Quelles mesures pour maîtriser le risque infectieux chez les patients immunodéprimés ? Recommandations formalisées d’experts

Zahar, Jean‐Ralph; Jolivet, Sarah; Adam, Holly L; Dananché, Cédric; Lizon, Julie; Alfandari, S.; Boulestreau, H.; Baghdadi, Nadiah A.; Bay, Jacques‐Olivier; Bénéteau, A.-M.; Bougnoux, Marie‐Elisabeth; Brenier-Pinchart, Marie-Pierre; Dalle, Jean‐Hugues; Fournier, Sandra; Fuzibet, J.G.; Kauffmann‐Lacroix, C.; Guinche, I. Le; Lepelletier, Didier; Loukili, Noureddine; Lory, A.; Morvan, M.; Oumedaly, R.; Ribaud, Patricia; Röhrlich, Pierre; Vanhems, P.; Aho, Serge; Vanjak, Dominique; Gangneux, Jean‐Pierre

doi:10.1016/j.mycmed.2017.10.004

Cited by 15 publications

(3 citation statements)

References 2 publications

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“…Exposure to bioaerosols has become one of the major problems in indoor air quality (IAQ) for occupational and public health [1]. The importance of assessment and control of contamination in critical environments, such as the physical environment of health care organizations [2][3][4] is a requirement to protect patients and healthcare workers from hospital-acquired (nosocomial) infections and occupational diseases [5].…”

Section: Introductionmentioning

confidence: 99%

Bacterial Contamination in Health Care Centers: Differences between Urban and Rural Settings

et al. 2021

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This study aims to assess the airborne bioburden of rural and urban Portuguese Primary Health Care Centers (PHCC) using active and passive sampling methods and identify the potential differences in airborne microbiota between both environments. The highest total aerobic mesophilic bacterial load in indoor air were found in the Vaccination Room (448 CFU.m−3) in the Rural PHCC and in the Waiting Room (420 CFU.m−3) for Urban PHCC. The total coliforms contamination level in indoor air was detected only in the Cleaning Supplies Room (4 CFU.m−3) in the Urban PHCC. The most frequent bacteria genera identified was Micrococcus (21% Rural PHCC; 31% Urban PHCC). The surface samples showed a highest total aerobic mesophilic bacterial contamination in the Treatment Room (86 × 103 CFU.m−2) from the Rural PHCC and in the Front Office (200 × 103 CFU.m−2) from the Urban PHCC. The electrostatic dust cloth (EDC) samples showed a highest bacterial load in the Urban PHCC. Total aerobic mesophilic bacterial load in settled dust and in the Heating, Ventilating and Air Conditioning (HVAC) filter samples in the Urban PHCC (8 CFU.g−1 and 6 × 103 CFU.m−2) presented higher values compared with the Rural PHCC (1 CFU.g−1 and 2.5 × 103 CFU.m−2). Urban PHCC presented higher bacterial airborne contamination compared with the Rural PHCC for the majority of sampling sites, and when compared with the indoor air quality (IAQ) Portuguese legislation it was the Rural PHCC in two sampling places who did not comply with the established criteria.

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Section: Introductionmentioning

confidence: 99%

Bacterial Contamination in Health Care Centers: Differences between Urban and Rural Settings

et al. 2021

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“…Several everyday activities from health care facilities can boost bio-aerosols dispersion [3][4][5][6], leading to infectious disease transmission. 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].…”

Section: Introductionmentioning

confidence: 99%

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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“…Additionally, fungal contamination in the air and on hospital surfaces has been associated with the number of fungal infections in hospitalized immunocompromised patients [9,34]. Monitoring and control of microbial contamination in HCE is, therefore, mandatory as it is crucial to prevent and control hospital-acquired infections [62,63]. Notably, several Aspergillus section Fumigati isolates from the environmental sampling were also able to grow in at least one azole, including isolates from air samples able to grow in two or more different azoles.…”

Section: Discussionmentioning

confidence: 99%

Cytotoxicity of Aspergillus Section Fumigati Isolated from Health Care Environments

Viegas

Twarużek

Almeida

et al. 2021

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This study analyzed 57 Aspergillus section Fumigati (AF) isolates collected by active and passive sampling (N = 450) in several health care facilities and from biological sampling of health care workers (N = 25) and controls (N = 22) in Portugal. All isolates were cultured in different media and screened for azole resistance. Cytotoxicity was assessed for 40 isolates in lung epithelial cells and kidney cells using the MTT assay. Aspergillus section Fumigati was prevalent in the health care facilities and in nasal swabs from health care workers and controls. All AF isolates reduced cell viability and presented medium to high cytotoxicity, with cytotoxicity being significantly higher in A549 lung epithelial cells. The cytotoxicity of isolates from air and nasal swab samples suggested the inhalation route as a risk factor. Notably, 42% of AF isolates exhibited a pattern of reduced susceptibility to some of the most used antifungals available for the treatment of patients infected with these fungi. In sum, the epidemiology and clinical relevance of Aspergillus section Fumigati should continue to be addressed. A deeper understanding of the mechanisms underlying Aspergillus-mediated cytotoxicity is necessary.

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Quelles mesures pour maîtriser le risque infectieux chez les patients immunodéprimés ? Recommandations formalisées d’experts

Cited by 15 publications

References 2 publications

Bacterial Contamination in Health Care Centers: Differences between Urban and Rural Settings

Bacterial Contamination in Health Care Centers: Differences between Urban and Rural Settings

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?

Cytotoxicity of Aspergillus Section Fumigati Isolated from Health Care Environments

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