title: Airborne fungal spore monitoring in a protective environment during hospital construction, and correlation with an outbreak of invasive aspergillosis.
abstract: OBJECTIVE
  Evaluate aerobiological monitoring for fungal spores during hospital construction and correlate results with an outbreak of invasive aspergillosis (IA).
  
  
  METHODS
  Prospective air sampling for molds was done using the gravity air-settling plate (GASP) method.
  
  
  METHODS
  A university medical center special care unit consisting of single-patient rooms with high-efficiency particulate air filtration under positive pressure.
  
  
  METHODS
  Five neutropenic patients who subsequently developed IA.
  
  
  RESULTS
  Four of the five patients with IA were housed in rooms adjacent to a construction staging area. Aerobiological monitoring detected an increase in the number of airborne fungal spores including Aspergillus species in these rooms; however, increased counts preceded IA diagnosis by 1 to 7 days in only three of the five patients. Swab cultures of the exhaust vents within each room confirmed results from air-settling plates. Follow-up monitoring, using the GASP method, demonstrated that control procedures were effective in reducing air mold contamination.
  
  
  CONCLUSIONS
  The GASP method, although able to demonstrate that infection control measures reduced mold contamination of the air, was insensitive to detect levels of mold contaminates in time to prevent IA.
authors.affiliation: Department of Pathology, University of Nebraska Medical Center, Omaha 68198-6495.
authors.forename: P C
authors.initials: PC
authors.lastname: Iwen
authors.forename: J C
authors.initials: JC
authors.lastname: Davis
authors.forename: E C
authors.initials: EC
authors.lastname: Reed
authors.forename: B A
authors.initials: BA
authors.lastname: Winfield
authors.forename: S H
authors.initials: SH
authors.lastname: Hinrichs
mesh_terms: D000391:Air Microbiology; D001228:Aspergillosis / Q000453:epidemiology*; D001231:Aspergillus flavus / Q000302:isolation & purification*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006749:Hospital Design and Construction; D006757:Hospital Units; D006801:Humans; D017053:Infection Control; D009329:Nebraska / Q000453:epidemiology; D009503:Neutropenia / Q000150:complications*; D011446:Prospective Studies