Fungal aerocontamination exposure risk for patients in 3 successive locations of a pediatric hematology unit department: Influence of air equipment and building structure on air quality


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Abstract

HighlightsRenovation of an old building did not significantly improve air quality.Rooms with laminar air flow were the only safe solution for deeply immunocompromised patients.Corridors are reliable sentinels to alert caregivers and medical staff in case of a fungal contamination outbreak in patient rooms.Background:Invasive fungal infections (IFIs) play an important role in the mortality of immunocompromised patients. The pediatric hematology department (PHD) at Besançon University Hospital has relocated 3 times: (1) from a building without an air filtration system (B1), (2) to a renovated building with low air pressure (B2), and (3) to a new building with high air pressure and high-efficiency particulate air filters (B3). This study aimed to investigate how these relocations influenced the fungal exposure risk for the PHD's patients.Methods:Air samples were taken monthly in patient rooms and weekly in corridors. The detection of opportunistic fungi species was used to assess IFI risk. Data were analyzed using univariate and multivariate random-effects negative binomial regression.Results:A total of 1,074 samples from 29 rooms over a 10-year period showed that renovation of an old building with a basic ventilation system did not lead to a significant improvement of air quality (P = .004, multivariate analysis). Among factors linked to higher risk of patient rooms mold contamination was fungal contamination of the corridors (P < .001).Conclusions:This study demonstrates that corridors can be used as reliable sentinel to prevent fungal contamination in patient rooms. Only relocation in building B3, equipped with laminar air flow, achieved adequate air quality.

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