emissive materials. Among SVOCs analyzed, some phthalates, permethrin, and hydrocarbons were found in significant concentrations upon the delivery of building as well as triclosan, suspected to be endocrine disruptor, and yet prohibited in the treatment of materials and construction since 2014. As some regulations exist for VOC emissions, it is necessary to implement them for SVOCs due to their toxicity.
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Affiliation(s)
- Victoria Gallon
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, University of Rennes, Rennes, France
| | - Pierre Le Cann
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, University of Rennes, Rennes, France
| | | | | | - Barbara Le Bot
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, University of Rennes, Rennes, France
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10
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Loeffert ST, Melloul E, Gustin MP, Hénaff L, Guillot C, Dupont D, Wallon M, Cassier P, Dananché C, Bénet T, Botterel F, Guillot J, Vanhems P. Investigation of the Relationships Between Clinical and Environmental Isolates of Aspergillus fumigatus by Multiple-locus Variable Number Tandem Repeat Analysis During Major Demolition Work in a French Hospital. Clin Infect Dis 2020; 68:321-329. [PMID: 30247539 DOI: 10.1093/cid/ciy498] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/17/2018] [Indexed: 01/28/2023] Open
Abstract
Background Genotyping is needed to explore the link between clinical cases from colonization of invasive aspergillosis (IA) and major building construction. Attempts to correlate Aspergillus fumigatus strains from clinical infection or colonization with those found in the environment remain controversial due to the lack of a large prospective study. Our aim in this study was to compare the genetic diversity of clinical and environmental A. fumigatus isolates during a demolition period. Methods Fungal contamination was monitored daily for 11 months in 2015. Environmental surveillance was undertaken indoors and outdoors at 8 locations with automatic agar samplers. IA infection cases were investigated according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria. Isolates were identified by amplification and sequencing of the β- tubulin gene. They were genotyped by multiple-locus variable number tandem repeat analysis (MLVA). The phylogenetic relationships between isolates were assessed by generating a minimum spanning tree. Results Based on 3885 samples, 394 A. fumigatus isolates (383 environmental and 11 clinical) were identified and genotyped using MLVA. Clinical isolates were collected from patients diagnosed as having probable IA (n = 2), possible IA (n = 1), or bronchial colonization (n = 6). MLVA generated 234 genotypes. Seven clinical isolates shared genotypes identical to environmental isolates. Conclusions Among the diversity of genotypes described, similar genotypes were found in clinical and environmental isolates, indicating that A. fumigatus infection and colonization may originate from hospital environments.
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Affiliation(s)
- Sophie T Loeffert
- Equipe Epidémiologie et Santé Internationale, Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon
| | - Elise Melloul
- EA 7380 Dynamyc, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil
| | - Marie-Paule Gustin
- Département de Santé Publique, Institut des Sciences Pharmaceutiques et Biologiques-Faculté de Pharmacie, Université Claude Bernard Lyon 1
| | - Laetitia Hénaff
- Equipe Epidémiologie et Santé Internationale, Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon
| | - Chloé Guillot
- EA 7380 Dynamyc, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil
| | - Damien Dupont
- Institut de Parasitologie et de Mycologie Médicale, Hôpital de la Croix Rousse, Lyon
| | - Martine Wallon
- Institut de Parasitologie et de Mycologie Médicale, Hôpital de la Croix Rousse, Lyon
| | - Pierre Cassier
- Laboratoire de Biologie Sécurité Environnement, Groupement Hospitalier Centre, Hospices Civils de Lyon
| | - Cédric Dananché
- Equipe Epidémiologie et Santé Internationale, Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon.,Unité d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, France
| | - Thomas Bénet
- Unité d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, France
| | - Françoise Botterel
- EA 7380 Dynamyc, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil
| | - Jacques Guillot
- EA 7380 Dynamyc, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil
| | - Philippe Vanhems
- Equipe Epidémiologie et Santé Internationale, Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon.,Unité d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, France
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11
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Outbreaks of Mucorales and the Species Involved. Mycopathologia 2019; 185:765-781. [PMID: 31734800 DOI: 10.1007/s11046-019-00403-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/22/2019] [Indexed: 01/27/2023]
Abstract
The order Mucorales is an ancient group of fungi classified in the subphylum Mucoromycotina. Mucorales are mainly fast-growing saprotrophs that belong to the first colonizers of diverse organic materials and represent a permanent part of the human environment. Several species are able to cause human infections (mucormycoses) predominantly in patients with impaired immune system, diabetes, or deep trauma. In this review, we compiled 32 reports on community- and hospital-acquired outbreaks caused by Mucorales. The most common source of mucoralean outbreaks was contaminated medical devices that are responsible for 40.7% of the outbreaks followed by contaminated air (31.3%), traumatic inoculation of soil or foreign bodies (9.4%), and the contact (6.2%) or the ingestion (6.2%) of contaminated plant material. The most prevalent species were Rhizopus arrhizus and R. microsporus causing 57% of the outbreaks. The genus Rhizomucor was dominating in outbreaks related to contaminated air while outbreaks of Lichtheimia species and Mucor circinelloides were transmitted by direct contact. Outbreaks with the involvement of several species are reported. Subtyping of strains revealed clonality in two outbreaks and no close relation in two other outbreaks. Based on the existing data, outbreaks of Mucorales can be caused by heterogeneous sources consisting of different strains or different species. Person-to-person transmission cannot be excluded because Mucorales can sporulate on wounds. For a better understanding and prevention of outbreaks, we need to increase our knowledge on the physiology, ecology, and population structure of outbreak causing species and more subtyping data.
