Ghodsi Soudabeh, Nikaeen Mahnaz, Aboutalebian Shima, Mohammadi Rasoul, Mirhendi Hossein
Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar Jrib Avenue, Isfahan, Iran.
Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Antimicrob Resist Infect Control. 2025 Apr 23;14(1):37. doi: 10.1186/s13756-025-01558-x.
Fungal infections are increasingly recognized as a global health concern, contributing to considerable morbidity and mortality in hospital settings. This underscores the urgent need for infection prevention and control in healthcare facilities to protect vulnerable patients from the risk of acquiring invasive fungal diseases (IFDs). Given the critical role of transmission-based precautions in limiting the spread of filamentous fungi responsible for IFDs, this study was conducted to explore the potential role of the hospital environment in the dissemination of these infections.
A total of 83 samples were collected from the air and surface of exhaust vents in the intensive care units (ICUs) of hospitals in Isfahan, Iran, to assess the presence and diversity of fungal species. Susceptibility testing against antifungal agents, including commonly used drugs and disinfectants, was performed on the identified fungal isolates. Furthermore, the antifungal resistance profiles of isolates from clinical IFD cases were compared with those of environmental isolates.
Fungi were detected in 45% of air samples and 100% of exhaust vent samples, with Aspergillus species being the most commonly identified genus. Mucorales were also found in 17% of exhaust vent samples. Aspergillus spp. and Rhizopus spp. showed the highest resistance to Amphotericin B, and a considerable proportion of these isolates exhibited simultaneous resistance to disinfectants. A similar antifungal resistance profile was noted between A. flavus and some R. arrhizus isolates from both environmental and clinical samples.
The findings of this study indicate that the hospital environment, particularly exhaust vents, may act as a significant reservoir for causative agents of IFDs. This highlights the importance of environmental surveillance in preventing and controlling nosocomial fungal infections.
真菌感染日益被视为一个全球卫生问题，在医院环境中导致相当高的发病率和死亡率。这凸显了医疗机构中预防和控制感染以保护脆弱患者免受侵袭性真菌病（IFD）感染风险的迫切需求。鉴于基于传播的预防措施在限制导致IFD的丝状真菌传播方面的关键作用，本研究旨在探讨医院环境在这些感染传播中的潜在作用。
从伊朗伊斯法罕医院重症监护病房（ICU）的空气和排气口表面共采集了83份样本，以评估真菌种类的存在和多样性。对鉴定出的真菌分离株进行了针对抗真菌药物（包括常用药物和消毒剂）的药敏试验。此外，还比较了临床IFD病例分离株与环境分离株的抗真菌耐药谱。
在45%的空气样本和100%的排气口样本中检测到真菌，曲霉菌属是最常见的鉴定属。在17%的排气口样本中也发现了毛霉目真菌。曲霉属和根霉属对两性霉素B的耐药性最高，相当比例的这些分离株同时对消毒剂耐药。在来自环境和临床样本的黄曲霉和一些少根根霉分离株之间观察到相似的抗真菌耐药谱。
本研究结果表明，医院环境，特别是排气口，可能是IFD病原体的重要储存库。这突出了环境监测在预防和控制医院内真菌感染中的重要性。
