Risk of Bioaerosol Contamination With <i>Aspergillus</i> Species Before and After Cleaning in Rooms Filtered With High-Efficiency Particulate Air Filters That House Patients With Hematologic Malignancy

Lee, Linda D.; Berkheiser, Matthew; Jiang, Ying; Hackett, Brenda; Hachem, Ray; Chemaly, Roy F.; Raad, Issam

doi:10.1086/519866

Cited by 23 publications

(12 citation statements)

References 7 publications

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“…Similarly, other studies have concluded that humidity was the main parameter affecting the bioaerosol concentrations in hospital lobbies and cleaning rooms (Ekhaise et al, 2008; Lee et al, 2007; Park et al, 2013). Moreover, a previous study demonstrated that airborne contamination was higher in old versus new ORs, which is consistent with the results of this work (Audurier et al, 1985).…”

Section: Discussionmentioning

confidence: 68%

Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms

Dehghani

Sorooshian

Nazmara

et al. 2018

Ecotoxicology and Environmental Safety

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Operating rooms (ORs) in hospitals are sensitive wards because patients can get infections. This work aimed to characterize the type and concentration of bioaerosols in nine ORs of an educational hospital before and after sterilization and disinfection. During 2017, fungal samples were incubated at 25–28 °C for 3–7 days and bacterial samples at 37 °C for 24–48 h. The study results showed that the concentrations of fungi before cleaning procedures (for both of disinfection and sterilization) were limited from 4.83 to 18.40 CFU/m3 and after cleaning procedures ranged from 1.90 to 8.90 CFU/m3. In addition, the concentrations of bacteria before cleaning procedures were limited 14.65–167.40 CFU/m3 and after cleaning procedures ranged from 9.50 to 38.40 CFU/m3. The difference between the mean concentrations of airborne bioaerosols before and after sterilization was significantly different than the suggested value of 30 CFU/m3 (p ≤ 0.05). The bacterial concentration was higher than the recommended value (30 CFU/m3) in 41% of the ORs. The main fungal species identified in the indoor air of ORs (before vs. after sterilization) were A. fumigatus (25.6 vs. 18.3%), A. Niger (11.6 vs. 5.8%), Penicillium spp. (5.5 vs. 3.3%), Alternaria spp. (2.8 vs. 0.7%), Fusarium spp. (9.7 vs. 3.7%), Mucor spp. (15 vs. 12.7%), Cephalotrichum spp. (1.7 vs. 0.8%), A. Flavus (24.6 vs. 18.5%), Cladosporium spp. (2.6 vs. 0.8%), and Trichoderma spp. (0 vs.0.9%). The growth of biological species even after sterilization and disinfection likely resulted from factors including poor ventilation, sweeping of OR floors, inadequate HVAC filtration, high humidity, and also lack of optimum management of infectious waste after surgery. Designing well-constructed ventilation and air-conditioning systems, replacing HEPA filters, implementing more stringent, frequent, and comprehensive disinfection procedures, and controlling temperature and humidity can help decrease bioaerosols in ORs.

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Section: Discussionmentioning

confidence: 68%

Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms

Dehghani

Sorooshian

Nazmara

et al. 2018

Ecotoxicology and Environmental Safety

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“…This can be attributed to type of service offered in each particular hospital. Among the reasons for increased density of microorganisms in some hospitals are commuting and crowd inside the ward as well as the type of services and hospitalized patients in the hospital (24,25). Bahonar hospital, is an old hospital that hosts patients with trauma (impact), the number of visitors is larger than other hospital, thus it is regarded as a busy place.…”

Section: Discussionmentioning

confidence: 99%

Investigation of type and density of bio-aerosols in air samples from educational hospital wards of Kerman city, 2014

Malakootian

Gharghani

2016

Environ Health Eng Manag

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Background: Bio-aerosols in the air of hospital wards have an important role in the development of infections. It is important to make quantitative and qualitative estimations of microorganisms in the air of these wards as an index for environmental hygiene applicable to different hospital wards. The aim of the study was to investigate degrees of diversity and density of bio-aerosols in the education hospitals of Kerman city. Methods: This study applied a descriptive-cross-sectional methodology in the second half of 2014 in the education hospitals of Kerman city, with bed capacity of over 300. As many as 200 samples were collected from the air in different wards of each hospital using the standard method of the National Occupational Health and Safety Institute. Following collection, samples were placed in an incubator for 48 hours and then bio-aerosol detections were made for and resulting data reported as colonies/m 3 . Results:Results indicated that maximum and minimum degrees of bacterial density were observed in operation rooms and in the intensive care unit (ICU) of Shafa hospital. Furthermore, comparison showed that the operating room at Afzalipour hospital had the lowest level of fungal contamination, while ICU at Bahonar hospital had the highest level of fungal contamination. The emitted fungi of Aspergillus and Penicillium along with the bacteria, staphylococci and Acinetobacter had greater frequencies. The means of bacterial density and fungal density were not equal across the studied hospitals and significant statistical, difference was observed between means of bacterial and fungal density (P ≤ 0.001). Conclusion: Amounts of bacterial and fungal density were greater than those proposed in the American Industrial Health State Conference in 73.3% of the wards in the educational hospitals of Kerman city sampled in this study. Therefore it is suggested that implementation of some, necessary measures for continuous monitoring, promotion of hygienic disinfection standards, and ventilation systems are taken more seriously by stipulating regulations to control this important issue in the country's hospitals.

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“…However, there is good evidence for increases in the level of Aspergillus conidia during structural work, both inside and in the vicinity of hospitals. The mean concentration of fungi of the Aspergillus genus within hospitals varies between 3 and 105 CFU/m 3 , according to the studies reviewed [49,54,92–95]. Curtis et al.…”

Section: Special and Additional Preventive Measuresmentioning

confidence: 99%

Guidelines for the prevention of invasive mould diseases caused by filamentous fungi by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)

Ruiz‐Camps

Aguado

Almirante

et al. 2011

Clinical Microbiology and Infection

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Invasive fungal infections (IFIs) caused by filamentous fungi still have high rates of mortality, associated with difficulties in early detection of the infection and therapeutic limitations. Consequently, a useful approach is to prevent patients at risk of fungal infection from coming into contact with conidia of Aspergillus and other mould species. This document describes the recommendations for preventing IFI caused by filamentous fungi worked out by Spanish experts from different medical and professional fields. The article reviews the incidence of IFI in different risk populations, and questions related to environmental measures for prevention, control of hospital infections, additional procedures for prevention, prevention of IFI outside of hospital facilities and antifungal prophylaxis are also analysed.

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Risk of Bioaerosol Contamination With Aspergillus Species Before and After Cleaning in Rooms Filtered With High-Efficiency Particulate Air Filters That House Patients With Hematologic Malignancy

Cited by 23 publications

References 7 publications

Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms

Concentration and type of bioaerosols before and after conventional disinfection and sterilization procedures inside hospital operating rooms

Investigation of type and density of bio-aerosols in air samples from educational hospital wards of Kerman city, 2014

Guidelines for the prevention of invasive mould diseases caused by filamentous fungi by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)

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