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12
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Stockwell RE, Ballard EL, O'Rourke P, Knibbs LD, Morawska L, Bell SC. Indoor hospital air and the impact of ventilation on bioaerosols: a systematic review. J Hosp Infect 2019; 103:175-184. [PMID: 31279762 DOI: 10.1016/j.jhin.2019.06.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
Abstract
Healthcare-acquired infections (HAIs) continue to persist in hospitals, despite the use of increasingly strict infection-control precautions. Opportunistic airborne transmission of potentially pathogenic bioaerosols may be one possible reason for this persistence. Therefore, this study aimed to systematically review the concentrations and compositions of indoor bioaerosols in different areas within hospitals and the effects of different ventilation systems. Electronic databases (Medline and Web of Science) were searched to identify articles of interest. The search was restricted to articles published from 2000 to 2017 in English. Aggregate data was used to examine the differences in mean colony forming units per cubic metre (cfu/m3) between different hospital areas and ventilation types. A total of 36 journal articles met the eligibility criteria. The mean total bioaerosol concentrations in the different areas of the hospitals were highest in the inpatient facilities (77 cfu/m3, 95% confidence interval (CI): 55-108) compared with the restricted (13cfu/m3, 95% CI: 10-15) and public areas (14 cfu/m3, 95% CI: 10-19). Hospital areas with natural ventilation had the highest total bioaerosol concentrations (201 cfu/m3, 95% CI: 135-300) compared with areas using conventional mechanical ventilation systems (20 cfu/m3, 95% CI: 16-24). Hospital areas using sophisticated mechanical ventilation systems (such as increased air changes per hour, directional flow and filtration systems) had the lowest total bioaerosol concentrations (9 cfu/m3, 95% CI: 7-13). Operating sophisticated mechanical ventilation systems in hospitals contributes to improved indoor air quality within hospitals, which assists in reducing the risk of airborne transmission of HAIs.
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Affiliation(s)
- R E Stockwell
- Lung Bacteria Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - E L Ballard
- Statistical Support Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - P O'Rourke
- Statistical Support Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - L D Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S C Bell
- Lung Bacteria Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia; Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Chermside, Queensland, Australia.
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Mousavi MS, Hadei M, Majlesi M, Hopke PK, Yarahmadi M, Emam B, Kermani M, Shahsavani A. Investigating the effect of several factors on concentrations of bioaerosols in a well-ventilated hospital environment. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:407. [PMID: 31165312 DOI: 10.1007/s10661-019-7559-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Abstract
This study characterized and quantified the bacterial and fungal bioaerosols in nine wards of the Razavi Hospital (Mashhad, Iran) that is equipped with an advanced heating, ventilating, and air conditioning (HVAC) system including HEPA filters for air cleaning. In this study, 432 samples were taken from the indoor air of multiple hospital wards during the morning and afternoon shifts during summer and autumn. The particle number concentrations with sizes of > 0.3, > 0.5, > 1, > 2, > 5, and > 10 μm were measured using a 6-channel handheld particle counter. A greater diversity of bioaerosol types were observed during the morning shifts and during summer. The microbial load was not affected significantly by the temperature, relative humidity, working shift, season, and number of visitors, indicating the effectiveness of a well-designed ventilation system to eliminate site-specific variations. For microbial number concentrations, a significant correlation was only observed between the number of particles with a diameter of > 10 μm and the airborne microbial loading. Thus, passive sampling may not properly reflect the actual concentrations of smaller bioaerosols. In conclusion, HEPA filters in the HVAC system successfully decreased the bioaerosol concentrations in the hospital environment. Additionally, we recommend that active sampling be used in cases where a well-functioning HVAC system exists.
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Affiliation(s)
| | - Mostafa Hadei
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Monireh Majlesi
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA
- Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, 13699, USA
| | - Maryam Yarahmadi
- Environmental and Occupational Health Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Bahahran Emam
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Abbasi F, Samaei MR. The effect of temperature on airborne filamentous fungi in the indoor and outdoor space of a hospital. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:16868-16876. [PMID: 29299864 DOI: 10.1007/s11356-017-0939-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/04/2017] [Indexed: 05/23/2023]
Abstract
Fungi are one of the bioaerosols in indoor air of hospitals. They have adverse effects on staff and patients. The aim of this study was to investigate the effects of three incubation temperature on the density and composition of airborne fungi in an indoor and outdoor space of hospital. Sabouraud dextrose agar was used for culture the fungi. For improvement of aseptic properties, chloramphenicol was added to this medium. The density of airborne fungi was less than 282 CFU/m3. The highest density was detected in emergency room and the lowest of them was in neonatal intensive care unit (NICU) and operation room (OR). Results showed that fungi levels at 25 °C were higher than 37 and 15 °C (p = 0.006). In addition, ten different genera of fungi were identified in all departments. The predominant fungi were Fusarium spp., Penicillium spp., Paecilomyces spp., and Aspergillus niger. Moreover, the density and trend of distribution of Fusaruim spp. in the indoor space was directivity to outdoor space by ventilation system. The present study has provided that incubation temperature had effect on airborne fungi remarkably. We are suggested that more studies would be conducted on incubation temperature and other ambient factors on airborne fungi.
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Affiliation(s)
- Fariba Abbasi
- Department of environmental health engineering, School of health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Samaei
- Research Center for Health Sciences, Institute of health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Newcomer DA, LaPuma P, Brandys R, Northcross A, Dasgupta A. Measuring airflow through the portable high-efficiency air filtration (PHEAF) device to assess reliability of instrument and sample location. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2019; 69:734-742. [PMID: 30698506 DOI: 10.1080/10962247.2019.1576554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
The portable high-efficiency air filtration (PHEAF) device is an engineering control common to the environmental remediation industry. Damage to the high-efficiency particulate air (HEPA) filter (e.g., filtration media, gasket), improper installation of the filter into the mounting frame, or defects in the filtration housing affect the capture efficiency of the device. PHEAF devices operating at less than marketed efficiencies justify periodic leak testing of the PHEAF device, especially when the filtered air is exhausted into occupied spaces. A leak test is accomplished by injecting a known concentration of aerosol upstream of the HEPA filter and measuring the percentage of aerosol penetrating through the filtration system. The test protocol scripted for stationary systems (i.e., biological safety cabinets) states that upstream concentrations can be empirically determined using the aerosol photometer to measure particulate matter (PM) in the airstream. This practice requires a homogenous mixture of the aerosol challenge agent within the airstream. However, design of the PHEAF device does not include a validated induction point for the aerosol. Absent of an acceptable means to achieve a homogenous mixture for upstream measurement, the aerosol concentration is mathematically derived based on the measured air volume passing through the PHEAF equipment. In this study, intake volume and exhaust volume for each PHEAF device were measured by either the balometer or the hot wire anemometer. Variability of measurements was examined by instrument and sample location (intake vs. exhaust) to understand which combination would be most consistent for measuring airflow volume. From this study, the authors conclude that the balometer is preferred compared with the hot wire anemometer for measuring airflow through the PHEAF device. Exhaust measurement by balometer seems more reliable than intake measurements by hot wire anemometer. Implications: Although testing of PHEAF devices is recommended by various public health authorities, no nationally recognized test protocol has been published in the United States. In support of measuring the performance of the PHEAF device in a field setting, this study evaluated the hot wire anemometer and balometer techniques and sample locations (intake vs. exhaust) to reliably measure airflow through the PHEAF device. Since accuracy of the particle measurement is associated with airflow volume, it is essential to obtain a true airflow reading. This study suggests that the balometer was more consistent in measuring airflow through the PHEAF device.
