Risk of invasive fungal infections during hospital construction: how to minimize its impact in immunocompromised patients

Curr Opin Infect Dis. 2019 Aug;32(4):322-329. doi: 10.1097/QCO.0000000000000566.

Abstract

Purpose of review: Fungal outbreaks have been reported in healthcare settings, showing that construction activities are a serious threat to immunocompromised hosts. Preventive measures to control fungal outbreaks (especially Aspergillus spp.) are considered essential during hospital construction. In this article, we update the main advances in each of preventive strategies.

Recent findings: Anticipation and multidisciplinary teamwork are the keystone for fungal outbreaks prevention. Strategies focused on environmental control measures of airborne dissemination of fungal spores have proven to be successful. It is important to recommend azole-resistant Aspergillus fumigatus active surveillance from both air (outdoors and indoors) and clinical samples during hospital construction works. Apart from genotyping, studies should be further encouraged to understand the environmental dynamics. Risk assessment and implement preventive measures (environment control strategies, air surveillance, inpatients immunocompromised patients in high-efficiency particulate air filters rooms, patient education, antifungal prophylaxis in high-risk patient groups, etc.) have shown that these accomplish to reduce the incidence of invasive fungal infection (IFI).

Summary: In general, it is not only a strategy that should be implemented to reduce the risk of IFI but is a bundle of preventive measures, which have proven to be successful in control infection and prevention of airborne transmission of fungi.

MeSH terms

  • Antifungal Agents / therapeutic use
  • Cross Infection*
  • Disease Outbreaks
  • Disease Susceptibility
  • Environmental Exposure
  • Hospital Design and Construction*
  • Humans
  • Immunocompromised Host*
  • Infection Control
  • Invasive Fungal Infections / epidemiology*
  • Invasive Fungal Infections / etiology*
  • Invasive Fungal Infections / prevention & control
  • Risk Assessment
  • Risk Factors

Substances

  • Antifungal Agents