Assessment of microbiological air quality in hemato-oncology units and its relationship with the occurrence of invasive fungal infections: an integrative review

Menegueti, Mayra Gonçalves; Ferreira, Lécio Rodrigues; Silva, Magda Fabbri Isaac; Silva, Anderson Soares da; Bellissimo-Rodrigues, Fernando

doi:10.1590/0037-8682-0022-2013

Cited by 15 publications

(13 citation statements)

References 19 publications

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“…The period before the construction, when the HEPA filters had not yet been installed, was winter and spring, while the installed HEPA filters were used in summer and autumn. The use of HEPA filters was associated with a lack of increase in IFI rates despite both the construction and the summer months [ 17 ]. We conclude that HEPA filter installation in hematology wards is a safe option to prevent IFIs during construction.…”

Section: Discussionmentioning

confidence: 99%

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

Ozen¹,

Yılmaz²,

Coşkun³

et al. 2016

Tjh

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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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Section: Discussionmentioning

confidence: 99%

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

Ozen¹,

Yılmaz²,

Coşkun³

et al. 2016

Tjh

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“…Çalışma-mızda ayrıca HEPA filtrelerin maliyet etkin bir yöntem olabileceği de dün-yada ilk kez gösterilmiştir (13). Hastaların soluduğu havadaki partikül miktarının önemli olduğu birçok çalış-mada gösterilmiştir (23). Bu nedenle hastane inşaatı döneminde alınması gereken önlemler arasında HEPA filtreli temiz odalar kılavuzlarda yer alan önerilerdendir (24).…”

Section: Discussionunclassified

İnşaat sırasında hematoloji bilim dalında alınan koruyucu önlemler

AZAP¹

2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Amaç: İnşaat dönemleri, bağışıklık sistemleri baskılanmış hematoloji hastaları için invaziv fungal infeksiyonlar açısından yüksek risk taşımaktadır. Bu yazıda inşaat dönemindeki deneyimimizi paylaşmaktayız. Gereç ve Yöntem:Hastanemizin çok yakınında yapılan inşaat nedeniyle hematoloji hastalarında meydana gelebilecek infeksiyonların engellenmesi amacıyla yaptıklarımızı ve bunların sonuçlarını burada özetlemekte-yiz.Bulgular: Hematoloji servisi ve kök hücre nakil ünitesinde tedavi edilen hastaların ve hastanenin fiziksel izolasyonu bu konuda esas önemli unsurlar olarak ortaya çıkmaktadır. Ayrıca yüksek riskli hastalarda ekstra ön-lem olarak antifungal profilaksi yararlıdır.Sonuç: Bu hastalarda infeksiyon kontrolünde risk odaklı multidisipliner bir yaklaşım etkin görünmekte ve infeksiyon kontrol ekibi de kritik bir rol oynamaktadır.Anahtar Sözcükler: İnşaat, İnvaziv Fungal İnfeksiyon, İnfeksiyon Kontrol Aim: Construction periods have an increased risk for invasive fungal infections in immunosuppressive hematology patients. We share our experience during a construction period in this article. Material and Method:We summarize what we had performed to prevent infections in hematology patients due to the construction next to our department building in our hospital and the results. Results:The most important issues in this setting are physical isolation of the hospital building and the patients treated in hematology and stem cell transplantation unit. Antifungal prophylaxis is also beneficial as an additional precaution in high risk patients.Conclusion: Risk based multidisciplinary approach seems to be effective in these patients and infection control team play a critical role.

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“…The results of published studies on HEPA filters are summarized as follows [ 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 ]:…”

Section: Evaluations Of the Outcomes Of Hepa Filter Usementioning

confidence: 99%

“…HEPA filters may be placed at different locations in and out of the room during and after construction until the surfaces are completely cleaned (Category 2). Microbiological analysis of the air samples during and immediately after construction is not recommended [ 98 , 99 , 100 ].…”

Section: The Efficacy Of Portable Hepa Filtersmentioning

confidence: 99%

Recommendations for Risk Categorization and Prophylaxis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Expert Opinion (TEO-4)

Boğa¹,

Bolaman²,

Cagirgan³

et al. 2015

Tjh

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This is the last of a series of articles on invasive fungal infections prepared by opinion leaders in Turkey. The aim of these articles is to guide clinicians in managing invasive fungal diseases in hematological malignancies and stem cell transplantation based on the available best evidence in this field. The previous articles summarized the diagnosis and treatment of invasive fungal disease and this article aims to explain the risk categorization and guide the antifungal prophylaxis in invasive fungal disease.

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Assessment of microbiological air quality in hemato-oncology units and its relationship with the occurrence of invasive fungal infections: an integrative review

Cited by 15 publications

References 19 publications

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

İnşaat sırasında hematoloji bilim dalında alınan koruyucu önlemler

Recommendations for Risk Categorization and Prophylaxis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Expert Opinion (TEO-4)

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