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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study
Elias J Anaissie1, Shawna L Stratton, M Cecilia Dignani
1Myeloma Institute for Research and Treatment, University of Arkansas for Medical Sciences, Little Rock 72205, USA. elias114@aol.com
Abstract:
The incidence of mold infections in patients with hematologic malignancies continues to increase despite the widespread use of air filtration systems, suggesting the presence of other hospital sources for these molds. Water sources are known to harbor pathogenic molds. We examined samples from water, water surfaces, air, and other environment sources from a bone marrow transplantation unit with optimal air precautions. Molds (Aspergillus species, others) were recovered in 70% of 398 water samples, in 22% of 1311 swabs from plumbing structures and environmental surfaces, and in 83% of 274 indoor air samples. Microscopic examination of the water plumbing lines revealed hyphal forms compatible with molds. Four findings suggest that indoor airborne molds were aerosolized from the water: (1) higher mean airborne concentrations of molds in bathrooms (16.1 colony-forming units [CFU]/m(3)) than in patient rooms (7 CFU/m(3)) and hallways (8.6 CFU/m(3); P =.00005); (2) a strong type and rank correlation between molds isolated from hospital water and those recovered from indoor hospital; (3) lack of seasonal correlation between the airborne mold concentration in outdoor and indoor air; and (4) molecular relatedness between a clinical strain and a water-related strain (previously reported). Hospital water distribution systems may serve as a potential indoor reservoir of Aspergillus and other molds leading to aerosolization of fungal spores and potential exposure for patients.
Insights
Hospital water systems may harbor molds, increasing infection risk for immunocompromised patients. This study found molds in 70% of water samples, suggesting water as a key source of airborne fungal spores in hospitals.
Area of Science:
- Medical Mycology
- Hospital Epidemiology
- Infectious Diseases
Background:
- Mold infections pose a significant threat to patients with hematologic malignancies.
- Despite air filtration, mold infections are increasing, indicating other hospital sources.
- Water systems are known reservoirs for pathogenic molds.
Purpose of the Study:
- To investigate hospital water systems as a potential source of airborne molds in a bone marrow transplantation unit.
- To determine the prevalence and characteristics of molds in various hospital environmental sources.
Main Methods:
- Collected and analyzed samples from water, plumbing, environmental surfaces, and indoor air.
- Utilized microscopic examination and mold culturing techniques.
- Performed correlation and molecular analyses to link environmental and clinical mold strains.
Main Results:
- Molds were recovered from 70% of water samples and 83% of indoor air samples.
- Higher mold concentrations were found in bathrooms compared to patient rooms and hallways.
- Strong correlations were observed between waterborne and airborne molds, suggesting aerosolization from water.
Conclusions:
- Hospital water distribution systems can act as reservoirs for molds like Aspergillus.
- Aerosolization of fungal spores from water poses a risk to vulnerable patients.
- Enhanced water system monitoring and control are crucial for infection prevention.
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Mode of...