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Affiliation(s)
- Derek A Newcomer
- a Division of Occupational Health and Safety, Office of Research Services , National Institutes of Health , Bethesda , MD , USA
| | - Peter LaPuma
- b Department of Environmental and Occupational Health, Milken Institute School of Public Health , George Washington University , Washington , DC , USA
| | - Robert Brandys
- c Occupational & Environmental Health Consulting Services, Inc ., Las Vegas , NV , USA
| | - Amanda Northcross
- b Department of Environmental and Occupational Health, Milken Institute School of Public Health , George Washington University , Washington , DC , USA
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Tolabi Z, Alimohammadi M, Hassanvand MS, Nabizadeh R, Soleimani H, Zarei A. The investigation of type and concentration of bio-aerosols in the air of surgical rooms: A case study in Shariati hospital, Karaj. MethodsX 2019; 6:641-650. [PMID: 30989056 PMCID: PMC6447748 DOI: 10.1016/j.mex.2019.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 03/15/2019] [Indexed: 12/28/2022] Open
Abstract
The presence of bio-aerosols is one of the main causes of hospital infections that can be dangerous especially for immunocompromised patients. This research aimed to determine the relationship between hospital infections and surgical incision size in addition to determining the concentration and bacterial and fungal bioaerosols found in the operating rooms. This cross-sectional descriptive-analytic study was carried out in the operating rooms of Shariati Hospital in Karaj, Iran during the years 2016 and 2017. A total of 198 bacterial samples and 198 fungal samples were collected and analyzed using a passive sampling standard method (1/1/1) for 180 days. Tryptic Soy Agar (TSA) and Sabouraud Dextrose Agar (SDA) medium were used for bacterial and fungal samples, respectively. Relevant differential tests were used to determine the genus and species of bacteria and fungi such as DNase test, Bile-esculin, motility test urease test. In general, this work presents: The present evaluated the relationship between bioaerosols concentration and surgical incision size. The intraoperative concentration of bacterial and fungal bioaerosols in indoor air of the orthopedic, internal and cesarean operating rooms was significantly higher than their preoperative concentration (p-value<0.05). Also, there was not significant difference between the bacterial and fungal concentrations in various operating rooms) p-value<0.05).
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Affiliation(s)
- Zahra Tolabi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Alimohammadi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Soleimani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Zarei
- Department of Environmental Health Engineering, School of Public Health, Gonabad University of Medical Sciences, Gonabad, Iran
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17
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Shajahan A, Culp CH, Williamson B. Effects of indoor environmental parameters related to building heating, ventilation, and air conditioning systems on patients' medical outcomes: A review of scientific research on hospital buildings. INDOOR AIR 2019; 29:161-176. [PMID: 30588679 PMCID: PMC7165615 DOI: 10.1111/ina.12531] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/10/2018] [Accepted: 12/21/2018] [Indexed: 05/04/2023]
Abstract
The indoor environment of a mechanically ventilated hospital building controls infection rates as well as influences patients' healing processes and overall medical outcomes. This review covers the scientific research that has assessed patients' medical outcomes concerning at least one indoor environmental parameter related to building heating, ventilation, and air conditioning (HVAC) systems, such as indoor air temperature, relative humidity, and indoor air ventilation parameters. Research related to the naturally ventilated hospital buildings was outside the scope of this review article. After 1998, a total of 899 papers were identified that fit the inclusion criteria of this study. Of these, 176 papers have been included in this review to understand the relationship between the health outcomes of a patient and the indoor environment of a mechanically ventilated hospital building. The purpose of this literature review was to summarize how indoor environmental parameters related to mechanical ventilation systems of a hospital building are impacting patients. This review suggests that there is a need for future interdisciplinary collaborative research to quantify the optimum range for HVAC parameters considering airborne exposures and patients' positive medical outcomes.
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Affiliation(s)
- Amreen Shajahan
- Energy Systems LaboratoryTexas A&M UniversityCollege StationTexas
- Department of ArchitectureTexas A&M UniversityCollege StationTexas
| | - Charles H. Culp
- Energy Systems LaboratoryTexas A&M UniversityCollege StationTexas
- Department of ArchitectureTexas A&M UniversityCollege StationTexas
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18
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Dehghani M, Sorooshian A, Nazmara S, Baghani AN, Delikhoon M. Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2018; 164:277-282. [PMID: 30121503 PMCID: PMC6151147 DOI: 10.1016/j.ecoenv.2018.08.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 05/21/2023]
Abstract
Operating rooms (ORs) in hospitals are sensitive wards because patients can get infections. This work aimed to characterize the type and concentration of bioaerosols in nine ORs of an educational hospital before and after sterilization and disinfection. During 2017, fungal samples were incubated at 25-28 °C for 3-7 days and bacterial samples at 37 °C for 24-48 h. The study results showed that the concentrations of fungi before cleaning procedures (for both of disinfection and sterilization) were limited from 4.83 to 18.40 CFU/m3 and after cleaning procedures ranged from 1.90 to 8.90 CFU/m3. In addition, the concentrations of bacteria before cleaning procedures were limited 14.65-167.40 CFU/m3 and after cleaning procedures ranged from 9.50 to 38.40 CFU/m3. The difference between the mean concentrations of airborne bioaerosols before and after sterilization was significantly different than the suggested value of 30 CFU/m3 (p ≤ 0.05). The bacterial concentration was higher than the recommended value (30 CFU/m3) in 41% of the ORs. The main fungal species identified in the indoor air of ORs (before vs. after sterilization) were A. fumigatus (25.6 vs. 18.3%), A. Niger (11.6 vs. 5.8%), Penicillium spp. (5.5 vs. 3.3%), Alternaria spp. (2.8 vs. 0.7%), Fusarium spp. (9.7 vs. 3.7%), Mucor spp. (15 vs. 12.7%), Cephalotrichum spp. (1.7 vs. 0.8%), A. Flavus (24.6 vs. 18.5%), Cladosporium spp. (2.6 vs. 0.8%), and Trichoderma spp. (0 vs. 0.9%). The growth of biological species even after sterilization and disinfection likely resulted from factors including poor ventilation, sweeping of OR floors, inadequate HVAC filtration, high humidity, and also lack of optimum management of infectious waste after surgery. Designing well-constructed ventilation and air-conditioning systems, replacing HEPA filters, implementing more stringent, frequent, and comprehensive disinfection procedures, and controlling temperature and humidity can help decrease bioaerosols in ORs.
