Evaluating of fungal contamination in hospital wet cooling systems in Markazi province, Central Iran

[Biodiversity of isolated fungal flora at the reanimation service of the University Hospital Souro Sanou of Bobo-Dioulasso, Burkina Faso]

Introduction

les maladies nosocomiales demeurent un problème majeur de santé publique en Afrique subsaharienne notamment au Burkina Faso. Cette étude avait pour but de déterminer la biodiversité de la flore fongique identifiée au service de réanimation du Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso.

Méthodes

l´étude transversale descriptive s´est déroulée d´août 2016 à janvier 2017. La flore fongique a été recherchée dans l´air ambiant et les espaces de réanimation. Les prélèvements ont été ensemencés et incubés pendant 3 à 4 jours à 37°C à l´étuve. L´identification des colonies fongiques était macroscopique et microscopique pour les champignons filamenteux. Le test de blastèse, les milieux chromogéniques et le test d´agglutination au latex ont servi à l´identification d´espèces de Candida.

Résultats

sur les 200 prélèvements collectés au total, 176 ont poussé sur la gélose Sabouraud-Chloramphénicol. La prévalence globale de la flore fongique était de 88% (176/200). Les moisissures étaient les agents fongiques majoritairement retrouvés (66,9%). Parmi les huit genres de moisissures identifiés, Aspergillus était le genre le plus représenté (48,9%) tandis qu´Aspergillus fumigatus était l´espèce la plus fréquemment rencontrée (32,9%).

Conclusion

la décontamination régulière des niches fongiques devraient être systématiques dans le service de réanimation du CHUSS de Bobo-Dioulasso.

Occurrence of Fungi in the Potable Water of Hospitals: A Public Health Threat

Since the last decade, attention towards the occurrence of fungi in potable water has increased. Commensal and saprophytic microorganisms widely distributed in nature are also responsible for causing public health problems. Fungi can contaminate hospital environments, surviving and proliferating in moist and unsterile conditions. According to Italian regulations, the absence of fungi is not a mandatory parameter to define potable water, as a threshold value for the fungal occurrence has not been defined. This study evaluated the occurrence of fungi in potable water distribution systems in hospitals. The frequency of samples positive for the presence of fungi was 56.9%; among them, filamentous fungi and yeasts were isolated from 94.2% and 9.2% of the samples, respectively. The intensive care unit (87.1%) had the highest frequency of positive samples. Multivariable model (p < 0.0001), the variables of the period of the year (p < 0.0001) and type of department (p = 0.0002) were found to be statistically significant, suggesting a high distribution of filamentous fungi in the potable water of hospitals. Further studies are necessary to validate these results and identify the threshold values of fungi levels for different types of water used for various purposes to ensure the water is safe for consumption and protect public health.

An Overview of the Management of the Most Important Invasive Fungal Infections in Patients with Blood Malignancies

In patients with hematologic malignancies due to immune system disorders, especially persistent febrile neutropenia, invasive fungal infections (IFI) occur with high mortality. Aspergillosis, candidiasis, fusariosis, mucormycosis, cryptococcosis and trichosporonosis are the most important infections reported in patients with hematologic malignancies that undergo hematopoietic stem cell transplantation. These infections are caused by opportunistic fungal pathogens that do not cause severe issues in healthy individuals, but in patients with hematologic malignancies lead to disseminated infection with different clinical manifestations. Prophylaxis and creating a safe environment with proper filters and air pressure for patients to avoid contact with the pathogens in the surrounding environment can prevent IFI. Furthermore, due to the absence of specific symptoms in IFI, rapid and accurate diagnosis reduces the mortality rate of these infections and using molecular techniques along with standard mycological methods will improve the diagnosis of disseminated fungal infection in patients with hematologic disorders. Amphotericin B products, extended-spectrum azoles, and echinocandins are the essential drugs to control invasive fungal infections in patients with hematologic malignancies, and according to various conditions of patients, different results of treatment with these drugs have been reported in different studies. On the other hand, drug resistance in recent years has led to therapeutic failures and deaths in patients with blood malignancies, which indicates the need for antifungal susceptibility tests to use appropriate therapies. Life-threatening fungal infections have become more prevalent in patients with hematologic malignancies in recent years due to the emergence of new risk factors, new species, and increased drug resistance. Therefore, in this review, we discuss the different dimensions of the most critical invasive fungal infections in patients with hematologic malignancies and present a list of these infections with different clinical manifestations, treatment, and outcomes.