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Risk of Bioaerosol Contamination With Aspergillus Species Before and After Cleaning in Rooms Filtered With High-Efficiency Particulate Air Filters That House Patients With Hematologic Malignancy

Published online by Cambridge University Press:  02 January 2015

Linda D. Lee ,
Matthew Berkheiser ,
Ying Jiang ,
Brenda Hackett ,
Ray Y. Hachem ,
Roy F. Chemaly  and
Issam I. Raad
Linda D. Lee*
Affiliation:
Departments of Environmental Health and Safety, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Matthew Berkheiser
Affiliation:
Departments of Environmental Health and Safety, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Ying Jiang
Affiliation:
Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Brenda Hackett
Affiliation:
Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Ray Y. Hachem
Affiliation:
Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Roy F. Chemaly
Affiliation:
Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Issam I. Raad
Affiliation:
Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
*
Executive Director, Dept. of Environmental Health and Safety, The University of Texas M. D. Anderson Cancer Center, PO Box 301439, Unit 713, Houston, TX 77230-1439 (ldlee@mdanderson.org)
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Abstract

Objective.

To examine the impact of cleaning and directional airflow on environmental contamination with Aspergillus species in hospital rooms filtered with high-efficiency particulate air (HEPA) filters that house patients with hematologic malignancy.

Design.

Detailed environmental assessment.

Setting.

A 475-bed tertiary cancer center in the southern United States.

Methods.

From April to October 2004, 1,258 surface samples and 627 bioaerosol samples were obtained from 74 HEPA-filtered rooms (in addition, 88 outdoor bioaerosol samples were obtained). Samples were collected from rooms cleaned within 1 hour after patient discharge and from rooms before cleaning. Positive and negative airflows were evaluated using air-current tubes at entrances to patient rooms.

Results.

Of 1,258 surface samples, 3.3% were positive for Aspergillus species. Univariate analysis showed no relationship between cleaning status and occurrence of Aspergillus species. Of 627 bioaerosol samples, 7.3% were positive for Aspergillus species. Multiple logistic analysis revealed independently significant associations with detection of Aspergillus species. Cleaned rooms positive for Aspergillus species had a higher geometric mean density of colonies than that of rooms sampled before cleaning (18.9 vs 5.5 colony-forming units [cfu] per cubic meter; P = .0047). Rooms with positive airflow had a detection rate for bioaerosol samples equivalent to that of rooms with negative airflow (7.3% vs 7.8%; P = .8). There was no significant difference in the density of Aspergillus species between rooms with negative airflow and rooms with positive airflow (12.5 vs 8.4 cfu/m3; P = .33).

Conclusions.

Concentration of bioaerosol contamination with Aspergillus species was increased in rooms sampled 1 hour after cleaning compared with rooms sampled before cleaning, suggesting a possible correlation between reentrained bioaerosols (ie, those suspended by activity in the room) after cleaning and the risk of nosocomial invasive aspergillosis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 9 , September 2007 , pp. 1066 - 1070
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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