title: [outbreak of invasive pulmonary mycosis in neutropenic hematologic patients in relation to remodelling construction work].
abstract: BACKGROUND
  An increase was observed in the number of cases of invasive pulmonary mycosis in neutropenic hematologic patients coinciding with construction work being carried out in the Hospital Clínico San Carlos (Madrid, Spain). The aim of this study was to confirm the existence of an outbreak, identify the factors related and adopt adequate control measures.
  
  
  METHODS
  A descriptive, epidemiologic, environmental microbiologic study was performed. The incidence of cases in the study period and a control period was compared. Air samples were collected in the affected area and other areas of hospitalization not related to the construction work. The ventilation system of the Hemalotogy Isolation Unit (HIU) was also sampled. The control measures undertaken included: hermetic sealing of the construction work adjacent to hematology followed by transfer of the patients to another floor of the hospital.
  
  
  RESULTS
  The existence of an outbreak was confirmed (significant increase in the incidence, p = 0.017). Eleven cases and one death by massive hemoptisis were reported. The mean total fungal count and to Aspergillus spp were 120 and 35 UFC/m3, respectively in the hematologic hospitalization area adjacent to the construction work and 37 and 5 UFC/m3 in other areas (p < 0.001). Contamination was detected in the ventilation system of the HIU by A. fumigatus (125 UFC/m3 of air from the interior of the conduct).
  
  
  CONCLUSIONS
  An elevated number of fungal spores found in samples from the hematologic hospitalization area as well as no further new cases being reported following the transfer of the patients suggest that the outbreak was related to the adjacent construction work being carried out.
authors.affiliation: Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid.
authors.forename: C
authors.initials: C
authors.lastname: Gaspar
authors.forename: A
authors.initials: A
authors.lastname: Mariano
authors.forename: J
authors.initials: J
authors.lastname: Cuesta
authors.forename: G
authors.initials: G
authors.lastname: Rodríguez
authors.forename: J
authors.initials: J
authors.lastname: Díaz
authors.forename: J
authors.initials: J
authors.lastname: Picazo
authors.forename: J
authors.initials: J
authors.lastname: Fereres
mesh_terms: D004196:Disease Outbreaks; D004781:Environmental Exposure; D005160:Facility Design and Construction; D005260:Female; D015386:Hazardous Substances; D006272:Health Facility Environment; D006402:Hematologic Diseases / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D008172:Lung Diseases, Fungal / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D013030:Spain / Q000453:epidemiology
chemical_list: D015386:Hazardous Substances