title: Mold colonization of fiberglass insulation of the air distribution system: effects on patients with hematological malignancies.
abstract: We investigated mold colonization of air handling units (AHUs) of heating, ventilating, and air conditioning (HVAC) systems and its effects, including invasive pulmonary mycoses and febrile neutropenia, in patients with hematological malignancies. Sample collection with transparent adhesive tape and culture swabs revealed that AHUs were heavily colonized with molds, including thermotolerant, variously distributed Penicillium spp. Cases of nosocomial invasive pulmonary mycosis were not clustered in specific patient rooms but did occur frequently when the HVAC systems were not in use, prior to intervention (i.e., sealing and disuse of AHUs in private room), and during construction of a new hospital building. Multivariate logistic regression analysis of initial episodes of febrile neutropenia showed that the rate of febrile neutropenia was significantly associated with the duration of neutropenia (odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.07-1.27) and with sex (OR: 0.469; CI: 0.239-0.902). An evaluation of private rooms showed that female patients also had a lower rate of fever after intervention (OR: 0.0016; 95% CI: 0.000-0.209). The reduced rate of febrile neutropenia after intervention suggests that mold colonization of AHUs had adverse effects on patients with hematological malignancies.
authors.affiliation: Department of Clinical Infectious Diseases, School of Medicine, Showa University, Tokyo. takuma@med.showa-u.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takuma
authors.forename: Kaoru
authors.initials: K
authors.lastname: Okada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamagata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimono
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Niki
mesh_terms: D000389:Air Conditioning; D004783:Environmental Microbiology; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D005658:Fungi / Q000302:isolation & purification*; D005898:Glass; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D009503:Neutropenia / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence
chemical_list: C009753:fiberglass