Bioburden in health care centers: Is the compliance with Portuguese legislation enough to prevent and control infection?

Viegas, Carla; Almeida, Beatriz; Monteiro, Ana; Caetano, Liliana Aranha; Carolino, Elisabete; Gomes, Anita Quintal; Twarużek, Magdalena; Kosicki, Robert; Marchand, Geneviève; Viegas, Susana

doi:10.1016/j.buildenv.2019.106226

Cited by 35 publications

(78 citation statements)

References 58 publications

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“…In contrast, guidelines regarding the ventilation of general wards, patient rooms, intensive care wards, or even other specific areas are much scarcer and often dedicated to clinical cases and not to the indoor environment. The same gap was found in microbial contamination studies, as indicated in scientific databases [13,14]. Furthermore, almost all studies focused on patients' health, disregarding clinical and laboratory health of staff [14].…”

Section: Introductionmentioning

confidence: 73%

“…A walkthrough survey and checklist were used in order to prioritize the more critical workplaces/areas regarding bioburdens, as previously published [13]. The assessed areas were equipped with central heating, ventilation, and air conditioning (HVAC) systems, with air handing units and a ductwork system.…”

Section: Indoor Environment Assessed and Sampling Locationsmentioning

confidence: 99%

“…As such, the assessment and control of microbial contamination in health care facilities is currently a mandatory and vital part of the strategies to prevent and control hospital-acquired infections [7,8]. Aiming at addressing this challenging assessment, several studies have already reported the upmost importance of applying passive sampling methods [9][10][11][12][13]. These methods allow characterization of the contamination from a larger period of time (weeks to several months) [14].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, almost all studies focused on patients' health, disregarding clinical and laboratory health of staff [14]. However, the staff can transport and disseminate microbial contamination through all hospital facilities, thus affecting patients [13].…”

Section: Introductionmentioning

confidence: 99%

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Bioburden Assessment by Passive Methods on a Clinical Pathology Service in One Central Hospital from Lisbon: What Can it Tell Us Regarding Patients and Staff Exposure?

et al. 2020

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The assessment and control of microbial contamination in health care facilities is presently a mandatory and vital part of strategies to prevent and control hospital-acquired infections. This study aims to assess the bioburden with two passive sampling methods (30 ventilations grids swabs and 16 electrostatic dust collectors (EDCs)) at Clinical Pathology Services. The fungal burden was characterized through molecular tools, antifungal resistance, and the mycotoxins and cytotoxicity profile. Total bacteria presented the highest prevalence in both matrixes, whereas Gram-bacteria presented the lowest. Swabs presented a higher prevalence (27.6%) for fungal burden. Chrysonilia sitophila presented the highest prevalence in swabs, whereas for EDCs, C. sitophila and Mucor sp. were the most prevalent. Concerning Aspergillus genera on swabs, section Flavi was the one with the highest prevalence (58.02%), whereas, for EDCs, section Versicolores was the only section observed (100%). Aspergillus section Fumigati was detected in 10 swabs and 7 EDC samples and Aspergillus section Versicolores was detected in one EDC sample. Fungal growth on azole-supplemented media was observed in eight EDC samples. No mycotoxins were detected in any of the samples. A low cytotoxic effect was observed in two sites upon incubation of collected samples with A549 and SK cells and in two other sites upon incubation of collected samples with SK cells only. A medium cytotoxic effect was observed with one EDC sample upon incubation with A549 cells. This study reinforces the need of determination of the azole resistance profile for fungal species and allowed a preliminary risk characterization regarding the cytotoxicity. An intervention including the use of a ultraviolet with wavelength between 200 nm and 280 nm (UVC)—emitting device and an increased maintenance and cleaning of the central heating, ventilation, and air conditioning (HVAC) systems should be ensured to promote the reduction of microbial contamination.

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Section: Introductionmentioning

confidence: 73%

Section: Indoor Environment Assessed and Sampling Locationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bioburden Assessment by Passive Methods on a Clinical Pathology Service in One Central Hospital from Lisbon: What Can it Tell Us Regarding Patients and Staff Exposure?

et al. 2020

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“…An increased prevalence of respiratory and asthmatic symptoms has been reported at dust exposures of 1.5-4.0 mg m −3 , with sensitization to flour dust being reported after exposures as low as 0.5 mg m −3 [6]. Additionally, occupational exposure to azole-resistant strains of fungi, such as Aspergillus sp., and toxigenic substances, such as mycotoxins, have been detected in cereals such as wheat, rye, oats, and corn, and are also of concern in this sector [2], especially with reports of the increasing prevalence of azole-resistant strains of fungal species in clinical settings [12].…”

Section: Introductionmentioning

confidence: 99%

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

et al. 2020

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For decades, occupational exposure to flour dust has been linked to a range of respiratory diseases, including occupational asthma, thought to result from exposure to fungi present in the flour. Antifungal resistance is of increasing prevalence in clinical settings, and the role of occupational and environmental exposures, particularly for specific fungal species, is of concern. Occupational exposure to flour dust can occur in a range of occupational settings, however, few studies have focused on restaurant workers. The objective of this study was to measure occupational exposure to flour and microbial contamination, including azole resistance screening, in two small commercial bakeries and in a pizzeria. Personal full shift inhalable dust measurements were collected from workers, and were analyzed for inhalable dust and fungi, bacteria, azole resistance, and mycotoxins. Samples of settled dust were collected, and electrostatic dust cloths (EDC) were deployed and analyzed for microbial contamination, including azole resistance screening, and mycotoxins. Geometric mean exposures of 6.5 mg m−3 were calculated for inhalable dust, however, exposures of up to 18.30 mg m−3 were measured—70% of personal exposure measurements exceeded the occupational exposure limit for flour dust of 1.0 mg m−3. The air and EDC fungal counts were similar to those reported in previous studies for similar occupational environments. The fungi were dominated by Penicillium genera, however Aspergillus genera, including Fumigati and Flavi sections, were observed using culture-based methods, and the Fumigati section was also observed by molecular tools. Both Aspergillus sections were identified on the azole resistance screening. Mycotoxins were also detected in the settled dust samples, dominated by deoxynivalenol (DON). The role of environmental exposure in both the development of antimicrobial resistance and the total mycotoxin body burden is a growing concern; therefore, the presence of azole-resistant fungi and mycotoxin contamination, although low in magnitude, is of concern and warrants further investigation.

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Occupational Exposure to Bioburden in Portuguese Ambulances

Dias

Sousa

Viegas³

2021

Studies in Systems, Decision and Control

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Bioburden in health care centers: Is the compliance with Portuguese legislation enough to prevent and control infection?

Cited by 35 publications

References 58 publications

Bioburden Assessment by Passive Methods on a Clinical Pathology Service in One Central Hospital from Lisbon: What Can it Tell Us Regarding Patients and Staff Exposure?

Bioburden Assessment by Passive Methods on a Clinical Pathology Service in One Central Hospital from Lisbon: What Can it Tell Us Regarding Patients and Staff Exposure?

Occupational Exposures to Organic Dust in Irish Bakeries and a Pizzeria Restaurant

Occupational Exposure to Bioburden in Portuguese Ambulances

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