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Affiliation(s)
- Mansooreh Dehghani
- Research Center for Health Sciences, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Armin Sorooshian
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, Arizona, USA; Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, Arizona, USA
| | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Norouzian Baghani
- Research Center for Health Sciences, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdieh Delikhoon
- Department of Occupational Health Engineering, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gonçalves CL, Mota FV, Ferreira GF, Mendes JF, Pereira EC, Freitas CH, Vieira JN, Villarreal JP, Nascente PS. Airborne fungi in an intensive care unit. BRAZ J BIOL 2017; 78:265-270. [PMID: 28793031 DOI: 10.1590/1519-6984.06016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 11/08/2016] [Indexed: 11/21/2022] Open
Abstract
The presence of airborne fungi in Intensive Care Unit (ICUs) is associated with increased nosocomial infections. The aim of this study was the isolation and identification of airborne fungi presented in an ICU from the University Hospital of Pelotas - RS, with the attempt to know the place's environmental microbiota. 40 Petri plates with Sabouraud Dextrose Agar were exposed to an environment of an ICU, where samples were collected in strategic places during morning and afternoon periods for ten days. Seven fungi genera were identified: Penicillium spp. (15.18%), genus with the higher frequency, followed by Aspergillus spp., Cladosporium spp., Fusarium spp., Paecelomyces spp., Curvularia spp., Alternaria spp., Zygomycetes and sterile mycelium. The most predominant fungi genus were Aspergillus spp. (13.92%) in the morning and Cladosporium spp. (13.92%) in the afternoon. Due to their involvement in different diseases, the identified fungi genera can be classified as potential pathogens of inpatients. These results reinforce the need of monitoring the environmental microorganisms with high frequency and efficiently in health institutions.
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Affiliation(s)
- C L Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - F V Mota
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - G F Ferreira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J F Mendes
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - C H Freitas
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J N Vieira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J P Villarreal
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - P S Nascente
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Could we predict airborne Aspergillus contamination during construction work? Am J Infect Control 2017; 45:39-41. [PMID: 27665035 DOI: 10.1016/j.ajic.2016.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/05/2016] [Accepted: 08/05/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Aspergillus fumigatus is a major opportunistic pathogen causing nosocomial infection. Hospital outbreaks of invasive aspergillosis have been associated with demolition and building construction. This study was designed to examine the impact of meteorologic factors and different periods of work on outdoor fungal airborne concentrations. METHODS The study was conducted at Necker Enfants Malades Hospital, a 650-bed teaching care hospital recently involved in a large construction program, including renovation, construction, and demolition. During the work phases, prospective external air samplings were performed 3 times a week, and meteorologic parameters were collected every day. RESULTS Two hundred and one samples were collected. Aspergillus spp were found in 80.1% of samples, with a median concentration of 16 colony forming units (CFU)/m3. A significant increase in the colony count of molds occurred after demolition. In the multivariate analysis, factors associated with overall fungi concentration were the type of work construction and temperature. Elevated Aspergillus spp concentrations (>20 CFU/m3) were associated with higher temperature. CONCLUSIONS Our findings underline the importance of environmental surveillance. According to our results we suggest that demolition work should be performed during the winter and fall seasons.
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Haig CW, Mackay WG, Walker JT, Williams C. Bioaerosol sampling: sampling mechanisms, bioefficiency and field studies. J Hosp Infect 2016; 93:242-55. [PMID: 27112048 PMCID: PMC7124364 DOI: 10.1016/j.jhin.2016.03.017] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/15/2016] [Indexed: 11/21/2022]
Abstract
Investigations into the suspected airborne transmission of pathogens in healthcare environments have posed a challenge to researchers for more than a century. With each pathogen demonstrating a unique response to environmental conditions and the mechanical stresses it experiences, the choice of sampling device is not obvious. Our aim was to review bioaerosol sampling, sampling equipment, and methodology. A comprehensive literature search was performed, using electronic databases to retrieve English language papers on bioaerosol sampling. The review describes the mechanisms of popular bioaerosol sampling devices such as impingers, cyclones, impactors, and filters, explaining both their strengths and weaknesses, and the consequences for microbial bioefficiency. Numerous successful studies are described that point to best practice in bioaerosol sampling, from the use of small personal samplers to monitor workers' pathogen exposure through to large static samplers collecting airborne microbes in various healthcare settings. Of primary importance is the requirement that studies should commence by determining the bioefficiency of the chosen sampler and the pathogen under investigation within laboratory conditions. From such foundations, sampling for bioaerosol material in the complexity of the field holds greater certainty of successful capture of low-concentration airborne pathogens. From the laboratory to use in the field, this review enables the investigator to make informed decisions about the choice of bioaerosol sampler and its application.
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Affiliation(s)
- C W Haig
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK.
