title: Reduction of invasive aspergillosis incidence among immunocompromised patients after control of environmental exposure.
abstract: BACKGROUND
  The objective of the study was to assess the impact of the relocation of an adult hematological intensive care unit on invasive aspergillosis (IA) incidence.
  
  
  METHODS
  A quasi-experimental study, including a control group and an intervention group that both underwent pretest and posttest evaluations, was conducted in the 3 adult hematological intensive care units (each composed of 14 single rooms) in a university hospital from 14 April 2005 through 1 February 2006. One of these units was relocated from the main building to an adjoining modular construction. In this unit, 4 rooms were equipped with laminar airflow before relocation; all rooms were equipped with positive pressure isolation after relocation. The 2 other units (control group), each containing 8 rooms with laminar airflow, did not undergo environmental modification. The diagnostic criteria for IA were based on the criteria of the European Organization for Research and Treatment of Cancer.
  
  
  RESULTS
  In total, 356 hospitalized patients were included. Of the 21 cases of IA, 18 were nosocomial, and 3 were of undetermined origin. In the relocated unit, the incidence of IA decreased from 13.2% (9 patients) before relocation to 1.6% (1 patient) after relocation (P=.018). Eight of the 9 patients with IA before relocation stayed in rooms without specific air treatment. The rate of IA did not change in the control group. Patient characteristics were similar in each unit before and after relocation.
  
  
  CONCLUSIONS
  We detected a straightforward association between environmental modification and decreased IA incidence, which emphasizes the use of an environmental strategy, including high-efficiency air filtration, in the prevention of IA.
authors: Department of Hygiene, Epidemiology, and Prevention, Hopital Edouard Herriot, Hospices Civils de Lyon, France.
authors: Thomas
authors: T
authors: Bénet
authors: Marie-Christine
authors: MC
authors: Nicolle
authors: Anne
authors: A
authors: Thiebaut
authors: Marie-Antoinette
authors: MA
authors: Piens
authors: Franck-Emmanuel
authors: FE
authors: Nicolini
authors: Xavier
authors: X
authors: Thomas
authors: Stéphane
authors: S
authors: Picot
authors: Mauricette
authors: M
authors: Michallet
authors: Philippe
authors: P
authors: Vanhems
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000453:epidemiology / Q000517:prevention & control*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004781:Environmental Exposure / Q000517:prevention & control*; D005260:Female; D005602:France / Q000453:epidemiology; D006405:Hematology; D006749:Hospital Design and Construction / Q000379:methods; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D017053:Infection Control / Q000379:methods; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged