Point-of-use filtration method for the prevention of fungal contamination of hospital water

Fusarium is considered an emerging pathogen, and there are few reports of fusariosis in children. The objective of this study was to describe an outbreak of invasive fusariosis in a children's cancer hospital. A neutropenic 17-year-old male patient hospitalized for 10 days for a relapse of acute myeloid leukaemia, under chemotherapy, presented fever without any other symptoms; a thoracic computerized tomography showed bilateral pulmonary nodules. During voriconazole treatment, 1-cm reddened and painful subcutaneous nodules appeared on arms and legs and the culture of a skin biopsy revealed F. solani. Another case occurred 11 days later and started an outbreak investigation. Water samples for cultures were collected from taps, showers and water reservoirs. Air from all patient rooms was sampled. Faucets and the drains of sinks and showers were swabbed and cultured. Environmental and clinical isolates were typed. There were 10 confirmed cases of infection caused by Fusarium spp. F. oxysporum and F. solani were isolated from water, swabs and air in patient rooms. Many control measures were instituted, but the outbreak was only controlled 1 year after the first case, when water filters filtering 0.2 μm were installed at the exit of all faucets and showers in all patient rooms (points-of-use). Typing demonstrated that clinical isolates of F. oxysporum were similar to those of the environment. In conclusion, to our knowledge this is the first reported outbreak of invasive fusariosis in children with oncohaematologic disease. It was controlled using 0.2-μm filters in all tap faucets and showers.

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“…[11,34,35] In our outbreak this seems to have been the ultimate control method. Four cases occurred after installing filters.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 72%

An outbreak of invasive fusariosis in a children’s cancer hospital

Litvinov

Silva

Heijden

et al. 2015

Clinical Microbiology and Infection

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“…For example, A. fumigatus was found in tap water originating from surface water but not in drinking water which originated from groundwater (Warris et al 2003(Warris et al ,2010.…”

Section: Discussionmentioning

confidence: 99%

Disinfection efficacy of chlorine and peracetic acid alone or in combination against Aspergillus spp. and Candida albicans in drinking water

Sisti

Brandi

Santi

et al. 2011

Journal of Water and Health

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The aim of the present study was to evaluate the fungicidal activity of chlorine and peracetic acid in drinking water against various pathogenic Aspergillus spp. and Candida albicans strains. A. nidulans exhibited the greatest resistance, requiring 10 ppm of chlorine for 30 min contact time for a complete inactivation. Under the same experimental conditions, peracetic acid was even less fungicidal. In this case, A. niger proved to be the most resistant species (50 ppm for 60 min for complete inactivation).All Aspergillus spp. were insensitive to 10 ppm even with extended exposure (>5 h). The combination of chlorine and peracetic acid against Aspergillus spp. did not show synergistic effects except in the case of A. flavus. Complete growth inhibition of C. albicans was observed after about 3 h contact time with 0.2 ppm. C. albicans was less sensitive to peracetic acid. Hence the concentrations of chlorine that are usually present in drinking water distribution systems are ineffective against several Aspergillus spp. and peracetic acid cannot be considered an alternative to chlorine for disinfecting drinking water. The combination of the two biocides is not very effective in eliminating filamentous fungi at the concentrations permitted for drinking water disinfection.

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“…The importance of the antimicrobial activity of chitosan also arises when it is applied as a sorbent in filtering systems, when favorable environment for the growth of bacteria and fungi emerges by keeping the filtering material in the wet state (Rosas, Collado, Fernández, Gutierrez-Lavin, & Diaz, 2013;Williams & Edyvean, 1998;Warris et al, 2010). Biological fouling reduces filtration performance and shortens filter element life as well as can cause negative health effects.…”

Section: Introductionmentioning

confidence: 99%