Influence of internal and outdoor factors on filamentous fungal flora in hematology wards.
BACKGROUND
Nosocomial invasive filamentous fungi infections could result from inhalation of filamentous fungi conidia present in hospital environment.


METHODS
The environmental fungal flora in 3 different hospital wards with similar air conditioning was prospectively studied during 30 months and compared to internal (presence of agranulocytosis patient, behavioral practices, activity, cleaning work) and outdoor factors (meteorologic data, outdoor fungi). The general preventive measures differed from one unit to another.


RESULTS
The hematology wards with filamentous fungi preventive measures were significantly less contaminated than a conventional ward without specific measures. Internal and outdoor factors influenced the level of fungal flora. However, the influence of internal factors was greater in the conventional ward than in hematology wards. The variation of flora in the hospital environment was seasonal, and the level of this contamination in each ward was influenced by the meteorology. However, outdoor factors more readily explain the variations of fungal load in hematology than in the conventional ward.


CONCLUSIONS
This study highlights that specific preventive measures participate significantly in the control of the filamentous fungal flora intensity due to internal factors but not those due to outdoor factors, stressing the importance of high-efficiency particulate air filtration in high-risk units.
Brenier-Pinchart
Marie-Pierre
MP
Parasitologie-Mycologie, Pôle de Biologie, Centre Hospitalier Universitaire, Grenoble, France. MPBrenierPinchart@chu-grenoble.fr
Lebeau
Bernadette
B
Quesada
Jean-Louis
JL
Mallaret
Marie Reine
MR
Borel
Jean-Luc
JL
Mollard
Annie
A
Garban
Frédéric
F
Brion
Jean-Paul
JP
Molina
Lysiane
L
Bosson
Jean-Luc
JL
Cahn
Jean-Yves
JY
Grillot
Renée
R
Pelloux
Hervé
H
D000389:Air Conditioning / Q000295:instrumentation* / Q000592:standards; D000391:Air Microbiology; D016902:Air Pollution, Indoor; D001228:Aspergillosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D001232:Aspergillus fumigatus; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D004783:Environmental Microbiology; D005374:Filtration; D005602:France; D006405:Hematology; D006757:Hospital Units; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000295:instrumentation / Q000379:methods; D019570:Inhalation Exposure / Q000517:prevention & control; D009181:Mycoses / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D013172:Spores, Fungal / Q000254:growth & development / Q000302:isolation & purification; D014691:Ventilation / Q000295:instrumentation / Q000592:standards; D014887:Weather