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Pumonary aspergillosis during hospital renovation
Abstract:
During a 4-week period, Aspergillus fumigatus caused disease in 2 patients and colonized a third patient in a renal transplant ward. Our investigation indicated that increased exposure of these patients to spores probably occurred during renovation of the ward one floor above it. Cases were significantly clustered (P = 0.014) during the period when work overhead caused dust to filter down through pores in the acoustical tiles of the false ceiling of the renal transplant ward. Swab cultures demonstrated A. fumigatus in the dust, and air samples showed heavy contamination with A. fumigatus and other fungi at and below a renovation site, but not on 2 distant wards. We concluded that dust can be an important source of aspergilli and that release of dust and spores during activities such as renovation may increase the risk of nosocomial Aspergillus infection in exposed, immunosuppressed patients.
Insights
Renovation dust can spread Aspergillus fumigatus spores, increasing infection risk for immunocompromised patients in hospitals. This study links construction activities to nosocomial Aspergillus infections in a renal transplant ward.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial infections pose a significant threat to immunocompromised patients.
- Aspergillus fumigatus is an opportunistic pathogen that can cause severe disease in susceptible individuals.
- Renovation activities in healthcare settings can potentially disrupt microbial containment.
Purpose of the Study:
- To investigate a cluster of Aspergillus fumigatus infections in a renal transplant ward.
- To identify the source and transmission route of Aspergillus fumigatus during ward renovation.
- To assess the risk of nosocomial Aspergillus infection associated with construction dust.
Main Methods:
- Epidemiological investigation of patient cases.
- Environmental sampling, including dust swabs and air cultures, in the affected ward and control areas.
- Correlation of case occurrence with renovation timelines and dust dissemination.
Main Results:
- Three cases of Aspergillus fumigatus colonization or disease occurred within a 4-week period.
- Cases were statistically clustered during renovation of the floor above.
- Aspergillus fumigatus was detected in dust and air samples at the renovation site and below, but not on distant wards.
Conclusions:
- Dust generated during renovation can serve as a significant source of Aspergillus spores.
- Release of dust and spores during construction activities increases the risk of nosocomial Aspergillus infections.
- Immunosuppressed patients, particularly those in renal transplant wards, are at heightened risk during nearby renovations.