| | - W G Mackay
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK
| | - J T Walker
- Public Health England, National Infection Service, Biosafety Unit, Porton Down, UK
| | - C Williams
- Institute of Healthcare Associated Infection, University of the West of Scotland, Paisley, UK
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The Plasmair Decontamination System Is Protective Against Invasive Aspergillosis in Neutropenic Patients. Infect Control Hosp Epidemiol 2016; 37:845-51. [PMID: 27340735 DOI: 10.1017/ice.2016.81] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Invasive aspergillosis (IA) is a rare but severe infection caused by Aspergillus spp. that often develops in immunocompromised patients. Lethality remains high in this population. Therefore, preventive strategies are of key importance. The impact of a mobile air decontamination system (Plasmair, AirInSpace, Montigny-le-Bretonneux, France) on the incidence of IA in neutropenic patients was evaluated in this study. DESIGN Retrospective cohort study METHODS Patients with chemotherapy-induced neutropenia lasting 7 days or more were included over a 2-year period. Cases of IA were confirmed using the revised European Organization for Research and Treatment of Cancer (EORTC) criteria. We took advantage of a partial installation of Plasmair systems in the hematology intensive care unit during this period to compare patients treated in Plasmair-equipped versus non-equipped rooms. Patients were assigned to Plasmair-equipped or non-equipped rooms depending only on bed availability. Differences in IA incidence in both groups were compared using Fisher's exact test, and a multivariate analysis was performed to take into account potential confounding factors. RESULTS Data from 156 evaluable patients were available. Both groups were homogenous in terms of age, gender, hematological diagnosis, duration of neutropenia, and prophylaxis. A total of 11 cases of probable IA were diagnosed: 10 in patients in non-equipped rooms and only 1 patient in a Plasmair-equipped room. The odds of developing IA were much lower for patients hospitalized in Plasmair-equipped rooms than for patients in non-equipped rooms (P=.02; odds ratio [OR] =0.11; 95% confidence interval [CI], 0.00-0.84). CONCLUSION In this study, Plasmair demonstrated a major impact in reducing the incidence of IA in neutropenic patients with hematologic malignancies. Infect Control Hosp Epidemiol 2016;37:845-851.
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Özen M, Yılmaz G, Coşkun B, Topçuoğlu P, Öztürk B, Gündüz M, Atilla E, Arslan Ö, Özcan M, Demirer T, İlhan O, Konuk N, Balık İ, Gürman G, Akan H. A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction. Turk J Haematol 2016; 33:41-7. [PMID: 26376622 PMCID: PMC4805340 DOI: 10.4274/tjh.2014.0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 10/17/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The increased risk of infection for patients caused by construction and renovation near hematology inpatient clinics is a major concern. The use of high-efficiency particulate absorption (HEPA) filters can reduce the risk of infection. However, there is no standard protocol indicating the use of HEPA filters for patients with hematological malignancies, except for those who have undergone allogeneic hematopoietic stem cell transplantation. This quasi-experimental study was designed to measure the efficacy of HEPA filters in preventing infections during construction. MATERIALS AND METHODS Portable HEPA filters were placed in the rooms of patients undergoing treatment for hematological malignancies because of large-scale construction taking place near the hematology clinic. The rates of infection during the 6 months before and after the installation of the portable HEPA filters were compared. A total of 413 patients were treated during this 1-year period. RESULTS There were no significant differences in the antifungal prophylaxis and treatment regimens between the groups. The rates of infections, clinically documented infections, and invasive fungal infections decreased in all of the patients following the installation of the HEPA filters. When analyzed separately, the rates of invasive fungal infections were similar before and after the installation of HEPA filters in patients who had no neutropenia or long neutropenia duration. HEPA filters were significantly protective against infection when installed in the rooms of patients with acute lymphocytic leukemia, patients who were undergoing consolidation treatment, and patients who were neutropenic for 1-14 days. CONCLUSION Despite the advent of construction and the summer season, during which environmental Aspergillus contamination is more prevalent, no patient or patient subgroup experienced an increase in fungal infections following the installation of HEPA filters. The protective effect of HEPA filters against infection was more pronounced in patients with acute lymphocytic leukemia, patients undergoing consolidation therapy, and patients with moderate neutropenia.
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Affiliation(s)
- Mehmet Özen
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey. Phone: +90 312 595 70 99 E-mail:
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Concomitant osmotic and chaotropicity-induced stresses in Aspergillus wentii: compatible solutes determine the biotic window. Curr Genet 2015; 61:457-77. [DOI: 10.1007/s00294-015-0496-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/28/2015] [Accepted: 05/13/2015] [Indexed: 12/17/2022]
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26
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Composition qualitative de la flore fongique de l’environnement de 07 services à risque d’infections fongiques au CHU Aristide Le Dantec (Dakar). J Mycol Med 2015; 25:e39-43. [DOI: 10.1016/j.mycmed.2014.10.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 10/24/2014] [Accepted: 10/30/2014] [Indexed: 11/22/2022]
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27
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Fernández-Rodríguez S, Tormo-Molina R, Maya-Manzano JM, Silva-Palacios I, Gonzalo-Garijo Á. Outdoor airborne fungi captured by viable and non-viable methods. FUNGAL ECOL 2014. [DOI: 10.1016/j.funeco.2013.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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28
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Azimi F, Naddafi K, Nabizadeh R, Hassanvand MS, Alimohammadi M, Afhami S, Musavi SN. Fungal air quality in hospital rooms: a case study in Tehran, Iran. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2013; 11:30. [PMID: 24355065 PMCID: PMC3891997 DOI: 10.1186/2052-336x-11-30] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 08/11/2013] [Indexed: 05/13/2023]
Abstract
Fungi are usually presented in indoor environments and cause of many diseases. The aim of this descriptive study was to investigate the level of fungal contamination in hospital rooms. Sampling was conducted with an Andersen one-stage viable impactor (Quick Take-30) and counting plates containing a fungus-selective medium. A total of 120 air samples from ten hospital environments were performed. Airborne fungi concentrations were determined 72-120 hours after sampling. Total mean concentration of detected fungi in the hospital rooms was 55 ± 56 (mean ± SD) cfu/m3. The findings of the fungal concentration in the various hospital rooms revealed different levels of contamination: the lowest mean counts (37 ± 17 cfu/m3) were observed in NS 1 (Nursing Stations 1), and the highest (97 ± 217 cfu/m3) were reported in Orthopedics Operating Room (OOR). The most common fungal genus isolated were Penicillium (70%), Aspergillus (14%), Cladosporium (12%), Alternaria (2%) and others (2%). The obtained results showed that fungal concentrations in the present study were nearly high and these conditions should be considered as a risk factor for patients and other persons in the hospital.
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Affiliation(s)
- Faramarz Azimi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Alimohammadi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Afhami
- Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Nejat Musavi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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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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Cunat L, Ahmed-Lecheheb D, Hartemann P, Hunter PR, Hautemanière A. Emergence of hand contamination with Aspergillus during demolition work. Am J Infect Control 2013; 41:83-5. [PMID: 22749129 DOI: 10.1016/j.ajic.2012.01.037] [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: 06/11/2010] [Revised: 01/31/2012] [Accepted: 01/31/2012] [Indexed: 11/18/2022]
Abstract
Hand rubbing with hydro-alcoholic solutions prevent the exogenous nosocomial infection, but the hydro-alcoholic solutions were not sporicidal. A major program of demolition was organized on the area of the University Hospital of Nancy (France) between 2007 and 2010, and this period is often considered as a possible source of suspending Aspergillus spores. This study shows the emergence of Aspergillus on the hands of the medical students during demolition period despite the same quality of hand hygiene.
