Sautour Marc, Dalle Frédéric, Olivieri Claire, L'ollivier Coralie, Enderlin Emilie, Salome Elsa, Chovelon Isabelle, Vagner Odile, Sixt Nathalie, Fricker-Pap Véronique, Aho Serge, Fontaneau Olivier, Cachia Claire, Bonnin Alain
Parasitology-Mycology Laboratory, IFR Santé-STIC, Faculty of Medicine and Pharmacy, University of Bourgogne, Dijon, France.
Am J Infect Control. 2009 Apr;37(3):189-94. doi: 10.1016/j.ajic.2008.06.009. Epub 2008 Dec 6.
Invasive filamentous fungi infections resulting from inhalation of mold conidia pose a major threat in immunocompromised patients. The diagnosis is based on direct smears, cultural symptoms, and culturing fungi. Airborne conidia present in the laboratory environment may cause contamination of cultures, resulting in false-positive diagnosis. Baseline values of fungal contamination in a clinical mycology laboratory have not been determined to date.
A 1-year prospective survey of air and surface contamination was conducted in a clinical mycology laboratory during a period when large construction projects were being conducted in the hospital. Air was sampled with a portable air system impactor, and surfaces were sampled with contact Sabouraud agar plates. The collected data allowed the elaboration of Shewhart graphic charts.
Mean fungal loads ranged from 2.27 to 4.36 colony forming units (cfu)/m(3) in air and from 0.61 to 1.69 cfu/plate on surfaces.
Strict control procedures may limit the level of fungal contamination in a clinical mycology laboratory even in the context of large construction projects at the hospital site. Our data and the resulting Shewhart graphic charts provide baseline values to use when monitoring for inappropriate variations of the fungal contamination in a mycology laboratory as part of a quality assurance program. This is critical to the appropriate management of the fungal risk in hematology, cancer and transplantation patients.
吸入霉菌分生孢子导致的侵袭性丝状真菌感染对免疫功能低下的患者构成重大威胁。诊断基于直接涂片、培养症状和真菌培养。实验室环境中存在的空气传播分生孢子可能会导致培养物污染，从而导致假阳性诊断。迄今为止，临床真菌学实验室中真菌污染的基线值尚未确定。
在医院进行大型建设项目期间，对一家临床真菌学实验室进行了为期1年的空气和表面污染前瞻性调查。使用便携式空气系统撞击器对空气进行采样，使用接触式沙保弱琼脂平板对表面进行采样。收集的数据用于绘制休哈特图表。
空气中的平均真菌载量为2.27至4.36菌落形成单位（cfu）/立方米，表面上为0.61至1.69 cfu/平板。
即使在医院现场进行大型建设项目的情况下，严格的控制程序也可能会限制临床真菌学实验室中的真菌污染水平。我们的数据以及由此产生的休哈特图表提供了基线值，可用于在作为质量保证计划一部分监测真菌学实验室中真菌污染的不适当变化时使用。这对于血液学、癌症和移植患者的真菌风险的适当管理至关重要。
