医院环境与血液恶性肿瘤患者侵袭性曲霉病

Hospital environment and invasive aspergillosis in patients with hematologic malignancy.

机构信息

Department of Administrative Facilities and Campus Operations, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Am J Infect Control. 2012 Apr;40(3):247-9. doi: 10.1016/j.ajic.2011.03.031.

DOI:10.1016/j.ajic.2011.03.031

PMID:21856045

Abstract

BACKGROUND

To determine whether there is a correlation between sources of Aspergillus spores in a high-efficiency particulate air (HEPA)-filtered environment and nosocomial invasive aspergillosis (IA), we performed a detailed environmental assessment and case review.

METHODS

From April to October 2004, 626 bioaerosol samples, 1,257 surface samples, and 607 water samples were obtained from 74 HEPA-filtered air hospital rooms occupied by 458 patients with hematologic malignancies. Samples were collected prospectively from the room before and after cleaning within 1 hour of patient admission or discharge. Aspergillus spp was isolated from 21 surface samples and 46 bioaerosol samples. Interestingly, Aspergillus spp was not isolated from any water samples.

RESULTS

Aspergillus spp was isolated from 21 surface samples and 46 bioaerosol samples. Interestingly, Aspergillus spp were not isolated from any water samples. The majority (90%) of the positive bioaerosol samples had ≤ 10 colony-forming units of Aspergillus/m3 of air. Only 2 patients developed nosocomial IA. No correlations were found between Aspergillus species isolated from the hospital rooms and those causing IA.

CONCLUSION

The risk of hematologic malignancy patients acquiring nosocomial aspergillosis from water or HEPA-filtered air is very low.

摘要

背景

为了确定高效空气过滤器（HEPA）环境中曲霉孢子的来源与医院获得性侵袭性曲霉病（IA）之间是否存在相关性，我们进行了详细的环境评估和病例回顾。

方法

2004 年 4 月至 10 月，从 74 间入住 458 名血液恶性肿瘤患者的 HEPA 过滤空气医院病房中采集了 626 份生物气溶胶样本、1257 份表面样本和 607 份水样。在患者入院或出院后 1 小时内，在清洁前后从房间内前瞻性采集样本。从 21 份表面样本和 46 份生物气溶胶样本中分离出了曲霉属。有趣的是，没有从任何水样中分离出曲霉属。