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Updated: May 28, 2026
Collection and Extraction of Occupational Air Samples for Analysis of Fungal DNA
Published on: May 2, 2018
Airborne Fungal Monitoring in Healthcare Environments: A Systematic Review
Dana L Surwill1, Patricia Cruz1, Mark P Buttner1
1Department of Environmental and Global Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA.
Background:
Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings.
Methods:
A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation.
Results:
Eighteen articles met the inclusion criteria, and four studies discussed potential guidelines for acceptable airborne fungal levels in healthcare environments. Guidelines ranged from <1 CFU/m3 for HEPA-filtered environments to >1000 CFU/m3 for non-filtered areas. The most common fungi identified were Aspergillus, Penicillium, Alternaria, Cladosporium, and Rhizopus, with six WHO-listed critical fungal pathogens found. Impaction was the sole sampling method used, with most studies employing Sabouraud dextrose or malt extract agar with chloramphenicol, incubation for 2-7 days at 25-30 °C, and morphological identification.
Conclusions:
The need for globally recognized fungal monitoring standards is pressing. Without them, preventable fungal exposure will persist, risking severe, potentially fatal infections for patients and healthcare workers.
Insights
Standardized airborne fungal monitoring is crucial for healthcare. Current guidelines vary, highlighting the urgent need for global standards to prevent serious fungal infections in patients and staff.
Area of Science:
- Environmental microbiology
- Public health
- Infection control
Background:
- Fungal infections cause millions of deaths annually, with indoor airborne spores posing a significant risk.
- Exposure occurs via inhalation or surface contact, necessitating effective monitoring for early detection and prevention.
- Routine airborne fungal testing is not universally mandated in healthcare settings, creating a critical gap in infection control.
Purpose of the Study:
- To systematically review current airborne fungal monitoring guidelines and best practices.
- To identify methods for sample collection, culture media, incubation, and interpretation of results.
- To assess the current state of fungal monitoring in healthcare environments.
Main Methods:
- A systematic review of peer-reviewed articles from four databases was performed.
- Inclusion criteria focused on airborne fungal monitoring guidelines and best practices.
- Eighteen articles were selected for analysis.
Main Results:
- Four studies proposed guidelines for acceptable airborne fungal levels, ranging from <1 CFU/m³ (HEPA-filtered) to >1000 CFU/m³ (non-filtered).
- Common airborne fungi included Aspergillus, Penicillium, Alternaria, Cladosporium, and Rhizopus, with six WHO-critical pathogens identified.
- Impaction sampling with specific agar media (Sabouraud dextrose/malt extract with chloramphenicol), 2-7 day incubation at 25-30°C, and morphological identification were common.
Conclusions:
- There is an urgent need for globally recognized standards for airborne fungal monitoring.
- Lack of standardized monitoring perpetuates preventable fungal exposure risks.
- Implementing consistent standards is vital to protect patients and healthcare workers from severe, potentially fatal fungal infections.
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