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An outbreak of invasive aspergillosis in a haematologic unit

Insights

An outbreak of invasive pulmonary aspergillosis occurred in a hematologic unit, with 8 cases over 15 months. Environmental sanitation, including duct cleaning and filter changes, successfully halted the Aspergillus fumigatus spore outbreak.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Hematology

Background:

  • Invasive pulmonary aspergillosis is a serious fungal infection.
  • A hematologic unit experienced an unprecedented cluster of cases.
  • Previous cases were absent since the unit's inception in 1979.

Purpose of the Study:

  • To investigate the cause of a sudden increase in invasive pulmonary aspergillosis cases.
  • To identify environmental factors contributing to Aspergillus fumigatus spore entry.
  • To determine effective control measures for the outbreak.

Main Methods:

  • Retrospective case review of 8 patients with invasive pulmonary aspergillosis.
  • Environmental assessment of the hematologic unit, including ventilation systems.
  • Microbiological sampling and analysis for Aspergillus fumigatus spores.

Main Results:

  • Seven out of eight cases occurred within a 10-month period in 1984.
  • Environmental factors identified included window renovation debris, inadequate air filter sealing, and ventilation system deficiencies.
  • Environmental sanitation interventions, specifically cleaning ventilation ducts and replacing filters, terminated the outbreak.

Conclusions:

  • Environmental factors significantly contributed to the invasive pulmonary aspergillosis outbreak.
  • Prompt and thorough environmental sanitation is crucial for controlling fungal spore contamination in healthcare settings.
  • Post-outbreak surveillance identified two sporadic cases, suggesting ongoing vigilance is necessary.

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