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Affiliation(s)
- Lisiane Cunat
- Department of Public Health and Environment, School of Medicine, Lorraine University, Nancy, France
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Technical note: the effect of different incubation temperatures on the recovery of Aspergillus species from hospital air. Am J Infect Control 2012; 40:1016-7. [PMID: 22683029 DOI: 10.1016/j.ajic.2012.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 01/17/2012] [Accepted: 01/20/2012] [Indexed: 11/22/2022]
Abstract
Environmental air monitoring is a common practice in many institutions. However, the methodology involved in different studies has not been standardized, with most centers incubating samples at room temperature. Here we demonstrate that the incubation of plates at 35-40°C facilitates growth of Aspergillus section Fumigati, the most important pathogenic mold in humans. We examine the implications of these findings.
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Monitoring the occurrence of indoor fungi in a hospital. Rev Iberoam Micol 2012; 29:227-34. [DOI: 10.1016/j.riam.2012.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 04/11/2012] [Accepted: 04/17/2012] [Indexed: 11/24/2022] Open
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Rammaert B, Lanternier F, Zahar JR, Dannaoui E, Bougnoux ME, Lecuit M, Lortholary O. Healthcare-associated mucormycosis. Clin Infect Dis 2012; 54 Suppl 1:S44-54. [PMID: 22247444 DOI: 10.1093/cid/cir867] [Citation(s) in RCA: 184] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Mucormycosis is a severe emerging invasive fungal infection that occurs as a consequence of environmental exposure. We exhaustively reviewed all the cases of mucormycosis (European Organisation for Research and Treatment of Cancer/Mycoses Study Group 2008 criteria) attributed to healthcare procedures that occurred between 1970 and 2008. A total of 169 cases were studied (29% children, 61% male). Major underlying diseases were solid organ transplantation (24%), diabetes mellitus (22%), and severe prematurity (21%). Skin was the most common localization (57%), followed by gastrointestinal tract (15%). Culture results were available in 75% (92% positive), and results of histological examination were positive in 95%. Rhizopus was the most frequent genus (43%). Infection portal of entry included surgery and presence of medical devices such as catheters or adhesive tape. Outbreaks and clusters were related to adhesive bandages (19 cases), wooden tongue depressors (n = 5), ostomy bags (n = 2), water circuitry damage (n = 2), and adjacent building construction (n = 5). Thorough investigations are mandatory to identify healthcare-associated mucormycosis, notably in neonatology, hematological, and transplantation units.
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Affiliation(s)
- Blandine Rammaert
- Sorbonne Paris Cité, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, APHP, Université Paris-Descartes, Centre d'Infectiologie Necker-Pasteur, 149 rue de Sèvres, Paris Cedex 15, France
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Sautour M, Edel-Hermann V, Steinberg C, Sixt N, Laurent J, Dalle F, Aho S, Hartemann P, L’Ollivier C, Goyer M, Bonnin A. Fusarium species recovered from the water distribution system of a French university hospital. Int J Hyg Environ Health 2012; 215:286-92. [DOI: 10.1016/j.ijheh.2011.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 11/03/2011] [Accepted: 11/13/2011] [Indexed: 12/26/2022]
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[Quantitative assessment of fungal risk in the case of construction works in healthcare establishments: Proposed indicators for the determination of the impact of management precautions on the risk of fungal infection]. J Mycol Med 2012. [PMID: 23177816 DOI: 10.1016/j.mycmed.2012.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Construction works in healthcare establishments produce airborne fungal spores and considerably increase the risk of exposure of immunosuppressed patients. It is necessary to reinforce protective measures, or even to implement specific precautions, during this critical phase. The aim of these precautions is to protect both those areas, which are susceptible to dust, and patients at risk of a fungal infection particularly invasive aspergillosis. When construction works are planned in healthcare establishments, the first step consists in the characterisation of the environmental fungal risk and the second one in proposing risk management methods. It is then essential to establish impact indicators in order to evaluate the risk management precautions applied. The working group promoted by the French societies of medical mycology and hospital hygiene (SFMM & SF2H) details here both environmental and epidemiological impact indicators that can be used.
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Sautour M, Fournel I, Dalle F, Calinon C, L'Ollivier C, Goyer M, Cachia C, Aho S, Sixt N, Vagner O, Cuisenier B, Bonnin A. Dynamics of fungal colonization in a new medical mycology laboratory. J Mycol Med 2011. [PMID: 23177809 DOI: 10.1016/j.mycmed.2011.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE OF THE STUDY Study of the spatio-temporal fungal colonization in a new medical mycology laboratory. METHODS A 17-month survey of airborne fungal contamination was conducted in a new medical mycology laboratory at a tertiary care university hospital. This survey was implemented at three different periods: before the new premises were occupied (period A), during the move into the new laboratory (period B) and after resumption of the mycological activities in these new premises (period C). RESULTS During period A, the airborne fungal load ranged from 2.3 to 6 cfu/m(3). The most frequently recovered airborne fungi were Penicillium spp. (75 to 100%). During period B, a dramatic increase in Penicillium chrysogenum conidia was observed in the air of the new laboratory (40 to 160 cfu/m(3)). During period C, the fungal load ranged from 4.5 to 8.4 cfu/m(3). Penicillium was the most common genus identified in rooms of the laboratory where no filamentous fungi were handled, while Aspergillus was clearly the predominant genus (78%) in the room dedicated to the culture of filamentous fungi. CONCLUSIONS We suggest that the specific fungal ecology in air of the room dedicated to the culture of filamentous fungi is due to the handling of a large number of medical strains of A. fumigatus.
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Affiliation(s)
- M Sautour
- Laboratoire de parasitologie-mycologie, plateau technique de biologie du CHU, 2, rue Angélique-Ducoudray, BP 37013, 21070 Dijon cedex, France.
