Journal Article

Reduction of Invasive Aspergillosis Incidence among Immunocompromised Patients after Control of Environmental Exposure

Thomas Bénet, Marie-Christine Nicolle, Anne Thiebaut, Marie-Antoinette Piens, Franck-Emmanuel Nicolini, Xavier Thomas, Stéphane Picot, Mauricette Michallet and Philippe Vanhems

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 6, pages 682-686
Published in print September 2007 | ISSN: 1058-4838
Published online September 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/521378
Reduction of Invasive Aspergillosis Incidence among Immunocompromised Patients after Control of Environmental Exposure

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Background. The objective of the study was to assess the impact of the relocation of an adult hematological intensive care unit on invasive aspergillosis (IA) incidence.

Methods. A quasi-experimental study, including a control group and an intervention group that both underwent pretest and posttest evaluations, was conducted in the 3 adult hematological intensive care units (each composed of 14 single rooms) in a university hospital from 14 April 2005 through 1 February 2006. One of these units was relocated from the main building to an adjoining modular construction. In this unit, 4 rooms were equipped with laminar airflow before relocation; all rooms were equipped with positive pressure isolation after relocation. The 2 other units (control group), each containing 8 rooms with laminar airflow, did not undergo environmental modification. The diagnostic criteria for IA were based on the criteria of the European Organization for Research and Treatment of Cancer.

Results. In total, 356 hospitalized patients were included. of the 21 cases of IA, 18 were nosocomial, and 3 were of undetermined origin. In the relocated unit, the incidence of IA decreased from 13.2% (9 patients) before relocation to 1.6% (1 patient) after relocation (P = .018). Eight of the 9 patients with IA before relocation stayed in rooms without specific air treatment. The rate of IA did not change in the control group. Patient characteristics were similar in each unit before and after relocation.

Conclusion. We detected a straightforward association between environmental modification and decreased IA incidence, which emphasizes the use of an environmental strategy, including high-efficiency air filtration, in the prevention of IA.

Journal Article.  2393 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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