title: Hospital environment fungal contamination and aspergillosis risk in acute leukaemia patients in Sousse (Tunisia).
abstract: Hospital environment is considered the main source of invasive aspergillosis (IA) in leukemic patients. This study aimed to describe Aspergillus colonisation in leukemic patients and their hospital environment and to test whether Aspergillus environmental contamination was associated with IA. For a 2-year period including 14-month renovation work, 91 acute leukaemia inpatients at the hematology department of University hospital in Sousse (Tunisia) were prospectively included. The incidence of probable IA (EORTC/MSG criteria) was 9.9%. Fifty-six Aspergillus were isolated from 53 (6.5%) of 811 sputa collected from 35 (38.5%) patients. Aspergillus spp. were isolated in 59.7% of 494 air samples and in 52.8% of 1579 surface samples taken in the patients' room. Aspergillus section Nigri (72.7%) was the most frequent. Aspergillus contamination peaked in autumn and winter on surface and in summer and autumn in air samples and was higher (P = 0.03) during the renovation work period. Multivariate analysis showed that for each Aspergillus section Nigri CFU airborne contamination IA risk increased by 1.05 (P = 0.04). In Tunisia, Aspergillus section Nigri and Flavi, but not Fumigati, are chiefly involved in IA. Our findings support swift implementation of airborne fungal contamination control measures in areas where immunocompromised patient are hospitalised.
authors: Service d'Hygiène Hospitalière, CHU Farhat Hached Sousse, Sousse, Tunisie.|Unité de recherche UR 12SP31, Ministère de la Santé Publique, Tunis, Tunisie.|Laboratoire de Parasitologie -Mycologie, CHU Farhat Hached, Sousse, Tunisie.
authors: Soukeina
authors: S
authors: Gheith
authors: Laboratoire de Parasitologie -Mycologie, CHU Timone-Adultes, Assistance Publique-Hôpitaux de Marseille, Marseille, France.|Aix-Marseille Université, IP-TPT UMR MD3, Marseille, France.
authors: Stéphane
authors: S
authors: Ranque
authors: Service d'Hygiène Hospitalière, CHU Farhat Hached Sousse, Sousse, Tunisie.
authors: Wadiaa
authors: W
authors: Bannour
authors: Service d'Hématologie clinique, CHU Farhat Hached, Sousse, Tunisie.
authors: Yosra
authors: Y
authors: Ben Youssef
authors: Service d'Hématologie clinique, CHU Farhat Hached, Sousse, Tunisie.
authors: Abderrahim
authors: A
authors: Khelif
authors: Laboratoire de Parasitologie -Mycologie, CHU Farhat Hached, Sousse, Tunisie.
authors: Moncef
authors: M
authors: Ben Said
authors: Service d'Hygiène Hospitalière, CHU Farhat Hached Sousse, Sousse, Tunisie.|Unité de recherche UR 12SP31, Ministère de la Santé Publique, Tunis, Tunisie.
authors: Mansour
authors: M
authors: Njah
authors: Laboratoire de Parasitologie -Mycologie, CHU Farhat Hached, Sousse, Tunisie.
authors: Fatma
authors: F
authors: Saghrouni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000391:Air Microbiology; D000818:Animals; D001228:Aspergillosis / Q000453:epidemiology*; D001230:Aspergillus / Q000145:classification / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006749:Hospital Design and Construction; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
keywords: Aspergillus environmental contamination; Invasive aspergillosis; Tunisia; acute leukaemia