Strategies to limit invasive fungal infection in a coronavirus disease 2019 (COVID-19) intensive care unit: The role of infection prevention for renovation and construction in resource-limited settings

Abstract

Hospital construction and renovation activities are the main cause of healthcare-associated fungal outbreaks. Infection control risk assessments (ICRAs) for renovation and construction decrease the risk of healthcare-associated fungal outbreaks, but they are typically not performed in developing countries. We reviewed an outbreak investigation to limit the construction-related fungal infections in a COVID-19 ICU in a resource-limited setting.

What’s New in Prevention of Invasive Fungal Diseases during Hospital Construction and Renovation Work: An Overview

“…Different preventive measures were applied in the studies published in the seven-year period from 2015 to 2022. Procedures intended to decrease and control dust contamination included: increased cleaning of surfaces and air conducts [ 29 , 33 , 40 ]; closing or sealing of windows of rooms with at-risk patients [ 29 , 31 , 33 ]; plastic barriers between inpatient-care areas and construction areas to prevent dust from entering [ 32 , 40 ]; adhesive carpets for collecting dust at the entry ways of the unit [ 31 ]; lock chambers between hospitalization units and building sites with temporary rigid plastic walls [ 31 ]; permanent humidification (moistening of construction debris) of the location of demolition by constant blasting of water (water jets) during demolition [ 29 , 31 ]; covering of rubble containers and quickly removing [ 31 ]. …”

“…plastic barriers between inpatient-care areas and construction areas to prevent dust from entering [ 32 , 40 ];…”

“…For them, the use of rooms equipped with high-efficiency particulate air filtration (HEPA) and positive pressure was applied. Portable HEPA filters were used in two studies [ 32 , 38 , 40 ]. The rest of the patients were placed in conventional units [ 32 , 33 , 40 ].…”

“…Portable HEPA filters were used in two studies [ 32 , 38 , 40 ]. The rest of the patients were placed in conventional units [ 32 , 33 , 40 ].…”

“…Locations were also different—100 cm from the patient’s bed, 50 cm from the room entrance, 1m above ground level, bathroom, corridors, etc. The mean total and specific fungal concentrations were expressed as colony-forming units per cubic meter of air (CFU per m 3 ) [ 29 , 30 , 40 ]. In some studies, surface samples were collected by the swabbing with a moist cotton swab of 25 cm 2 of each of the following surfaces: bed, window, curtain, door wrist, nightstand, table, and cupboard [ 30 ].…”