Brenier-Pinchart Marie-Pierre, Lebeau Bernadette, Quesada Jean-Louis, Mallaret Marie Reine, Borel Jean-Luc, Mollard Annie, Garban Frédéric, Brion Jean-Paul, Molina Lysiane, Bosson Jean-Luc, Cahn Jean-Yves, Grillot Renée, Pelloux Hervé
Parasitologie-Mycologie, Pôle de Biologie, Centre Hospitalier Universitaire, Grenoble, France.
Am J Infect Control. 2009 Oct;37(8):631-7. doi: 10.1016/j.ajic.2009.03.013. Epub 2009 Jul 23.
Nosocomial invasive filamentous fungi infections could result from inhalation of filamentous fungi conidia present in hospital environment.
The environmental fungal flora in 3 different hospital wards with similar air conditioning was prospectively studied during 30 months and compared to internal (presence of agranulocytosis patient, behavioral practices, activity, cleaning work) and outdoor factors (meteorologic data, outdoor fungi). The general preventive measures differed from one unit to another.
The hematology wards with filamentous fungi preventive measures were significantly less contaminated than a conventional ward without specific measures. Internal and outdoor factors influenced the level of fungal flora. However, the influence of internal factors was greater in the conventional ward than in hematology wards. The variation of flora in the hospital environment was seasonal, and the level of this contamination in each ward was influenced by the meteorology. However, outdoor factors more readily explain the variations of fungal load in hematology than in the conventional ward.
This study highlights that specific preventive measures participate significantly in the control of the filamentous fungal flora intensity due to internal factors but not those due to outdoor factors, stressing the importance of high-efficiency particulate air filtration in high-risk units.
医院内侵袭性丝状真菌感染可能源于吸入医院环境中存在的丝状真菌分生孢子。
对3个配备类似空调的不同医院病房的环境真菌菌群进行了为期30个月的前瞻性研究，并与内部因素（存在粒细胞缺乏症患者、行为习惯、活动、清洁工作）和室外因素（气象数据、室外真菌）进行了比较。不同科室的一般预防措施有所不同。
采取丝状真菌预防措施的血液科病房的污染程度明显低于未采取特定措施的传统病房。内部和室外因素会影响真菌菌群水平。然而，传统病房中内部因素的影响大于血液科病房。医院环境中菌群的变化具有季节性，每个病房的污染程度受气象因素影响。但是，与传统病房相比，室外因素更容易解释血液科真菌负荷的变化。
本研究强调，特定的预防措施在很大程度上有助于控制由内部因素导致的丝状真菌菌群强度，但对由室外因素导致的菌群强度控制作用不大，这凸显了高效空气微粒过滤在高危科室的重要性。
