Division of Hospital Hygiene, Clinical Institute for Hygiene and Medical Microbiology, Medical University Vienna, Austria.
Am J Infect Control. 2011 Nov;39(9):746-51. doi: 10.1016/j.ajic.2011.01.011. Epub 2011 Jun 25.
Aspergillus spp are ubiquitous spore-forming fungi. Construction work, renovation, demolition, or excavation activities within a hospital or in surrounding areas increase the risk for aspergillus infection in susceptible patients and are the main cause of nosocomial aspergillus outbreaks.
We investigated the efficacy of infection control measures on the frequency of fungal infection among hemato-oncologic patients undergoing stem cell transplantation during excavation and construction work of an adjacent hospital building. Clinical isolates from these patients obtained before and during the excavation and construction period were analyzed. Preventive measures consisted in the implementation of a multibarrier concept to protect these patients from fungal infection.
There was no record of any clinical isolate of Aspergillus spp in the observation period before the beginning of the groundwork. However, 3 clinically significant isolates of Aspergillus spp were detected in respiratory tract specimen of 2 patients after the beginning of excavation and demolition work, which were found to be community acquired.
Although our data cannot demonstrate the efficacy of infection control measures during construction work, it can be concluded that excavation work close to immunocompromised patients is safe if a bundle of preventive measures is implemented before groundwork.
曲霉菌属是无处不在的孢子形成真菌。医院内部或周围的建筑施工、翻新、拆除或挖掘活动会增加易感患者发生曲霉菌感染的风险,是医院内曲霉菌暴发的主要原因。
我们调查了感染控制措施对接受干细胞移植的血液肿瘤患者在毗邻医院建筑施工和挖掘期间真菌感染频率的影响。分析了这些患者在挖掘和施工前以及期间获得的临床分离株。预防措施包括实施多屏障概念,以保护这些患者免受真菌感染。
在基础工程开始前的观察期内,没有记录到任何曲霉菌属的临床分离株。然而,在挖掘和拆除工作开始后,2 名患者的呼吸道标本中检测到 3 株有临床意义的曲霉菌属分离株,这些分离株被认为是社区获得的。
尽管我们的数据不能证明在建筑施工期间感染控制措施的有效性,但可以得出结论,如果在基础工程前实施一整套预防措施,那么靠近免疫功能低下患者的挖掘工作是安全的。