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Bergeron V, Chalfine A, Misset B, Moules V, Laudinet N, Carlet J, Lina B. Supplemental treatment of air in airborne infection isolation rooms using high-throughput in-room air decontamination units. Am J Infect Control 2011; 39:314-20. [PMID: 21095042 DOI: 10.1016/j.ajic.2010.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 06/10/2010] [Accepted: 06/15/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence has recently emerged indicating that in addition to large airborne droplets, fine aerosol particles can be an important mode of influenza transmission that may have been hitherto underestimated. Furthermore, recent performance studies evaluating airborne infection isolation (AII) rooms designed to house infectious patients have revealed major discrepancies between what is prescribed and what is actually measured. METHODS We conducted an experimental study to investigate the use of high-throughput in-room air decontamination units for supplemental protection against airborne contamination in areas that host infectious patients. The study included both intrinsic performance tests of the air-decontamination unit against biological aerosols of particular epidemiologic interest and field tests in a hospital AII room under different ventilation scenarios. RESULTS The unit tested efficiently eradicated airborne H5N2 influenza and Mycobacterium bovis (a 4- to 5-log single-pass reduction) and, when implemented with a room extractor, reduced the peak contamination levels by a factor of 5, with decontamination rates at least 33% faster than those achieved with the extractor alone. CONCLUSION High-throughput in-room air treatment units can provide supplemental control of airborne pathogen levels in patient isolation rooms.
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Ruiz-Camps I, Aguado J, Almirante B, Bouza E, Ferrer-Barbera C, Len O, Lopez-Cerero L, Rodríguez-Tudela J, Ruiz M, Solé A, Vallejo C, Vazquez L, Zaragoza R, Cuenca-Estrella M. Guidelines for the prevention of invasive mould diseases caused by filamentous fungi by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). Clin Microbiol Infect 2011; 17 Suppl 2:1-24. [DOI: 10.1111/j.1469-0691.2011.03477.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alangaden GJ. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infect Dis Clin North Am 2011; 25:201-25. [PMID: 21316001 DOI: 10.1016/j.idc.2010.11.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Fungal infections are an increasing cause of morbidity and mortality in hospitalized patients. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis and aspergillosis. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.
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Affiliation(s)
- George J Alangaden
- Division of Infectious Diseases, Wayne State University, 3990 John R, Suite 5930, Detroit, MI 48201, USA.
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40
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Comparison of two control measures of weatherstripping in reducing blowing dust during hospital renovations. J Infect Chemother 2010; 16:431-5. [PMID: 20981562 DOI: 10.1007/s10156-010-0173-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 09/28/2010] [Indexed: 10/18/2022]
Abstract
Hospital renovation projects pose risks of invasive infection by fungi from dust that is blown about during the period in question. Control measures to reduce the amount of dust during hospital renovation are thus necessary. Currently, no study has compared different control measures for effectiveness through more than one period of renovation. In this study, we examined the capacities of two control measures of weatherstripping (0.15 mm poly film and adhesive tape) to reduce the amount of blowing dust during two different hospital renovations (in 2008 and 2009). The amount of dust in the air of the hospital before and during the renovation was measured about once a week in both 2008 and 2009, and the between-year and within-year differences were tested. Our study revealed that the weatherstripping used in 2009 (adhesive tape) was significantly more effective than the measures taken in 2008 (0.15 mm poly film) to reduce the amount of dust during the renovations (p < 0.001), while in both years the amount of dust became significantly higher during the renovations than before the renovations. Differences in the effectiveness of weatherstripping during renovations between floors of the hospital were not significant in both 2008 and 2009. The number of Aspergillus-positive samples did not significantly increase compared with the number observed before the start of the hospital renovations (2006-2007) in 2008 and 2009, respectively. The weatherstripping potentially reduced the associated risk of airborne fungal infection.
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Airborne Aspergillus contamination during hospital construction works: efficacy of protective measures. Am J Infect Control 2010; 38:189-94. [PMID: 19923037 DOI: 10.1016/j.ajic.2009.07.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 07/14/2009] [Accepted: 07/14/2009] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Dijon University Hospital in Dijon, France is involved in a large construction program with heavy truck traffic and a very dusty environment. This study aimed to assess the impact of outdoor hospital construction work on Aspergillus air contamination in the immediate environment of patients at high risk for aspergillosis in the presence of protective measures. METHODS Prospective air and surface sampling (n=1301) was performed in 3 hospital units over a 30-month period. Generalized estimating equations were used to test the relationship between Aspergillus air contamination and the different variables (construction period, air treatment system, and surface contamination). RESULTS Positivity rates of Aspergillus spp varied from 21.1% before construction work to 16.9% during work for air samples (P=.07), and the associated mean fungal load varied from 1.21 colony-forming units (CFU)/m(3) to 0.64 CFU/m(3) (P=.04). In multivariate analysis, only the use of an air treatment system was associated with decreased airborne Aspergillus contamination (P < .0001). No significant difference was observed between the presence or absence of construction work and the proportion of airborne Aspergillus contamination (P=.91) or the Aspergillus fungal load (P=.10). CONCLUSIONS No influence of hospital construction work on airborne Aspergillus contamination was demonstrated when protective measures were taken, including reinforcement of the importance of environmental cleaning.
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Ruiz-Camps I, Aguado JM, Almirante B, Bouza E, Ferrer Barbera C, Len O, López-Cerero L, Rodríguez-Tudela JL, Ruiz M, Solé A, Vallejo C, Vázquez L, Zaragoza R, Cuenca-Estrella M. Recomendaciones sobre la prevención de la infección fúngica invasora por hongos filamentosos de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC). Enferm Infecc Microbiol Clin 2010; 28:172.e1-172.e21. [DOI: 10.1016/j.eimc.2009.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 11/24/2009] [Indexed: 11/30/2022]
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Hütter G, Ganepola S, Thiel E, Blau IW. Correlation between the incidence of nosocomial aspergillosis and room reconstruction of a haematological ward. J Infect Prev 2009. [DOI: 10.1177/1757177409350235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Invasive pulmonary aspergillosis (IPA) represents ~ a major cause of morbidity and mortality in patients I with impaired function of the immune system such as in patients with acute myeloid leukaemia (AML). We investigated the in uence of the patients’ room occu- pancy and the sanitary facilities with regard to the inci- dence of IPA after reconstruction of a haematological ward. This is a retrospective cohort-control study in patients with newly diagnosed AML. Thirty ve patients were treated before and 28 patients in the time after the reconstruction works. The median time of neutropenia was 18.5 days vs. 19.5 days. Twelve patients before and 11 patients after the reconstruction developed IPA (p = 0.794). The incidence of IPA did not decrease after a reduction in the patients’ occupancy and improvement of the sanitary equipment. This study emphasises the presumed importance of optimal physical barriers, e.g. air ltration and/or antimycotic prophylaxis in high-risk patients.
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Affiliation(s)
- G. Hütter
- Medical Department Hematology, Oncology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany,
| | - S. Ganepola
- Medical Department Hematology, Oncology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany
| | - E. Thiel
- Medical Department Hematology, Oncology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany
| | - IW Blau
- Medical Department Hematology, Oncology, Charité Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany
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Brenier-Pinchart MP, Coussa-Rivière L, Lebeau B, Mallaret MR, Bulabois CE, Ducki S, Cahn JY, Grillot R, Pelloux H. Mobile air-decontamination unit and filamentous fungal load in the hematology ward: how efficient at the low-activity mode? Am J Infect Control 2009; 37:680-2. [PMID: 19362390 DOI: 10.1016/j.ajic.2008.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Revised: 12/23/2008] [Accepted: 12/29/2008] [Indexed: 11/17/2022]
Abstract
Air treatment with a mobile Plasmair air-decontamination unit significantly reduces the fungal spore load in hematology wards. We report that this system used at a low aspiration flow does not perform total biodecontamination against filamentous fungi. Moreover, the filamentous fungus load remaining in rooms equipped with this mobile air-decontamination unit is lowest in wards in which other preventive measures against nosocomial filamentous fungal infections are implemented.
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Affiliation(s)
- Marie-Pierre Brenier-Pinchart
- Parasitology and Mycology Laboratory, Grenoble Universitary Hospital and Joseph Fourier University, Grenoble, France.
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Sautour M, Sixt N, Dalle F, L'Ollivier C, Fourquenet V, Calinon C, Paul K, Valvin S, Maurel A, Aho S, Couillault G, Cachia C, Vagner O, Cuisenier B, Caillot D, Bonnin A. Profiles and seasonal distribution of airborne fungi in indoor and outdoor environments at a French hospital. THE SCIENCE OF THE TOTAL ENVIRONMENT 2009; 407:3766-71. [PMID: 19286244 DOI: 10.1016/j.scitotenv.2009.02.024] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 02/06/2009] [Accepted: 02/12/2009] [Indexed: 05/21/2023]
Abstract
A one-year prospective survey of fungal air contamination was conducted in outdoor air and inside two haematological units of a French hospital. Air was sampled with a portable Air System Impactor. During this period of survey, the mean viable fungal load was 122.1 cfu/m(3) in outdoor air samples, and 4.1 and 3.9 cfu/m(3) in samples from adult and pediatric haematology units, respectively. In outdoor samples, Cladosporium was the dominant genus (55%) while in the clinical units, Penicillium sp. (23 to 25%), Aspergillus sp. (15 to 23%) and Bjerkandera adusta (11 to 13%) were the most frequently recovered airborne fungi. The outdoor fungal load was far higher in autumn (168 cfu/m(3)), spring (110 cfu/m(3)) and summer (138 cfu/m(3)) than in winter (49 cfu/m(3)). In indoor air, fungal concentrations were significantly lower in winter (2.7 to 3.1 cfu/m(3)) than in summer (4.2 to 5.0 cfu/m(3)) in both haematology units. In the outdoor environment, Penicillium sp. and Aspergillus sp. were more abundant in winter while the levels of Cladosporium were lowest during this season. In the haematological units, the presence of Aspergillus sp. was stable during the year (close to 20%), Bjerkandera sp. was particularly abundant in winter (close to 30%); levels of Penicillium sp. were highest in autumn while levels of Cladosporium sp. were highest in spring and summer.
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Affiliation(s)
- Marc Sautour
- Parasitology and Mycology laboratory, CHU, Hôpital du Bocage, BP 77908, 21079 Dijon Cedex, France.
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Sautour M, Dalle F, Olivieri C, L'ollivier C, Enderlin E, Salome E, Chovelon I, Vagner O, Sixt N, Fricker-Pap V, Aho S, Fontaneau O, Cachia C, Bonnin A. A prospective survey of air and surface fungal contamination in a medical mycology laboratory at a tertiary care university hospital. Am J Infect Control 2009; 37:189-94. [PMID: 19059674 DOI: 10.1016/j.ajic.2008.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 06/13/2008] [Accepted: 06/20/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND Invasive filamentous fungi infections resulting from inhalation of mold conidia pose a major threat in immunocompromised patients. The diagnosis is based on direct smears, cultural symptoms, and culturing fungi. Airborne conidia present in the laboratory environment may cause contamination of cultures, resulting in false-positive diagnosis. Baseline values of fungal contamination in a clinical mycology laboratory have not been determined to date. METHODS A 1-year prospective survey of air and surface contamination was conducted in a clinical mycology laboratory during a period when large construction projects were being conducted in the hospital. Air was sampled with a portable air system impactor, and surfaces were sampled with contact Sabouraud agar plates. The collected data allowed the elaboration of Shewhart graphic charts. RESULTS Mean fungal loads ranged from 2.27 to 4.36 colony forming units (cfu)/m(3) in air and from 0.61 to 1.69 cfu/plate on surfaces. CONCLUSIONS Strict control procedures may limit the level of fungal contamination in a clinical mycology laboratory even in the context of large construction projects at the hospital site. Our data and the resulting Shewhart graphic charts provide baseline values to use when monitoring for inappropriate variations of the fungal contamination in a mycology laboratory as part of a quality assurance program. This is critical to the appropriate management of the fungal risk in hematology, cancer and transplantation patients.
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Affiliation(s)
- Marc Sautour
- Parasitology-Mycology Laboratory, IFR Santé-STIC, Faculty of Medicine and Pharmacy, University of Bourgogne, Dijon, France.
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Garner D, Machin K. Investigation and management of an outbreak of mucormycosis in a paediatric oncology unit. J Hosp Infect 2008; 70:53-9. [DOI: 10.1016/j.jhin.2008.05.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 05/15/2008] [Indexed: 11/26/2022]
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